RE: Re: FW: New Prostate Cancer Videos

[Guest guest]

Fuller

Perhapos you could have a discussion off line and issue a joint statement

B

New Prostate Cancer Videos> > I am writing to inform you of several new videos added at the Prostate Video> Website. I hope you find them informative and I welcome your feedback,> questions and suggestions for other videos.> Gerald Chodak, M.D.> > Cyberknife Radiation for Prostate Cancer- Experts> Disagree<http://www.prostatevideos.com/prostate-reports-in-the-media/a-contr> oversy-about-cyberknife-radiation-for-prostate-cancer/>> > www.prostatevideos.com/prostate-reports-in-the-media/a-controversy-about-cyb> erknife-radiation-for-prostate-cancer/> > > Minimally Invasive Radical Prostatectomy- Robotic and> Laparoscopic<http://www.prostatevideos.com/prostate-cancer/treatment-options> /radical-prostatectomy-retropubic-and-perineal/robotic-laparoscopic-prostate> ctomy/>> > www.prostatevideos.com/prostate-cancer/treatment-options/radical-prostatecto> my-retropubic-and-perineal/robotic-laparoscopic-prostatectomy/> > > An Update of Immediate Radiation after Radical> Prostatectomy<http://www.prostatevideos.com/prostate-cancer/treatment-option> s-for-locally-advanced-disease/radiation-therapy-after-radical-prostatectomy> -an-update/>> > www.prostatevideos.com/prostate-cancer/treatment-options-for-locally-advance> d-disease/radiation-therapy-after-radical-prostatectomy-an-update/> > > Proton Beam> Therapy<http://www.prostatevideos.com/prostate-cancer/treatment-options/prot> on/>> > www.prostatevideos.com/prostate-cancer/treatment-options/proton/> > Treatments for Impotence after Prostate Cancer> Therapy<http://www.prostatevideos.com/managing-side-effects-of-cancer-therap> y/impotence/>> > www.prostatevideos.com/managing-side-effects-of-cancer-therapy/impotence/> > Focal and Total Cryotherapy for Localized> Disease<http://www.prostatevideos.com/prostate-cancer/treatment-options/cryo> surgery/>> > www.prostatevideos.com/prostate-cancer/treatment-options/cryosurgery/>

[Guest guest]

I am sorry Fuller, but that is not correct, the information it contains is based on published data.  I think it only fair that you demonstrate with data that what is said is inaccurate.To: ProstateCancerSupport Sent: Friday, December 12, 2008 5:27:23 AMSubject: Re: FW: New Prostate Cancer Videos

Some of the information in the proton therapy video by Dr. Chodak is

inaccurate.

Fuller

-- In ProstateCancerSuppo rtyahoogroups (DOT) com, "Kathy Meade"

<kmeadelist@ ...> wrote:

>

> You may be interested in these new videos. Especially appropriate

for newly

> diagnosed men.

>

> Kathy

>

> New Prostate Cancer Videos

>

> I am writing to inform you of several new videos added at the

Prostate Video

> Website. I hope you find them informative and I welcome your

feedback,

> questions and suggestions for other videos.

> Gerald Chodak, M.D..

