RapidArc versus current IMRT

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colorado61
New Member


Date Joined Jan 2011
Total Posts : 2
   Posted 1/21/2011 12:44 AM (GMT -6)   
Newly diagnosed and am looking at RapidArc for primary treatment of PC.  Wondering if it is worth the trouble of a 1.25hr trip out of town for RapidArc versus 15min trip for std IMRT in town.  I am not finding too much information on the newer technology.  Talked to highly rated radiologist who recomended RapidArc.  I will be getting HT as well for 2 years.
 

Age 50yrs
Biopsy 12/22/10 (49 yrs)
5 out of 8 cores positive 1 X 60%/ 2 X 50% / 2 X 20%
PSA 17.5 Gleason Score 4+3=7 Diagnose Stage T2b
CT shows partial filling left seminal vesicle
Bone scan clear
never smoke or drank

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/21/2011 1:26 AM (GMT -6)   
Welcome aboard, colorado. i had imrt, and can answers questions about that. a few others here are either curently undergoing rapid ard or are considering it. please keep us posted.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 1/21/2011 1:28 AM (GMT -6)   
I am at the moment receiving SRT on a Varian Rapid Arc machine in Denver..I went out of my way to be treated on one..I believe the main benefit is in reduced damage to the surrounding healthy tissue and therefore reduced side-effects..Some Radiation Oncologists will use a slightly higher dose because of this precision. The machine can apply the prescribed dose to the target while reducing the whole body dose by two thirds compared to other machines...The gantry is in motion when the beam is on, moving the beam over and around my abdomen and limiting the amount given to healthy tissue while the target remains at the focal point of the beam... A CAT scan is given just before each treatment to make sure the patient is properly positioned...I completed treatment number 23 today..The only side-effect so far is increased urinary frequency..

As far as curing your cancer, the IMRT machine can probably do just as well..Where are you being treated?
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 NOW

Grinnell86
Regular Member


Date Joined Feb 2010
Total Posts : 267
   Posted 1/21/2011 6:16 AM (GMT -6)   
If you are from Colorado, I would get a second opinion on treatment from Dr. David Crawford at the University of Colorado Anschutz Cancer Center. He is one of the leading PC experts in the U.S., and he actually spends quite a bit of time with you going over you options. He then goes over your case with the hospital staff and sends you their recommendations.
Age 46
PSA 10/09=4.60
Biopsy 12/09
Left side benign
Rt side 3of 4 cores positive, 70%
Initial Gleason 3+4
2nd Opinion Gleason 3+3
DaVinci surgery 2/16/10
Catheter removed 2/27/10
Post surgery PSA 5/10 <.05, 8/10 .12, 9/10 .12, 12/10 .16

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 1/21/2011 9:10 AM (GMT -6)   
I had IMRT, not rapid arch, and cannot comment on any advantages of that treatment. I did travel almost 2 hours daily each way for treatment. I was not has concerned with the equipment as I was with the quality and experience of the Drs and techs. Rather than being treated by a local Dr and facility. I traveled to a highly regarded cancer treatment center and teaching hospital. I believe that the equipment was the same. Best of luck. BB

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 1/21/2011 12:51 PM (GMT -6)   
From what I have read Rapid ARC is more beneficial to the radiological clinic than to the patient. It is much faster and the clinic can cycle through many more patients thereby increasing revenue.
JohnT
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.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 1/22/2011 5:34 PM (GMT -6)   
At my treatment center, they schedule patients a half hour apart..That leaves them with about 15 minutes of slack time between each..

But nobody's waiting on line in Denver. For whatever reason, they have twice as many linac's as they need....

colorado61
New Member


Date Joined Jan 2011
Total Posts : 2
   Posted 1/26/2011 1:23 PM (GMT -6)   
Thanks for all the posts! I decided to go to the Denver center for the RapidArc treatment to try to reduce the radiation exposure to healthy tissue. The doctor is Kevin Schewe at Mountain Radiation Oncology Consultants. The biggest decision for me was if I should try surgery first becasue of the high risk of the disease not being contained. I decided to just do radiation with the HT. I have been reading a great deal about nutrition as well. Does anyone know any good posts about nutrition helping with PC? I am all for a lifestyle change if it will help me live longer to see my grandkids!
Age 50yrs
Biopsy 12/22/10 (49 yrs)
5 out of 8 cores positive 1 X 60%/ 2 X 50% / 2 X 20%
PSA 17.5 Gleason Score 4+3=7 Diagnose Stage T2b
CT shows partial filling left seminal vesicle
Bone scan clear
never smoke or drank

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/26/2011 1:39 PM (GMT -6)   
colorado,
Diet and supplementing are very hotly debated particularly concerning those seeking a "prostate diet". The truth is that no one can certify a diet as being prostate healthy but there is a heart healthy diet plan than many can follow. And since "you are more likely to die with prostate cancer than from it", that is certainly a good move to focus on watching your weight and dietary intake as it pertains to something that has a higher chance of interfering with your journey to seeing your grandkids.

