HealingWell
Search Close Search
☰

Tomotherapy?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/22/2013 10:46 AM (GMT 0)
Folks:

Does anyone have opinions or experience with tomotherapy?

Looks like radiation as a salvage therapy after my recent surgery is pretty likely. I have one positive surgical margin 1.2 cm in the posterior / bladder neck area. Nonaggressive Gleason 3 level, but due to length of margin it's likely radiation is going to be inevitable.

Anybody have any feedback with the tomotherapy system?
Posted 3/22/2013 10:57 AM (GMT 0)
Can't say I've ever heard of it.

Tomotherapy is a type of radiation therapy in which the radiation is delivered slice-by-slice (hence the use of the Greek prefix tomo-, which means "slice"). This method of delivery differs from other forms of external beam radiation therapy in which the entire tumor volume is irradiated at one time.
en.wikipedia.org/wiki/Tomotherapy

EDIT: If you use the search function here you'll find many threads on the subject.
Posted 3/22/2013 1:28 PM (GMT 0)
I had salvage radiation in 2009. It was tomography. It was administered incorrectly, and as the results, my bladder and bladder neck were severely burned and damaged. As a result, I was left disabled with both chronic pain and fatigue, and ended up with a Urostomy. Rare? Perhaps, but it happened.

david in sc
Posted 3/22/2013 1:30 PM (GMT 0)
David:

I'm really sorry to hear that.

But thank you for sharing. I want to hear all stories, including ones like yours.
Posted 3/22/2013 1:31 PM (GMT 0)
David:

Was your positive margin in the bladder neck / posterior area?

Do you think that was a factor in failure?
Posted 3/22/2013 1:33 PM (GMT 0)
posterior area.

the radiation was administered each time on a completely empty bladder vs. a full bladder, that was a big mistake on the part of the radiation oncologist. I have been in litigation with her and the radiation clinic ever since.

btw, despite the damage, the radiation failed to slow or stop the cancer. it failed in less than 9 months.

david
Posted 3/22/2013 1:37 PM (GMT 0)
I consulted two ROs and the both said I could get tomo if I wanted it, but didn't think it was necessary for SRT. In SRT they're radiating a large area rather than a pinpoint tumor, so the main thing is to avoid radiating the bladder or rectum to much. I'm getting Varian rapid arc igrt and after 29 of 39 treatments have almost zero side effects. Just be sure you get IGRT of some kind. That's where they do a ct scan before each treatment.
Posted 3/22/2013 1:40 PM (GMT 0)
Reachout:

I thought the whole thing with tomotherapy is that the ct scan is built in.

What would the difference between tomotherapy and Varian be?
Posted 3/22/2013 2:49 PM (GMT 0)
Aachen, I didn't mean that Varian has the CT scan and tomo doesn't, I meant that whatever you do, get a treatment that relies on IGRT, which would include both the RapidArc or the tomo. I don't know enough about tomotherapy to know the difference, other than the slicing methodology.

My point, based on what my ROs told me, is that tomo may be "overkill" in the sense that it's modulating each slice whereas as with SRT they are pretty much delivering the same dose to the entire prostate bed. So tomotherapy may be better suited to some head and neck cancers where they have to follow some intensity contours within the targeted region.

But I don't think you can go wrong with tomo, unless you ask David, who used it and got burned, but I think he just had a terrible RO and/or the techs or the machine were no good.

Disclaimer: I'm just a patient, not a medical person.
Posted 3/22/2013 5:01 PM (GMT 0)
I had Tomo as part of my primary treatment along with seeds. A CT scan was done before each treatment. This is the first I heard about Tomo being delivered in slices; I thought the CT scan was the major difference in treatments.
JT
Posted 3/22/2013 5:20 PM (GMT 0)
dana jennings received tomography after surgery failed.

http://well.blogs.nytimes.com/2009/06/23/radiation-fears-poisoned-to-be-cured/

ed

Posted 3/23/2013 2:56 AM (GMT 0)
I have two different RO that i see. One's cancer center has Tomo machines, the other uses the Varian.

Tomo is more like a CT scan with the rotating wheel. The Varian also does a CT scan before each treatment, but it does it using the arms in one pass. Then it does the radiation from one of the arms as well.

Both doctors are top notch and basically told me either machine would work fine. (As an engineer i wanted the 'newer' one :-))

Ray
Posted 3/23/2013 12:22 PM (GMT 0)
Steel, that sounds about right.

The Varian being used on me (rapid arc) extends two square plates then does a 360 degree rotation around me taking a ct scan, after which the plates fold away. That takes about two minutes. Then I have to hold still for about five minutes while the doctor checks the scan. I know they're good when I feel a couple of minor bumps from the table being adjusted a few millimeters at a time.

The head of the machine, minus plates, then does a 360 dosing me in a continuous motion for about 1 minute. It then stops, waits about 30 seconds making some clicking noises, and comes around for another 360 in the other direction. The radiation just takes a couple of minutes and the entire process about 10.
✚ New Topic ✚ Reply