>

> Cyberknife Radiation for Prostate Cancer- Experts

> Disagree<http://www.prostate videos.com/ prostate- reports-in- the-

media/a-contr

> oversy-about- cyberknife- radiation- for-prostate- cancer/>

>

> www.prostatevideos. com/prostate- reports-in- the-media/ a-controversy-

about-cyb

> erknife-radiation- for-prostate- cancer/

>

>

> Minimally Invasive Radical Prostatectomy- Robotic and

> Laparoscopic<http://www.prostate videos.com/ prostate-

cancer/treatment- options

> /radical-prostatect omy-retropubic- and-perineal/ robotic-laparosc opic-

prostate

> ctomy/>

>

> www.prostatevideos. com/prostate- cancer/treatment -options/ radical-

prostatecto

> my-retropubic- and-perineal/ robotic-laparosc opic-prostatecto my/

>

>

> An Update of Immediate Radiation after Radical

> Prostatectomy<http://www.prostate videos.com/ prostate-

cancer/treatment- option

> s-for-locally- advanced- disease/radiatio n-therapy- after-radical-

prostatectomy

> -an-update/>

>

> www.prostatevideos. com/prostate- cancer/treatment -options- for-

locally-advance

> d-disease/radiation -therapy- after-radical- prostatectomy- an-update/

>

>

> Proton Beam

> Therapy<http://www.prostate videos.com/ prostate- cancer/treatment -

options/prot

> on/>

>

> www.prostatevideos. com/prostate- cancer/treatment -options/ proton/

>

> Treatments for Impotence after Prostate Cancer

> Therapy<http://www.prostate videos.com/ managing- side-effects- of-

cancer-therap

> y/impotence/ >

>

> www.prostatevideos. com/managing- side-effects- of-cancer-

therapy/impotence/

>

> Focal and Total Cryotherapy for Localized

> Disease<http://www..prostate videos.com/ prostate- cancer/treatment -

options/cryo

> surgery/>

>

> www.prostatevideos. com/prostate- cancer/treatment -

options/cryosurgery /

>

[Guest guest]

I am sorry Fuller, but that is not correct, the information it contains is based on published data.  I think it only fair that you demonstrate with data that what is said is inaccurate.To: ProstateCancerSupport Sent: Friday, December 12, 2008 5:27:23 AMSubject: Re: FW: New Prostate Cancer Videos

Some of the information in the proton therapy video by Dr. Chodak is

inaccurate.

Fuller

-- In ProstateCancerSuppo rtyahoogroups (DOT) com, "Kathy Meade"

<kmeadelist@ ...> wrote:

>

> You may be interested in these new videos. Especially appropriate

for newly

> diagnosed men.

>

> Kathy

>

> New Prostate Cancer Videos

>

> I am writing to inform you of several new videos added at the

Prostate Video

> Website. I hope you find them informative and I welcome your

feedback,

> questions and suggestions for other videos.

> Gerald Chodak, M.D..

>

> Cyberknife Radiation for Prostate Cancer- Experts

> Disagree<http://www.prostate videos.com/ prostate- reports-in- the-

media/a-contr

> oversy-about- cyberknife- radiation- for-prostate- cancer/>

>

> www.prostatevideos. com/prostate- reports-in- the-media/ a-controversy-

about-cyb

> erknife-radiation- for-prostate- cancer/

>

>

> Minimally Invasive Radical Prostatectomy- Robotic and

> Laparoscopic<http://www.prostate videos.com/ prostate-

cancer/treatment- options

> /radical-prostatect omy-retropubic- and-perineal/ robotic-laparosc opic-

prostate

> ctomy/>

>

> www.prostatevideos. com/prostate- cancer/treatment -options/ radical-

prostatecto

> my-retropubic- and-perineal/ robotic-laparosc opic-prostatecto my/

>

>

> An Update of Immediate Radiation after Radical

> Prostatectomy<http://www.prostate videos.com/ prostate-

cancer/treatment- option

> s-for-locally- advanced- disease/radiatio n-therapy- after-radical-

prostatectomy

> -an-update/>

>

> www.prostatevideos. com/prostate- cancer/treatment -options- for-

locally-advance

> d-disease/radiation -therapy- after-radical- prostatectomy- an-update/

>

>

> Proton Beam

> Therapy<http://www.prostate videos.com/ prostate- cancer/treatment -

options/prot

> on/>

>

> www.prostatevideos. com/prostate- cancer/treatment -options/ proton/

>

> Treatments for Impotence after Prostate Cancer

> Therapy<http://www.prostate videos.com/ managing- side-effects- of-

cancer-therap

> y/impotence/ >

>

> www.prostatevideos. com/managing- side-effects- of-cancer-

therapy/impotence/

>

> Focal and Total Cryotherapy for Localized

> Disease<http://www..prostate videos.com/ prostate- cancer/treatment -

options/cryo

> surgery/>

>

> www.prostatevideos. com/prostate- cancer/treatment -

options/cryosurgery /

>

[Guest guest]

This will be my last response on this topic.  The fact that centers are doing protons does not mean that they have demonstrated its comparability.  I am not alone in pointing out the missing information.  You  can accept this or not but the data I have mentioned over and over is just not out there.  For those who are content without it, all I can do is try to provide information and to help get patients to a point of knowing what each therapy offers and does not offer.   My video is accurate and there is no information published in any country that would indicate that I have excluded anything.   I wish your group well and only ask that you tell the facts as they are.  Anecdotal cases do matter to individuals, but everyone should know that at this time no one has shown

information that justifies Proton therapy as either equivalent or better either in terms of safety or ability to control cancer.   For everyone's sake, I pray this data gets published soon so we really can find out if this therapy should be the best way to deliver radiation.   I will inform you if other videos are produced for those who might be interested.Good luck to all.Gerald Chodak, M.D.To: ProstateCancerSupport Sent: Friday, December 12, 2008 9:30:37 PMSubject: Re: FW: New Prostate Cancer Videos

