Is Proton therapy more effective than IMRT?

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Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 9/23/2009 6:33 PM (GMT -6)   
I heard an commercial about Proton radiation at MD Anderson and was wondering if it is more effective with less side affects than IMRT. Also is it covered by Medicare?
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 9/23/2009 7:15 PM (GMT -6)   
Ed,
My dad had proton out at Loma Linda California back in 1996. It was the first center to offer proton's. His side effects during treatments was having to urinate frequently and not being able to make it to the bathroom and having a mucus discharge from his rectum. He still caries a container with him if he doesn't have a bathroom available readily. Towards the end of his treatments he started getting very tired. Was it more effective then IMRT? I do not know. But his 13 year post PSA level was .002 I believe. I posted earlier this month about his PSA if you want to look it up for sure on this forum. about 5-7 years after treatment he developed ED. He tried Viagra and didn't like the headaches. I've talked to him about other methods but he and my mom our happy and healthy. He is 77 and fine overall. His only complaint is the need to find the bathroom frequently.

Larry
Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/23/2009 7:24 PM (GMT -6)   
More effective? no. Less SE's, so they claim. But study information is scant. Loma Linda has been doing PBT since the early 90's but have not released long term data. And newer types of radiation delivery systems have severely reduced the SE's with conventional IMRT.

PBT is effective and has been used for years. MD Anderson will have data in time, and since they are a multifaceted center, we can hope it is unbiased. Most PBT patients are quite pleased after therapy, and I was quite pleased with the SE's after IMRT. Long term SE's do set in in both therapies, but the information is much more scant with PBT. I always wonder why that is.

There is talk that unless PBT is proven better, and soon, many insurance companies will not cover it soon. PBT is very expensive when compared to IMRT and both the government bill, HR3200, and you can bet insurance companies, will deny claims if there is a Least Cost Alternative (LCA). Already Blue Cross has petitioned Medicare to stop covering PBT, but I think everything stopped awaiting to see what happens with HR3200.

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!

Post Edited (TC-LasVegas) : 9/23/2009 9:19:35 PM (GMT-6)


engineer55
Regular Member


Date Joined May 2009
Total Posts : 121
   Posted 9/23/2009 7:40 PM (GMT -6)   
Lots of debate on this health care issue, but it would be a good idea that products would have to be proven more effective to justify the extra costs. I think I read the beam cost is $125 million, really seems like it is better suited for other things. If you go to their website they feature a lot of golf pictures so made me question the difference.
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 130
   Posted 9/23/2009 10:06 PM (GMT -6)   
I did research into the various forms of radiation. The proton guys claim that protons are the safest, but the other radiation specialists claim that their radiation treatments are stronger and just as safe.

IGRT is said to be an improvement over IMRT in IGRT being more accurate and stronger. You might want to look at brachytherapy (seeds) also. Many doctors claims it is safer and superior to radiation beams.

As always, research, research, and research some more before deciding on a final treatment. Don't let anybody rush you into anything.

EDIT--Oops. Just read your profile and it looks like you've already dealt with your prostate cancer. Well, for anyone considering radiation treatment--RESEARCH them all. :)

Jayadub
Regular Member


Date Joined May 2007
Total Posts : 89
   Posted 9/23/2009 11:04 PM (GMT -6)   

Sounds like you guys ought to stick to discussing what you know and it appears none of you know much about Protons.

Just seems to be very topical to diss the teatment based on cost or proof of efficacy.

U of Penn recently released a study showing that PBT delivers 1 1/2 to 2 1/2 times less radiation to adjacent tissues than IMRT. Radiating adjacent tissue and possible positive margins is one of the reasons I went the PBT route.

Blue Cross of Texas, Oklahoma, New Mexico and Illinois has dropped any action taken to stop reimbursement for protons. This happened several months ago, partly due to letter writing campaigns from PBT patients in those states.

I find it funny that except for NM all of those states have a treatment center.

Loma Linda has published 10 year data from 2004 and is ready to publish 15 year data soon.

engineer55 how do plan to prove that PBT is or isn't more efficacious? There is a reason that no randomized studies have been done not the least of which is an ethical issue in who would you choose to not receive PBT?

