Proton Beam Therapy

Has anyone here had any experience with Proton Beam therapy or know any statistics on results?  I have gone to the Loma Linda site but of course they are pushing their own process.

Check out the study last fall by the Agency for Healthcare Research and Quality, which was published in the Annals of Internal Medicine on October 20, 2009 (vol. 151, issue 8):

http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=174

Conclusion: case not proven, need more evidence on comparative effectiveness and safety.

Zen9

I seriously considered PBT when researching options for treating my PCa.  I read www.protonbob.com "cover to cover" and even spent an hour so so on a telephone consult with a doc at the PB center in Jacksonville.  There are tons of anecdotes on the effectiveness of this procedeure but little in the way of hard statistics.  My final concluson was that other modern day radiation treatments are just as effective and have hard facts to demonstrate their success.  So, I chose a different non-invasive treatment with a history of documented results.

Tudpock

Whoa! I though Proton Therapy was the best external method of delivery. I though this was a well proven fact. I have researched TomoTherapy which I think is brilliant. Rotate the beam around the focal point and define the outside shape of the beam to be the same size as the target. This results in a concentrated beam of radiation right where you want it. But it's still hot coming in and exiting. This is where Proton Therapy is supposed to work better. The magic part (I don't understand) is the beam is not as hot going in, and stops short of going through. This is a bit of a setback to me...

....but, unfortunately, the theory hasn't been translated into usable data from which patients can make informed decisions....at least not that I was able to find...

Tudpock

Throwing in another 2 cents worth...and please take it as that....My dad was treated back in the early days (1997) at Loma Linda as mentioned. Back then they were treating anyone, pretty much any Gleason. Even the heavy hitters in the 9 and 10 range. Since that time they have started limiting down around a 6 or 7 and with a 7 they also give traditional Radiation along with the Proton.
I know this for a fact since I researched last July/August before settling on Davinci. Loma Linda told me with my Gleason 7 it would be proton plus traditional radiation.

Perhaps the 'early years' of experimenting with the higher Gleasons has 'scewed' the number for 10 - 15 year stats? My dad has tried to find some of the guys back in his treatment period but no luck. My dad's was low, low Gleason and caught VERY Early.

Larry

Jim,

what you are talking about is the Bragg Peak in which Proton beams release their energy in a predetermined spot. This is why some say Proton is better.

The counter arguement is that proton beams travel in a straight line, which is great for treating small tumors in hard to get at places, such as the brain, but the beam has to be scattered when treating large areas like the prostate. IMRT and IGRT photon beams can be sculputured to conform to the exact shape of the prostate.

Proton is also used in much lower doses, around 65gy to 71 gy. IMRT can deliver 81gy and a combination seeds and IMRT around 140 to 150 gy. Dose equals killing power, but also equals side affects to surrounding tissue. The golden ring is to deliver as much GY as possible to only the prostate and not hit anything else. The accurracy of IMRT and IGRT is such that the dose can be increased over the old ERBT dose of 65gy without increasing damage to surrounding tissue.

JT

IMRT is suppose to be more pinpoint, but I am a living reminder that despite the latest radiation technology, you can still get "scattering" of the radiation, which can and often causes collateral damage to the surrounding areas. My salvage radiation ended almost 5 months ago, and I am still dealing with radiation damage in the bladder neck area, some in the rectal area, even though neither area was targeted.

At first, the radiation folks denied scattering, but after the damage was done, they admit that it happened. Might not happen often, but those considering, should realize that even RT or SRT has risks too, and side effects. I am still dealing with radiation related fatigue after all these months as well.

Now they are saying it may take many more months to heal up from all of the damage, thus why I am still on a catheter after almost 7 continuous months.

David in SC

As a tag on to Zen's response...yeah, getting a second opinon on the path report from a recognized expert lab e.g. Epstein at JH or Bostwick labs would seem to be prudent.  Also, if you were seriously considering PBT I assume it was because of the lower SE's than surgery.  If that is one of your concerns, why are you not considering brachytherapy and/or other radiation?

Tudpock