 ,   Been there, done that.   Dr. Chodak and I have had lengthy discourse during the past several days.   At this point all I can say is that we disagree.   His proton video leaves one with the impression that there is almost no data supporting the use of proton beam, and further that there is no evidence that the side effects of proton therapy are minimal when compared to other treatment modalities.   As you know from my earlier postings, Loma University Medical Center has been using protons since the early 1990s, and Massachusetts General Hospital for about ten years.  The other centers are now well on their way to establishing their own records. The Japanese proton centers have contributed to the available records, as has the Scherrer Institute in Switzerland.   To say that good longer-term data is limited is therefore inaccurate, as I stated. It is out there!   There are many references to learn about proton therapy.  All it takes is time, patience, and perseverance.   Dr. Chodak says the data is "limited."  I say it is not, and as a doctor, he has for better access to these records.  He says PSA is not an accurate indication of long-term survivability.  I say reaching a PSA nadir and maintaining it is as good an indication as we have right now for being cancer free after therapy (any treatment modality for prostate cancer).   The other factor that is seemingly overlooked in all discussions of pros and cons of proton therapy is the immensely important work done in treating other forms of cancer, especially pediatric cancers.   Dr. Chodak is doing a worthwhile service with his videos, but the proton video does not represent the present state of the art in proton therapy. Since Dr. Chodak is in Chicago,  I have suggested to him that he contact one of the lead radiation oncologists at Northern Illinois University, where a new proton center is now under construction, to get a physician-to- physician viewpoint on the latest in proton beam therapy knowledge.   Fuller> >> > You may be interested in these new videos. Especially appropriate > for newly> > diagnosed men. > > > > Kathy> > > > New Prostate Cancer Videos> > > > I am writing to inform you of several new videos added at the > Prostate Video> > Website. I hope you find them informative and I welcome your > feedback,> > questions and suggestions for other videos.> > Gerald Chodak, M.D.> > > > Cyberknife Radiation for Prostate Cancer- Experts> > Disagree<http://www.prostate videos.com/ prostate- reports-in- the-> media/a-contr> > oversy-about- cyberknife- radiation- for-prostate- cancer/>> > > > www.prostatevideos.. com/prostate- reports-in- the-media/ a-controversy-> about-cyb> > erknife-radiation- for-prostate- cancer/> > > > > > Minimally Invasive Radical Prostatectomy- Robotic and> > Laparoscopic<http://www.prostate videos.com/ prostate-> cancer/treatment- options> >

/radical-prostatect omy-retropubic- and-perineal/ robotic-laparosc opic-> prostate> > ctomy/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options/ radical-> prostatecto> > my-retropubic- and-perineal/ robotic-laparosc opic-prostatecto my/> > > > > > An Update of Immediate Radiation after Radical> > Prostatectomy<http://www.prostate videos.com/ prostate-> cancer/treatment- option> > s-for-locally- advanced- disease/radiatio n-therapy- after-radical-> prostatectomy> > -an-update/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options- for-> locally-advance> > d-disease/radiation -therapy- after-radical- prostatectomy- an-update/> > > > > > Proton Beam> > Therapy<http://www.prostate videos.com/ prostate- cancer/treatment -> options/prot> > on/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options/

proton/> > > > Treatments for Impotence after Prostate Cancer> > Therapy<http://www.prostate videos.com/ managing- side-effects- of-> cancer-therap> > y/impotence/>> > > > www.prostatevideos. com/managing- side-effects- of-cancer-> therapy/impotence/> > > > Focal and Total Cryotherapy for Localized> > Disease<http://www.prostate videos.com/ prostate- cancer/treatment -> options/cryo> > surgery/>> > > > www.prostatevideos. com/prostate- cancer/treatment -> options/cryosurgery /> >>

[Guest guest]