 

 


54 years old (56 currently)

PSA 5.6 on 3/20/07

DRE: Negative

Biopsy on 4/20/07 

Results 4/25/07:

3 out of 12 cores positive, 2 on the right lobe with 5% adenocarcinoma Gleason 3+3, 1 on the left lobe 10% adenocarcinoma Gleason 3+4, overall Gleason graded 7 Cancer T1C.  Decided onProton Beam Therapy and went to Loma Linda for consult. Started treatment at Loma Linda on 7/26/07. Completed treatment 9/28/07. Some urinary irritation during treatment but currently have ZERO side effects. 1st PSA result on January 28, 2008 is 1.1. PSA result on July 17, 2008 .73 . PSA result on January 22, 2009 .66 PSA on July 17, 2009 .60  24 months removed from start of treatment.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/23/2009 11:41 PM (GMT -6)   
I read about the petitioning and it was a great community effort. The LCA issue is still very real and this could effectively keep reviving the issue of coverage until scientific study results are available showing that PBT is better and safer. All we know right now is that it's costlier. Apparently Tufts University is all over this and has released this data Mike Scott lists in his post at the Infolink last week...

http://prostatecancerinfolink.net/2009/09/18/proton-beam-radiation-a-systematic-review/

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!

Post Edited (TC-LasVegas) : 9/23/2009 11:44:16 PM (GMT-6)


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 9/24/2009 7:01 AM (GMT -6)   
Thank you all for your input. I hope my situation doesn't require either therapy, at least not for a while. Living in Austin TX. I continue to hear those ads from MD Anderson and was curious to hear from those who might have had PBT.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/24/2009 8:07 AM (GMT -6)   
We have a few guys who did PBT, Jayadub is one, there are more. Smilingoldcoot, Richard, did it in Jacksonville, Dutch and Jay in Loma Linda.

Below is the "Ten Year study" link at that site. The numbers are favorable but it is inclusive of guys who also supplimented their proton therapy with IMRT therapy. Brachytherapy centers are now also combining IMRT to seeding with excellent early results.

http://www.protoninfo.com/TenYearData/TenYearStudy.pdf

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 9/24/2009 9:21 AM (GMT -6)   
My father had proton treatment at Loma Linda 10 or 11 years ago and seemed happy with the result. It was salvage treatment for surgery done in 1975. It seemed to work. He lived another 10 years until almost everything else broke down.
Diagnosed at 54
PSA 8.7
Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7
Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09
Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence
Pad free week 5
PSA 6/6/09 <0.1
PSA 9/10/09 <0.1


channelsurferdude
New Member


Date Joined Jul 2009
Total Posts : 9
   Posted 9/24/2009 1:52 PM (GMT -6)   
I am currently doing PBT at At Loma Linda. I have to agree with jayadub. Do your research about the modalities. I spent 2 months researching and am grateful I found out about Protons. Check out the stories on YANANOW, BOB, and yahoo group protoninfo, to get information directly from patients.
I would be happy to share my experience with anyone. We here at Loma Linda wonder why it is not so widely known about.
The Brotherhood of the Balloon has over 4000 members that you can read about. For the most part very few side effects...
Keep the faith

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 9/24/2009 3:23 PM (GMT -6)   
The only head to head study I have seen is the ICER 2008 report comparing Seeds, IMRT, and PBT. I posted the link about a month ago. It's a 114 page report and uses the long term Loma Linda data and compares it to Long term data on Brachytherapy and IMRT.
In short, Proton Beam had the highest biochemical relapse rate of the three, (it was slightly higher). The acute toxicity rates were similar in all three. Proton costs 3X brachytherapy, 2X IMRT and was shown to have no advantage.
Dattoli just had an article in PAACT newsletter, basically stating that PBT is ok for small cancer tumors in the brain and other areas, but does not work well on large areas such as the prostate and cannot be conformed to contours like IMRT. He goes into a lot of technical stuff saying that the surrounding tissues actually get more radiation from Proton. Dattoli of course is biased, but if you want to know the cons of Proton it's a good read.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/24/2009 4:29 PM (GMT -6)   
John, that sounds like some pretty serious negatives in the fine print on the proton. The cost factor would be hard to justify with a lot of HMO's and other health insurers. Didn't realize it cost that much more.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, mapping on 9/21/9, 9/24 - mtg & procedure? with uro/surg, IMRT starts 10/5/9


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 9/24/2009 5:29 PM (GMT -6)   
But you would have to include the cost factor of the side effects. If Proton Beam has less side effects then the other three procedures (surgery, imrt and seeds) add up the cost of the associated side effects and compare it with proton beam. Just from anectodal experiences reading patients from posting their experiences with proton beam, it seems patients are very happy with it. I rarely found someone posting about negative side effects on Yana.

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 9/24/2009 5:37 PM (GMT -6)   
Bob Marckini has much knowledge on proton beam, in addition, secondary cancers are more rare with proton beam compared with photon.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 9/24/2009 6:34 PM (GMT -6)   
I don't know if Proton has less side affects than IMRT. The studies say no dfference; patients say that there is definately a difference. It could be the plecebo affect, if you expect something it influences the outcome.
I had IMRT and seeds; a much higher dose of radiation that can be given by Proton and I have had no side affects. Killing PC is all about radiation dose whether it is Proton or Photon; the higher the dose the better the outcome.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 9/29/2009 5:10 PM (GMT -6)   
I am a PBT guy. It is my opinion that it was MY best option even though I had a combination of  IMRT and PBT plus 2 years of Hormone Therapy. I believe one should go for the treatment that makes them feel is the best for THEM.
 
