After 6 months of research, I am looking at 3 PC therapy options: (a) robotic surgery, (b) combination of brachytherapy (internal radiation) plus IMRT (external radiation) and (c) proton beam therapy. Right now I am leaning towards proton beam therapy.
I have talked to a urologist and a radiation oncologist about
PBT and they both say PBT has shown no better long term benefits than other therapies. Dr. Peter Scardino says the same thing in his 2010 edition of his Prostate Book. They also all say PBT is very expensive. Are there any long term statistics for PBT and can I access them?
Online postings listing negatives of PBT include: expensive, insurance coverage issues and few US treatment sites (I believe the current number is 9). I have not looked very extensively but I do not find online PBT postings where ED or incontinence is listed as a major issue. I can’t say that about
other PC therapies.
I like what I read about
PBT online (I would welcome recommendations for the most active online sites discussing PC). In his book Dr. Scardino says PBT is “YET to show any real benefits of this expensive new technology”. I am wondering if the current state of PBT will show real improvement in long term benefits. MD Anderson Cancer Center touts an advance in proton therapy called “Pencil Beam Technology”. They describe the Pencil Beam as spraying a narrow 1 cm beam like an air brush versus the current proton technique employed at many treatment centers as using a can of spray paint (this seems a much wider spray area depending on how far the spray can is placed from the object you are spraying). For all you US non-metric experts, one centimeter is approximately the distance from the center of a US penny to the outside edge (i.e. the radius of a US penny).
I live near the Mayo Clinic and saw the Mayo Clinic was not listed in the 9 treatment centers in the USA currently providing PBT. A little online searching discovered the Mayo Clinic is building TWO proton beam facilities and plan to
open them in late 2014 or early 2015 (the Mayo Clinic has 3 major clinics in the US and two of them are getting PBT facilities). The cost of these new facilities runs into the hundreds of millions of dollars. “We are enthusiastically moving forward with this program because we believe it offers additional, innovative options for cancer patients” says john Noseworthy, M.D., Mayo Clinic president and CEO. Does anyone think spending this amount of money on multiple facilities can be viewed as a positive endorsement of PBT?
One other reason why PBT is now on the top of my list is it does not remove my prostate. I also believe it is less invasive than other radiation therapies. I am hoping this means I am not eliminated as a candidate for future noninvasive PC therapies now in clinical trials if PC ever reappears in my body. I have read about
problems with surgery following radiation but I will take that risk hoping my treatment options in the future will be superior to my salvage treatment options today. What are the current salvage treatment options following PBT if necessary?
One new approach for treating PC has arrived: Provenge: Provenge is the VERY FIRST immunotherapy approved by the FDA for treating advanced PC patients. From provenge.com: Provenge is designed to work “By stimulating the natural ability of your body’s immune cells to target and attack advanced prostate cancer”. Treating my blood to attack my cancer is an early stage PC treatment choice I would like to have today. Other immunotherapy treatments for PC are currently in clinical trials and hopefully they will provide improved PC therapy options for all of us.
Your comments and opinions are appreciated.
Male, age 63, psa 4.34, biopsy 7/27/11 2 of 14 cores positive & 1 PIN
Gleason 3 + 3 = 6, T2
9/27/11 PCA3 score 14.0
9/28/11 biopsy 2 of 14 cores positive, Gleason 3+3 = 6
10/06/11 Mayo reviewed 9/28/11 biopsy & upgraded Gleason 3+4 = 7
11/28/11 PSA 3.43
Post Edited (imtls) : 12/6/2011 6:07:21 PM (GMT-7)