This is a post to another website from Dr. Sandler who wrote the paper you quoted.  If he is saying this, and he does the therapy, why is it so hard to hear if said on my video? Sandler, on April 25th, 2008 at 11:34 am Said:Proton therapy and prostate cancer have become inextricably linked – most patients treated with proton therapy at Loma ’s facility have been prostate cancer patients, for example.Despite the theoretical dosimetric advantage of a proton beam, there are enough questions about proton delivery to justify the ethical performance of a randomized trial comparing proton to photon treatment. Concerns, or example, might include issues such as: proton beam’s sensitivity to heterogeneity of density (i.e. bone and air) with a patient’s pelvis, the widening of penumbra (i.e. beam edges become “fuzzy”) the deeper the beam penetrates, and issues with secondary neutron generation that could have implications for secondary neoplasm

generation.The RTOG and others are currently exploring a non-randomized clinical trial design that would evaluate toxic effects of IMRT and proton therapy that might provide some useful data.As of today, there are inadequate scientific data to justify the claim that proton therapy offers a strategy with either better cure rates or fewer side effects compared with IMRT.Gerald Chodak, MDTo: ProstateCancerSupport Sent: Friday, December 12, 2008 9:30:37 PMSubject: Re: FW: New Prostate Cancer Videos

 ,   Been there, done that.   Dr. Chodak and I have had lengthy discourse during the past several days.   At this point all I can say is that we disagree.   His proton video leaves one with the impression that there is almost no data supporting the use of proton beam, and further that there is no evidence that the side effects of proton therapy are minimal when compared to other treatment modalities.   As you know from my earlier postings, Loma University Medical Center has been using protons since the early 1990s, and Massachusetts General Hospital for about ten years.  The other centers are now well on their way to establishing their own records. The Japanese proton centers have contributed to the available records, as has the Scherrer Institute in Switzerland.   To say that good longer-term data is limited is therefore inaccurate, as I stated. It is out there!   There are many references to learn about proton therapy.  All it takes is time, patience, and perseverance.   Dr. Chodak says the data is "limited."  I say it is not, and as a doctor, he has for better access to these records.  He says PSA is not an accurate indication of long-term survivability.  I say reaching a PSA nadir and maintaining it is as good an indication as we have right now for being cancer free after therapy (any treatment modality for prostate cancer).   The other factor that is seemingly overlooked in all discussions of pros and cons of proton therapy is the immensely important work done in treating other forms of cancer, especially pediatric cancers.   Dr. Chodak is doing a worthwhile service with his videos, but the proton video does not represent the present state of the art in proton therapy. Since Dr. Chodak is in Chicago,  I have suggested to him that he contact one of the lead radiation oncologists at Northern Illinois University, where a new proton center is now under construction, to get a physician-to- physician viewpoint on the latest in proton beam therapy knowledge.   Fuller> >> > You may be interested in these new videos. Especially appropriate > for newly> > diagnosed men. > > > > Kathy> > > > New Prostate Cancer Videos> > > > I am writing to inform you of several new videos added at the > Prostate Video> > Website. I hope you find them informative and I welcome your > feedback,> > questions and suggestions for other videos.> > Gerald Chodak, M.D.> > > > Cyberknife Radiation for Prostate Cancer- Experts> > Disagree<http://www.prostate videos.com/ prostate- reports-in- the-> media/a-contr> > oversy-about- cyberknife- radiation- for-prostate- cancer/>> > > > www.prostatevideos.. com/prostate- reports-in- the-media/ a-controversy-> about-cyb> > erknife-radiation- for-prostate- cancer/> > > > > > Minimally Invasive Radical Prostatectomy- Robotic and> > Laparoscopic<http://www.prostate videos.com/ prostate-> cancer/treatment- options> >

/radical-prostatect omy-retropubic- and-perineal/ robotic-laparosc opic-> prostate> > ctomy/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options/ radical-> prostatecto> > my-retropubic- and-perineal/ robotic-laparosc opic-prostatecto my/> > > > > > An Update of Immediate Radiation after Radical> > Prostatectomy<http://www.prostate videos.com/ prostate-> cancer/treatment- option> > s-for-locally- advanced- disease/radiatio n-therapy- after-radical-> prostatectomy> > -an-update/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options- for-> locally-advance> > d-disease/radiation -therapy- after-radical- prostatectomy- an-update/> > > > > > Proton Beam> > Therapy<http://www.prostate videos.com/ prostate- cancer/treatment -> options/prot> > on/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options/

proton/> > > > Treatments for Impotence after Prostate Cancer> > Therapy<http://www.prostate videos.com/ managing- side-effects- of-> cancer-therap> > y/impotence/>> > > > www.prostatevideos. com/managing- side-effects- of-cancer-> therapy/impotence/> > > > Focal and Total Cryotherapy for Localized> > Disease<http://www.prostate videos.com/ prostate- cancer/treatment -> options/cryo> > surgery/>> > > > www.prostatevideos. com/prostate- cancer/treatment -> options/cryosurgery /> >>

