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New member diagnosed from MRI after negative biopsy. Strange?

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Posted 2/1/2014 6:13 PM (GMT 0)

Somebody said...
for Pencil Beam Proton: I don't know whether the new proton machine at Hampton is pencil beam or traditional.


Hampton currently does not have pencil beam, but it is scheduled for 3rd or 4th qtr 2014.[]
Posted 2/1/2014 6:20 PM (GMT 0)
Thanks, richh - it may be worth waiting for. I wonder, with all these new proton machines coming online, where do they find experienced ROs to use them? Probably the manufacturer trains the new staff. I don't know what the learning curve is like.
Posted 2/1/2014 8:56 PM (GMT 0)
Tall:

Check your email. I sent you a few questions

Mel

Posted 2/3/2014 10:04 PM (GMT 0)
Is anyone familiar with VMAT, a form of IMRT? I am also looking at brachy.
Posted 2/4/2014 12:47 AM (GMT 0)
My SBRT treatment was with the Novalis TX system with RapidArc. RapidArc is the most familiar machine that uses VMAT. Other linacs that use VMAT include Elekta Axesse, and the new Brainlab Vero system. Vero combines IMRT and VMAT in the same machine. VMAT can be used to deliver standard fractionation (like IMRT) or hypofractionation (like SBRT). The principle advantage of VMAT is that it's very fast - only 5 minutes per session for me.

There are several linacs now that can deliver the high precision, sub-millimeter accuracy necessary for SBRT. What is more important is the system in place for tracking prostate motion, and how often it is tracked during treatment. Most use image guidance based on tracking the position of implanted gold fiducials or radio transponders tracked with cone-beam CTs, with re-positioning of the bench. CyberKnife re-positions a robotic X-ray gun instead. Tomotherapy solves the problem by using the waste treatment X-rays to simultaneously track position. A new development is the ViewRay system that doesn't use CT, but has a built in MRI instead. This lowers X-ray exposure and has greater image resolution.

All of them are capable of giving you a good treatment plan.
Posted 2/4/2014 10:37 PM (GMT 0)
Thanks, TA. Your explanation and analysis gives me comfort. After conducting additional research into proton therapy and reading the threads on this site, I have become reluctant to go that route.

Moreover, the commute time to Hampton is three hours round trip, excluding the proton therapy itself. Caveat: If my cancer were to require me to walk that distance, then I would not hesitate. But there are other options with equally good residues and/or advocates.

Here is a link to a portion of the the Massey Cancer Center news release from 2011 announcing the VMAT addition to its arsenal.

http://wp.vcu.edu/masseynews/2011/01/10/vcu-massey-cancer-center-introduces-safer-more-effective-form-of-radiation-therapy/
Posted 2/4/2014 11:29 PM (GMT 0)
The biggest benefit of VMAT is to the treatment center that can schedule and bill for more treatments per day. While a short session is nice, it has less benefit to the patient. The patient's chief concern is the treatment plan that is most effective with the least exposure of organs at risk. There are any number of systems out there that can do this.
Posted 2/21/2014 4:13 AM (GMT 0)
Good evening, gentlemen.

I have participated in this thread in the past, but now a decision draweth nigh.

First, a rehash of my status:

60 years old
Health otherwise: Excellent
April 2013 PSA: 5.7
Traditional biopsy in May 2013: Results benign
Urologists suspected prostatitis and subscribed 30-day regimen of Cipro
October 2013: PSA 5.3; active surveillance begins
December 2013: PSA still 5.3; patient inists on MRi;
January 2013: 3D MRI at Massey Cancer Center in Richmond, VA, shows suspicious area in transitional zone
Mid-January 2013: Final pathology report concludes there is only one tumor, moderate in size, Stage 2, located in the transitional zone at the right apex; Gleason Score: 7 (3+4), favorable intermediate risk

I have ruled out surgery for various reasons, chief of which it is not necessary given the parameters of my diagnosis. But now I am frankly in angst as to whether to go with IGRT/IMRT or the Calypso method for radiation.

Your thoughts?

Thanks --

Windsor11
Posted 2/21/2014 9:25 PM (GMT 0)
Calypso is a type of igrt that uses radio transmitters. It's one of several possible image tracking devices. It has been used with imrt or sbrt. It doesn't make much of a difference.
Posted 4/19/2014 6:25 PM (GMT 0)
I've just signed up to this site, and my experience may be of interest.
Age 61 (today!)
Diagnosed with anterior index lesion in October, by MRI under Mark Emberton.
After much prayer and discussion and research, decided to have focal cryotherapy next week at UCLH.

I've started a blog on all of this, many more details can be read at:

(Link to blog deleted here, but it is in his profile, which is the correct location per our rules. We don't allow links in a new member's first few posts, mostly as a prevention of spam, but it has to apply to everyone. - 142)

Andy, I gave you a new thread since you might get "lost" in the depths of this one.

Jim (aka Tudpock18)

Post Edited By Moderator (142) : 4/19/2014 3:10:55 PM (GMT-6)

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