SRT - What is now state of the art?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/19/2010 10:24 AM (GMT -6)   
I understand that there are several options for SRT: 3D conformal, IMRT, IGRT, proton beam. Is there a best option (most effective) for SRT? What do the best institutions use? Any help would be appreciated.
Dx with PC Dec 2008 at 56, PSA 3.4, Biopsy: T1c, Geason 7 (3+4)

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Junl 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
Aril 10 MRI and Bone Scan show lesion on lower spine, no SRT


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 5/19/2010 11:59 AM (GMT -6)   
BB,
Based on where I reside the state of the art is IMRT and IGRT. Not sure about Proton although there have been a number of posts about the subject and you can read the old posts on those. At the bottom of your signature you put no SRT, so does that mean they are not suggesting that to you after your last PSA of .31?
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 5/19/2010 12:17 PM (GMT -6)   
BB,  A new treatment center in my area just opened and claims to have the latest.  This is a statement from their site:
 

Varian Trilogy Linear Accelerator for Radiation Therapy with Rapid Arc Technology.

 

Delivers the most precise treatment up to eight times faster than other systems.

Increased patient comfort with shorter treatment times


Diagnosed 2/2008 at age 71, Gleason score 5+3=8, stage T1c, PSA 9.1. 
Robotic surgery 5/2008, nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3=8 
PSA <0.1 at 20 months and each test since surgery.


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/19/2010 12:44 PM (GMT -6)   
Thanks Michael/Carlos. Michael, hopefully I will update my signiture soon. I got a second MRI last week, Lumbar this time with gadolinium (whatever that is). This one indicates that the lesion on my spine is a benign hemangiomata. I am waiting on the results of a CT scan to confirm. If true (yipee!!!!), SRT will be back on. BB

Dx with PC Dec 2008 at 56, PSA 3.4, Biopsy: T1c, Geason 7 (3+4)

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Junl 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
Aril 10 MRI and Bone Scan show lesion on lower spine, no SRT


LuvMyDAD
Regular Member


Date Joined Dec 2009
Total Posts : 316
   Posted 5/19/2010 12:47 PM (GMT -6)   
Hi BB-Fan I know that at Sloan-Kettering they use the IMRT machine. Hope that helps!
Lynne
Father diagnosed Nov. 9, 2009
Open radical prostatectomy Dec. 21, 2009, post op pathology report T3a, Gleason 7
5 week post op psa .55
Combination therapy, hormone and IMRT. 40 sessions 72gy.
Hoping and praying for a cured dad.


JerseyGuy
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 5/19/2010 1:36 PM (GMT -6)   
BB:
 
I recently finished SRT with the Varian Rapid-Arc, the process from start to finish each day was less then 15 minutes, however as with all the Radiation Therapy it was 7 weeks every day and that was exhausting.  The device is a combination of 3D-conformal and IMRT, it is very precise and causes less damage to the health tissue around the target area.  A new Proton Beam Center just opened at the Hospital of the Univerisity of PA, but after I started my treatment. 
 
Good luck.
 

PSA - 2008 = 2.4
PSA - 2009 = 3.2
Family Doctor recommends seeing Urologist. Concerned about change and fact that I have taken Saw Palmetto for years. Thinks the SawP schewed the PSA down.

1/09 - Urology exam - Dr. thought is was an infection until DRE, felt nodules, scheduled Biopsy.
5/1/09 - Biopsy 6/12 core samples positive - Classified 3+3 T2C.
5/21/09 - Urologist spent 2.5 hours with wife and I explaining all options. Chose DaVinci surgery
7/30/09 - DaVinci surgery performed - 1 night in hospital, cath - 10 days.
Both nerves spared
No PNI involved
No Seminal vessel involvement
Positive Margins - Left Apical Microscopic margin.
Post surgical PSA = 0.2
Nov 2009 - 100% Continence (no pads).
PSA Dec 1, 2009 = 0.4 (I am getting nervous now, it doubled). Urologist recommeds Adjuvant Radiation using Rapid Arc.
Pre Radiation PSA = 0.8 (doubled again, uggh!)
Jan 27, 2010 - Began IMRT x 36 treatments @1.8 Gy = 64.8 Gy. Completed March 17, 2010. Minimal side-effects.
April 28, 2010 = Follow-up exam with Radiologist - PSA stayed at 0.8. Didn't move, which is good.
July 2010 next PSA.


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 5/19/2010 1:45 PM (GMT -6)   
I would add to the list of options Tomotherapy -- a form of IMRT -- though I know very little about it.

http://www.urotoday.com/61/browse_categories/prostate_cancer/a_dosimetric_analysis_comparing_treatment_of_lowrisk_prostate_cancer_with_tomotherapy_versus_static_field_intensity_modulated_radiation_therapy__abstract07312009.html
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/19/2010 2:19 PM (GMT -6)   
I had Tomotherapy IMRT here in Greenville, SC for my SRT
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 5/19/2010 2:27 PM (GMT -6)   
I heard the following about proton versus photon

With photon the rays (xrays) penetrate the body and gradually get weaker the further they go in (thus it is handy they only have to go about three to four inches to reach the target.)

With proton the beam (engergized particles) behaves strangely so that it is at its strongest about three to four inches after pentration so they arrange things to match the characteristics of the beam to the location of the target.

The thought is thus that the proton beam as a result does less damage to the area that is not the target, but which the beam has to pass through to get to the target.

The proton beam is also easier to focus/aim.

There are not so many proton machines, though. (It was not an option for me in Holland)

Alfred
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.
Nov 17th 2009 PSA = 0.1
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)


Hope and Prayer
Regular Member


Date Joined May 2010
Total Posts : 59
   Posted 5/19/2010 2:54 PM (GMT -6)   
BB Fan, that is great news on your MRI. I hope CT confirms as well!
Boyfriend dx at age 44 with Stage 4 PC on 11/09. Gleason 4+5, 11 of 12 cores +; PSA 51.34
DaVinci surgery on 12/09
Gleason 4+5 confirmed. Lymph and vesicle invasion, right nerves spared.
HT: Casedox and Lupron started 1/10
PSA 1/13/10  23.15  2/8/10 .37  3/18/10 <.05  5/14/10 .02
Bone metastasis
Radiation: 42 sessions ending 6/10
 
 
 


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/19/2010 3:04 PM (GMT -6)   
Thanks H&P. Will post when I find out.

Dx with PC Dec 2008 at 56, PSA 3.4
 
Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31

Aril 10 MRI and Bone Scan show lesion on lower spine, SRT on hold pending further testing.

New Topic Post Reply Printable Version
Forum Information
Currently it is Monday, September 24, 2018 2:16 AM (GMT -6)
There are a total of 3,005,991 posts in 329,291 threads.
View Active Threads


Who's Online
This forum has 161817 registered members. Please welcome our newest member, Butterfly_.
235 Guest(s), 3 Registered Member(s) are currently online.  Details
dbrookenz, ppm guy, jwebb