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Starting Proton tomorrow

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Posted 7/29/2015 1:08 AM (GMT 0)
Hi all,

I had a my RD in 11/10. Now my PSA is .230. It has been going up .04 every 3 months for 18 months. So now I will do Proton at Scripps.

Has anyone else had this? Thoughts?

Thanks for any responses!

Scott
Posted 7/29/2015 1:24 AM (GMT 0)
It sounds like you are having salvage radiation. Are you having a mix of proton and photon?

Regards,
Kris
Posted 7/29/2015 1:41 AM (GMT 0)
Proton for salvage -- is this a clinical trial? I saw where UF Jacksonville was doing a clinical trial of protons for salvage - I guess Scripps is too. The standard of care is IMRT because it is thought that salvage RT requires a broad spray rather than a narrow rifle shot.

Thanks for pioneering a new treatment - I hope it works. Please report back.

- Allen
Posted 7/29/2015 2:05 AM (GMT 0)
How old are you? Who is paying for it?
Posted 7/29/2015 4:45 AM (GMT 0)
65 medicare and a full supplemental by Blue Shield of California. I should not see a billing. It started with a full review of records of the last 5 years. The director of scripts Proton department did the review and will design the program.

It is Proton Therapy. Tomorrow starts with a CT Scan and a MRI. Then a program is written. Then there are 28-35 treatments. They are 5 days a week whenever possible. I will be at Scrips 30-60 minutes each day. The treatment it self includes a rectal balloon for stabilization. The actual radiation is 7 minutes each day.

This is done at about 16 places in the US to include the Mayo Clinic and Kettering along with Scripps.

Wish me luck!!
Posted 7/29/2015 6:36 AM (GMT 0)
Good luck! If you get a chance, ask them how they are defining the margins for the "planned target volume." I love to know details like that.

Medicare reduced its payment for protons to $682 per session last year, so around $24,000 in total for SRT, which is similar to the salvage IMRT payment. Private insurers are balking, but in a case like this, where there is a clinical trial of a new therapy, usually at a reduced cost, they often agree to pay it. All the new proton installations, like Scripps, are eager to prove its benefit and don't mind reducing the cost until it's proven. Scripps had their machine entirely paid for by donor contributions anyway, so they only have to meet variable costs.

- Allen
Posted 7/29/2015 10:39 AM (GMT 0)
Themacs, I will indeed wish you luck! I had proton as my initial treatment, and it has worked well so far. I actually know a couple of folks who have had proton, or a combination of proton/photon as SRT after failed RP. And don't worry about the rectal balloon. It is a minor "inconvenience" but basically painless, and it helps protect the rectum and stabilize the treatment area.
Posted 7/29/2015 2:08 PM (GMT 0)
Thanks to all. Leaving shortly for the CT and MRI (and the balloon).
Posted 7/29/2015 8:54 PM (GMT 0)
Good luck on your proton treatment. Proton was my primary treatment at UFPTI in late 2014. So far so good.

I wonder too why proton and not IMRT. When I first consulted with UFPTI it was thought that I might have SVI and the treatment would have been IMRT for 4 weeks, followed by 4 weeks of proton. I asked why IMRT for 4 weeks and the RO said IMRT was better suited for treating the pelvic lymph nodes than proton. Proton does treat the entire prostate and some margin around it and much of the SV's, but I guess it has its limitations.
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