I would point out that hormone therapy put on 25 pounds on me. Rigorous work outs were not high enough on my priority list and I would recommend that you don't allow the weight gain as I did.

As far as the RapidARC system is concerned. It will take time to see if it is as effective as IMRT. The likelihood is that it is a safe treatment method that reduces your time in therapy. This is good for those who would like to reduce the doctors visits while still using photon therapy. Good luck with your treatments. Keep us posted on the experience...

Books on lifestyle and dietary changes:
"Promoting Wellness for Prostate Cancer Patients" by Mark Moyad
"Beating Prostate Cancer: Hormonal Therapy and Diet" by Snuffy Myers

This link has several books including cook books...
www.pcf.org/site/c.leJRIROrEpH/b.5814065/k.FB26/Nutrition__Wellness.htm

I hope this helps...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 1/26/2011 1:49 PM (GMT -6)   
Dr. Schewe is treating me also..He is one of the more aggressive radiation oncologists, a regular General Sherman 'March to the Sea" kind of guy. Sometimes his "bedside manner" is a little abrasive but his knowledge and skills can not be questioned..You will be treated on the newest Novalis / Varian Rapid Arc machine in the Denver area...

I just finished #28 (out of 40) today. Smooth sailing so far...best of luck to you..
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
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/26/2011 2:05 PM (GMT -6)   
Questions for you to consider:
Did any doctor run nomograms and other data to discuss how your odds would be for any treatments? Is brachy seeds with or without IMRT a bad choice, and/or adding HT within that and why?

Is doing HT therapy in advance for 3-6 months like in Bolla Studies prior to radiations, an advantage in doing both these modalities?
 
Do ask about what is the maxium exposure level, since this is your primary treatment and we will assume your doc will plan a mapping area that would include the areas that SRT would cover, so ask to hear such perhaps. More food for thought, your decision is huge. Notice my stats and journey, lucky to be here period. I got 8 opinions and sure glad I did. One righteous doctor denied me surgery....he was most correct Dr. Menon our first LRRP doc in the U.S.  Not advising you what to do, just take some time to answer the kinds of questions you might not get to do a replay on. Always good to clarify with any doc, exactly what is the program(s) and details, know about side effects and what to expect, too. Just trying to have your back in this.
 
Best to you, I turned just 52 when found with a big case of PCa.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Post Edited (zufus) : 1/26/2011 12:22:19 PM (GMT-7)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 1/26/2011 4:21 PM (GMT -6)   
Fairwind:
 
I noticed your signature. Are you also doing
HT?
 
Mel

Jitters99
Regular Member


Date Joined Jan 2011
Total Posts : 222
   Posted 1/26/2011 7:37 PM (GMT -6)   
My husband will be starting IMRT mid to late Feb. after prostate surgery. Can someone tell us your major side effects (if any). We are in CT. and will drive every day to Hartford for treatment, hopefully mother nature will be on our side..
Jitters

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 1/26/2011 7:46 PM (GMT -6)   
Jitters,  i just finished my 28th (out of 38) IMRT sessions on a Varian Rapid Arc and have not had any side effects yet.  Looks good for the short term but no way of knowing for the long term.
 
Carlos
Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, started SRT 12/15/2010.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 1/26/2011 7:55 PM (GMT -6)   
Carlos:
 
I'm glad to read that. I suspect I'll be following in your shoes in about a month.
 
Any bladder urgency? Any fatigue? Any bowel issues?
 
Mel

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 1/26/2011 8:07 PM (GMT -6)   
Mel, No bladder nor bowel issues.  Wine doesn't seem to agree with me but the three wise men are still safe (Jim, Jack and Johnny). No fatique yet.  I got my normal 5k (about 43 min) this morning.
 
Carlos
Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, started SRT 12/15/2010.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 1/26/2011 8:46 PM (GMT -6)   
Yes Mel, HT too...My R-doc insisted on it..he says it makes a big difference in high-risk cases..

Carlos and I are on the same track..I completed #28 today too..Urinary frequency has increased from 4 hours to 2 hours..No bowel problems..Weight started to climb but I clamped down hard on that and managed to shed 2 pounds last week...

The HT is causing annoying but manageable hot flashes and night sweats..
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
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 1/26/2011 8:56 PM (GMT -6)   
Good luck guys. Don't look back as I'm right behind you!
 
Mel
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