Re: LLUMC Medical and Cancer Treatment and Research

[Guest guest]

Fuller, happy to see that you are still " here " . I thought you had

left me all alone to post proton messages, clear up misconceptions

and answer questions. A daunting prospect.

Laurel

> > ...

> > > The one negative reported was an increase in rectal

> > > toxicity in higher-grade tumours. Perhaps these men

> > > should not have been radiated at all?

> > ...

> >

> > I'm certainly no expert, but I would think that the higher

> > rectal toxicity could only be caused by delivering more

> > radiation to the rectum.

> >

> > I presume that, when the patient has a higher grade tumor,

> > the radiation oncologists will expand the radiation delivery

> > field and the amount of radiation delivered to that expanded

> > field. The decision to do that is probably independent

> > of whether protons or photons are used, though as another

> > poster pointed out, it may be that photons are used for this

> > expanded field even when protons are used on the prostate

> > itself.

> >

> > What to do in these situations is a tough call. From the

> > numbers given (61.4% vs. 80.4% PSA failure rates), it

> > appears that one can significantly improve the chances for

> > a cure by accepting the higher risk of toxicity. In the

> > lower risk cases, the higher toxicity is probably not needed.

> > In the higher risk cases, it may become a more acceptable

> > risk.

> >

> > Curiously, I'll bet that most radiation oncologists never

> > discuss these issues with their patients. They make the

> > decision for the patient based on their own idea about what

> > is best.

> >

> > Alan

> >

> > Alan Meyer

> > ameyer2@

> >

> >

> >

>

______________________________________________________________________

> ______________

> > Looking for last minute shopping deals?

> > Find them fast with Yahoo! Search.

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category=shopping

> >

>

[Guest guest]

Trying to catch up on this thread. Hard to believe they allow a 5 CM

margin, that is 2 inches. Wow. Would seem you'd for sure burn into

the rectum, bladder, etc. Guess I haven't read enough about the

approach with proton beams.

>

> Hi Terry, Laurel and all:

>

> Allan is spot on. Past posts have indicated the fact that proton

>

[Guest guest]

People, I really apologize. I was really tired last evening, and did

not proof read my posts. The margin for protn beam treatment around

the gland is about 10 millimeters or half an inch.

Very sorry for the confusion. I should really not try to post late in

the evening.

Fuller

> >

> > Hi Terry, Laurel and all:

> >

> > Allan is spot on. Past posts have indicated the fact that proton

> >

>

[Guest guest]

Fuller and Laurel.

I want to be sure I understand this

correctly. Protons alone are used for individuals who appear to have their

cancer totally within the prostate. If there is a chance that it has escaped,

they are currently using IMRT for radiation of the prostate bed in addition to

the proton treatment of the prostate?

If not how do they treat the lymph nodes?

Under what other circumstances do they

combine protons with IMRT?

Kathy

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Fuller

Sent: Monday, February 04, 2008

7:34 AM

To:

ProstateCancerSupport

Subject: Re:

LLUMC Medical and Cancer Treatment and Research

People, I really apologize. I was really tired last evening, and did

not proof read my posts. The margin for proton beam treatment around

the gland is about 10 millimeters or half an inch.

Very sorry for the confusion. I should really not try to post late in

the evening.

Fuller

>

> Trying to catch up on this thread. Hard to believe they allow a 5 CM

> margin, that is 2 inches. Wow. Would seem you'd for sure burn into

> the rectum, bladder, etc. Guess I haven't read enough about the

> approach with proton beams.

>

>

[Guest guest]

Hi all,

If my memory serves me well the margin is between 1 cm and 1.2 cm and

not 5 cm.

Good luck all.

Beau

> >

> > Hi Terry, Laurel and all:

> >

> > Allan is spot on. Past posts have indicated the fact that proton

> >

>

[Guest guest]

> I want to be sure I understand this correctly. Protons alone are used

> for individuals who appear to have their cancer totally within the

> prostate. If there is a chance that it has escaped, they are currently

> using IMRT for radiation of the prostate bed in addition to the proton

> treatment of the prostate?

>

> If not how do they treat the lymph nodes?

>

> Under what other circumstances do they combine protons with IMRT?

Coincidentally, Dr. Strum wrote on that subject just this morning on

P2P. See the thread " Fairly New Dx. "

Regards,

Steve J

[Guest guest]

Maybe I can help . . . .

LLUMC has several protocols depending on risk. I was high risk, PSA 22,

Gleason 6/7, no evidence of extracap. 36 months ago I had 4 mos ADT

and LLUMC gave me protons (20 treatments) plus photons (24

treatments). I can't tell you what the margins were, that's the

radiation oncologist's job. I have mild urinary obstruction, no rectal

issues whatsoever and had minor ED for two years, now hardly any.

I had recurrent cancer after 30 mos (rising PSA with biopsy confirmed),

no evidence of metastatic disease, but probably micro-metastatic

ddisase. I manage my diet and have had more ADT. I received an NCI

intraprostatic vaccine protocol and will have salvage brachytherapy

soon.

I look at it this way, I went to LLUMC with 16 of 16 confirmed cores

and now I have 1 in 11. My PSA hovers at .5 for many months now. On

one hand LLUMC protons did not erradicate cancer (failure?) but on the

other hand it shut down the cancer and left me quite intact, few

injuries, high QOL and hopefully ready to take on more radiation

(success?).

I would do proton plus photons again but be more diligent in the 1st

three years of followup. I believe their treatment protocol is

excellent and the theory behind protons doing little collateral damage

was borne out true in my case. Is LLUMC the best? I don't know. My

only complaint about LLUMC is that once you leave, they no longer care

about your outcome. The proton Bob's are a cult of optimism, golf and

fishing stories. Great guys they are but overly confident and they

don't like to hear bad news.

There's no such thing as a free lunch. (grin)

Albert