Proton Therapy

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aspen4
Regular Member


Date Joined Dec 2008
Total Posts : 59
   Posted 7/5/2010 9:09 AM (GMT -6)   
Happy 4th to all who visit this board,
A quick update to those good people in and around the same boat as myself.
After my visit to M.D Anderson this past April it was decided that I would go off the hormone therapy and stop the Lupron.............but not before I go through Proton therapy. M.D Anderson thought that because of my initial 344 PSA and lymph node involvement that Proton therapy would would be a proactive move before going off of the Hormone therapy. My PSA remains undetectable and has been so since April 2009. Doctors told me that people who respond to Hormone therapy initially will respond to it again when and if they go back on the therapy.
I have just finished up 22 of the 44 treatments scheduled for myself and have no real problems to speak of. I do take Flomax to shrink a somewhat swollen prostate. A common result of radiation, so I am told. Treatments are quick and painless. 200cc of saline are used to stabilize the prostate. No balloons are used.
I appreciate all the positive and insightful posts here at healing well. I look forward to the "Hormone Holiday" in the near future. PSA screenings will done at 2 month intervals instead of the usual 3 month. When and if the PSA rises to 1.0 will I go back on the "Meds"
Thanks again to all,

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3741
   Posted 7/5/2010 9:50 AM (GMT -6)   
Sounds like you are undergoing "salvage radiation" after what seems like a successful prosectomy?? Or has hormones been your primary treatment, taking your PSA from 344 to zero?
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. A "top" radiation oncologist here in Denver, equipped with the latest IMRT/IGRT/RapidArc machine says he can do better by me..


aspen4
Regular Member


Date Joined Dec 2008
Total Posts : 59
   Posted 7/5/2010 12:33 PM (GMT -6)   
Fairwind, No surgery since the "horse has left the barn" Just Lupron and Casodex.

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 7/6/2010 7:56 AM (GMT -6)   
Aspen:  It's great to hear from you, its amazing how far you have come since your diagnosis.  You're the poster boy for why some of us travel to MDAnderson, the best in the world.  If you have time to post let us know how the recovery goes from the ADT.  There is a lot of confusion on this board about Hormone therapy.  I'm down to 1 more year of HT then hopefully no more harpoons.
 
No baloon huh, that's great !
 
Good luck
 
David
 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/6/2010 8:14 AM (GMT -6)   
Hey Aspen ever skied down Pallavacinni at Araphoe Basin (Denver) at age 51, double black diamond?(gulp) Even the locals talk about this 2.5 mile run with moguls the size of VW's (LOL). Probably should have died back then(LOL) it is called the longest and 2nd steepest ski run in North America. I made it going very slowly and picking my way along, felt like I was skiing for my life and probably was. I had no problems with all the other runs at Araphoe, steep is not a problem, 2.5 miles of moguls added, huge problem. Amazing being up at 10,000-13,000 feet and looking around at the tops.

Well PCa is very similar in this regard. I don't fully trust abstracts because agendas on PCa issues pervade everything, but at www.cancerforums.com Fairwind had a question on radiation and John AzPeaks gave references by leading USA radiologist about comparison abstract data on Proton vs. IMRT-Photon...they supposedly say Proton has no clinical definable found difference. I am not saying I agree with that, just the links are there to read. The Proton ray is more powerful than Photon, logically seems better there and has some different properties which you can read all about in Dr. Strums book A Primer on Prostate Cancer, it has 'all' the radiation protocols that were available in the early 2000's, including Neutron . The docs will usually show their bias as to their machine, protocol, treatment, so in order for you to know the differences you either have to get mulitple opinions or read alot and compare what you can for yourself and decide. Anyway always look at everything, taking nothing for granted PCa does not play by rules or fair, the docs add to this confusion. Be looking further down the road now, as to what do I do 'when' failing Lupron or similar...you have choices to investigate beside chemo or leukine and high dollar protocols, that should atleast precede considering those options.
Youth is wasted on the Young-(W.C. Fields)


aspen4
Regular Member


Date Joined Dec 2008
Total Posts : 59
   Posted 7/6/2010 8:16 AM (GMT -6)   
Thanks David.
I look forward to the holiday. Hopefully it will last a while. I am convinced that there are many things "on the shelf" for us guys. I wondered myself about the balloon. The therapists at the proton center primarily use the saline, but have on occasion used the balloon. It all depends on how much the prostate moves while on the table.
As for the confusion about the ADT, IMHO, I think that everyone is unique when it comes to "side effects"
Be Well David

aspen4
Regular Member


Date Joined Dec 2008
Total Posts : 59
   Posted 7/6/2010 9:41 AM (GMT -6)   
Hello Zufus,
I know the area you are talking about.....reserved for the experienced skiers. I myself do not ski........yet. My wife does. I am more a hiker who likes to get outdoors away from people, if you get my drift:))
The decision to go Proton was an easy one for myself. Less damage and side effects to the area around the prostate because of the precision of the beam. It was not going to hurt my situation either way. However, I realize that down the road I might have the IMRT done to my lymph nodes, unless of course they devise a way for protons to do the same thing. Either way, I have, IMHO the best team of doctors at my disposal who all have opinions as to what might work best. Going into this decision about Protons I did find out that there are "surgery urologists, radiation urologists and urologist who like protons" I myself opted for the protons.......after much investigation.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3741
   Posted 7/6/2010 9:49 AM (GMT -6)   
http://www.dattoli.com/technology/proton.cfm

Dr. Hall continues,
... "the scattering foil becomes a source of neutrons, which results
in a total-body dose to the patient."
Because of this widening cone-shaped bean, the side effects with
protons will be greater even at lower dose levels than with our high
energy photons, the complete opposite of what most patients
currently are told and/or what patients think!
Protons versus photons: Which is state
of the art?
Many people believe that proton therapy
causes significantly fewer complications
than does traditional external radiation
therapy (EBRT), which utilizes photons.
However, the newest technology in
external radiation therapy with photons
surpasses both proton therapy and
traditional external radiation therapy. It
is called 4 Dimensional Image Guided
Intensity Modulated Radiation Therapy
(4D-IG IMRT) with Dynamic Adaptive
Radiotherapy (DART). This advanced
technology allows for “inverse treatment
planning” utilized for the initial IMRT
planning phase. Inverse treatment planning provides the oncologist
with the ability to plan for and control the amount of radiation received
by the tissues surrounding the prostate while maximizing the dose to
the prostate. Thereafter, a number of technological advances,
including but not limited to SonArray, Cone Beam Tomography, Exact
Couch ™, Portal Vision, On-Board Imaging, and Respiratory Gating
are combined to allow for the analysis of organ motion in real-time
(the 4th dimension) to achieve unsurpassed accuracy. Once the motion
is detected, numerous software programs activate to adapt the radiation
to target the organ site which may have moved.
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. A "top" radiation oncologist here in Denver, equipped with the latest IMRT/IGRT/RapidArc machine says he can do better by me..

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