RapidArc Varian for SRT

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compiler
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Date Joined Nov 2009
Total Posts : 7205
   Posted 11/18/2010 7:53 AM (GMT -6)   
Just read the following in Uro Today"
 
 
It is very encouraging.
 
On the cynical side: who supported/funded the study.
 
Also, if it was done by the hospital place, assuming they bought all this new equipment, I don't think they would want to imply that it was a waste.
 
But, at least taking the study at face value, I am pleased with those results.
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06

Fairwind
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Date Joined Jul 2010
Total Posts : 3748
   Posted 11/18/2010 11:11 AM (GMT -6)   
I start SRT on a Varian Trilogy RapicArc machine Dec 8 at a major Denver hospital..I had a nice long talk with the department head, who happens to be my R-doc, about whether the new machine offered advantages in my case..He was unsure...He said it would enable him to use a higher dose more accurately aimed with less healthy tissue damage..But he added.."I'm the one who will decide where to aim the beam and I must decide what areas will receive treatment, so the outcome will depend more on me than the machine..."

Since I also was considering a second radiation oncologist who used an older (but modern) IGRT machine, (the two docs know each other) he added: "Don't base your decision on the type of machine..Base your decision on who you think will do the best job for you...

So that's what I did...

I have learned that many, many hours can go into treatment planning with radiation. Lots of checks and double checks..Computers are a great help, but they don't decide on the actual target of the beam..Your R-doc does that..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

John T
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Date Joined Nov 2008
Total Posts : 4229
   Posted 11/18/2010 11:24 AM (GMT -6)   
I agree with Fairwind. The doctor you choose is more important than the technology, we have seen this in DiVince surgery and it is also applicable in radiation as long as one is using modern technology. There are a few good artists in any field that will consistantly get better results than the average.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/18/2010 11:52 AM (GMT -6)   
Unfortunately, it seems much more difficult to judge a rad. onc.
(than a surgeon).
 
Sigh...
 
I think/hope the guy I saw is good!
 
Mel

Fairwind
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Date Joined Jul 2010
Total Posts : 3748
   Posted 11/18/2010 12:29 PM (GMT -6)   
I chose my R-doc because of his confidence in his abilities..It just radiated out of him. His attitude about treating people ("If I think I'm going to do more harm than good, then I won't do it." "If I didn't think this will work for you, this meeting would be over already")

R-docs work with a staff of 4 or 5 people. So there are some checks and balances surgeons do not have... Problems in a treatment plan tend to get spotted and eliminated before a technician pushes that "on" button...The guy runs a tight ship, his staff loves him, everyone knows where they stand and what will happen if they screw up.. My kind of guy..

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/18/2010 1:11 PM (GMT -6)   
Fairwind:
 
All good points, but I do know a few bad doctors that have a great gift of gab and are good salepeople.
 
But, we are mature and we have been around the block a bit, so hopefully we can read these people too.
 
I have similar confidence in my guy. But it was still easier to research and compare surgeons!!
 
Mel
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