The stated cost of PBT was $159,000.00.  I know that Medicare and Tricare for Life did not pay that amount even though my cost was  Zero except for the 4 months in our RV at Naval Air Station Jacksonville and the trip there and back twice.
 
Again I state that one should do their research into all treatment options and do what they feel comfortable with and then don't look back.
 
Rich
Biopsy 1998 = Neg Bio 2000 = Neg with PIN Bio 1/10/08 Gleason 10, Stage T1C 8 of 12 samples positive all < Than 5%
Bone Scan, CTs and MRI Negative early 2008
March 2008 MD Anderson - No Surgery or Proton = No Action
Feb & Mar PET (Possilbe Lymph Node Involvement  & Prostacint Scan Negative
March 2008 U of Florida Proton Therapty Lupron & Casodek May 08 for 2 years
Completed 25 IMRT and 17 PBRT U of Florida Proton Therapy Institute 7/24/08
Latest CT June 08) showed no trace of tumor in lymph node area
7/24/2008 PSA .21, free PSA .08, Percent free PSA 38.1, testosterone 14.6
8/1/2008 2nd Lupon Shot -- 10/27/2008 PSA <.01 -- 12/9/2008 3rd Lupon Shot
12/11/08 MRI Suspicious for Metastic disease L5 & S1 -- Bone Scan 12/19/08 Indicates No Bone Mets Spinal Stenosis and Neropathy in my legs
2/06/09 PSA = < .01  -- 4/09/2009  PSA <.01 --4th Lupron shot 7/02/2009 PSA <.01 Lupron
Our Journey is on WWW.GLEASONSCORE10.COM


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/29/2009 5:39 PM (GMT -6)   
Richard you forgot that you paid for dinner with Deb and me...LOL, it is an added expense I was most grateful for.

I see Debbie all the time in Facebook, but I miss you brother. God bless you and peace to you...

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 10/6/2009 7:07 PM (GMT -6)   

Just ran across an article in "The New Prostate Cancer Infolink". It was a study to compare proton with other treatments; "Loma Linda has failed to collect, analyze and publish data that has delayed any chance of demonstating the clinical value of PBRT in the treatment of prostate cancer." It was very critical of Loma Linda's data and said now that it will take another 15 years to have comparable data.

JohnT

 

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 10/7/2009 4:56 AM (GMT -6)   

Here is the link to the article to which JohnT referred.  Very dissapointing and it leaves us with still comparing PBT results and SE's in an anecdotal way rather than scientifically.

Tudpcok

http://prostatecancerinfolink.net/2009/09/18/proton-beam-radiation-a-systematic-review/


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 10/7/2009 8:35 AM (GMT -6)   

 

  ....don't mean to hijack a thread, but, Hi there Rich...it's good to see your post...

   Ok, back on topic....good info here!

  


 
  age: 53 @ Dx, Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  6.23.09 1yr Post-op PSA Still a zero..
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 10/7/2009 8:56 AM (GMT -6)   
lewvino said...
Ed,
My dad had proton out at Loma Linda California back in 1996. It was the first center to offer proton's. His side effects during treatments was having to urinate frequently and not being able to make it to the bathroom and having a mucus discharge from his rectum. He still caries a container with him if he doesn't have a bathroom available readily. Towards the end of his treatments he started getting very tired. Was it more effective then IMRT? I do not know. But his 13 year post PSA level was .002 I believe. I posted earlier this month about his PSA if you want to look it up for sure on this forum. about 5-7 years after treatment he developed ED. He tried Viagra and didn't like the headaches. I've talked to him about other methods but he and my mom our happy and healthy. He is 77 and fine overall. His only complaint is the need to find the bathroom frequently.

Larry

Remember that IMRT wasn't available in 1996.
 
My father had external beam radiation around 97 along with seeds and had a host of issues afterwards.

lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 10/7/2009 2:43 PM (GMT -6)   
Didn't mean to imply that IMRT was available in 1996. The proton was my dad's first choice back in 1996. Now that I've had the DaVinci he has been impressed with my results so far. Though I don't get my first post surgery PSA until Oct. 19th.

Larry
Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/7/2009 2:44 PM (GMT -6)   
Larry, we need you in the zero club, someone has to take my place after I lost my membership, sobs.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - first treatment IMRT.

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