[Guest guest]

First, To Mr.Gerald Chodak, M.D., I will first say, thank you for posting here. I have been with this site for some time and have only recently seen your posts so I will assume you are rather new here. New information is always welcome but I will say this can be a critical group, as it should be. My own experience with Pca is this dx in June of 2006 with a Gleason 4+3 with most cores positive in both lobes. My PSA was 11.2 back then, now 16.4. All that is kind of beside the point as regards to my observation which is this.... I have read and think I understand the Partin tables as they give the percentages, as we are now capable of calculating at this time with our limited understanding, of a "cure", or more accurately non recurrance. Then I look at the Han tables and find the over

time, there is an increasing likelyhood of recurrance even if local therapy is undertaken. I have no medical or research background but to my laymens mind this suggests that most all of prostate cancer is systemic from the beginning. So my question is this...If this is a correct assumption, why treat this cancer at all, unless it is known to be the agressive type? Please, to all, I have no wish to ignite a firestorm of passionate answers here so please refrain from doing so. I only seek input.Jeff Subject: Re: Re: FW: New Prostate Cancer VideosTo: ProstateCancerSupport Date: Friday, December 12, 2008, 11:08

PM

This will be my last response on this topic. The fact that centers are doing protons does not mean that they have demonstrated its comparability. I am not alone in pointing out the missing information. You can accept this or not but the data I have mentioned over and over is just not out there. For those who are content without it, all I can do is try to provide information and to help get patients to a point of knowing what each therapy offers and does not offer. My video is accurate and there is no information published in any country that would indicate that I have excluded anything. I wish your group well and only ask that you tell the facts as they are. Anecdotal cases do matter to individuals, but everyone should know that at this time no one has shown

information that justifies Proton therapy as either equivalent or better either in terms of safety or ability to control cancer. For everyone's sake, I pray this data gets published soon so we really can find out if this therapy should be the best way to deliver radiation. I will inform you if other videos are produced for those who might be interested.Good luck to all.Gerald Chodak, M.D.From: Fuller <cnsjonesyahoo (DOT) com>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Friday,

December 12, 2008 9:30:37 PMSubject: [ProstateCancerSupp ort] Re: FW: New Prostate Cancer Videos

, Been there, done that. Dr. Chodak and I have had lengthy discourse during the past several days. At this point all I can say is that we disagree. His proton video leaves one with the impression that there is almost no data supporting the use of proton beam, and further that there is no evidence that the side effects of proton therapy are minimal when compared to other treatment modalities. As you know from my earlier postings, Loma University Medical Center has been using protons since the early 1990s, and Massachusetts General Hospital for about ten years. The other centers are now well on their way to establishing their own records. The Japanese proton centers have contributed to the available records, as has the Scherrer Institute in Switzerland. To say that good longer-term data is limited is therefore inaccurate, as I stated. It is out there! There are many references to learn about proton therapy. All it takes is time, patience, and perseverance. Dr. Chodak says the data is "limited." I say it is not, and as a doctor, he has for better access to these records. He says PSA is not an accurate indication of long-term survivability. I say reaching a PSA nadir and maintaining it is as good an indication as we have right now for being cancer free after therapy (any treatment modality for prostate cancer). The other factor that is seemingly overlooked in all discussions of pros and cons of proton therapy is the immensely important work done in treating other forms of cancer, especially pediatric cancers. Dr. Chodak is doing a worthwhile service with his videos, but the proton video does not represent the present state of the art in proton therapy. Since Dr. Chodak is in Chicago, I have suggested to him that he contact one of the lead radiation oncologists at Northern Illinois University, where a new proton center is now under construction, to get a physician-to- physician viewpoint on the latest in proton beam therapy knowledge. Fuller> >> > You may be interested in these new videos. Especially appropriate > for newly> > diagnosed men.

> > > > Kathy> > > > New Prostate Cancer Videos> > > > I am writing to inform you of several new videos added at the > Prostate Video> > Website. I hope you find them informative and I welcome your > feedback,> > questions and suggestions for other videos.> > Gerald Chodak, M.D.> > > > Cyberknife Radiation for Prostate Cancer- Experts> > Disagree<http://www.prostate videos.com/ prostate- reports-in- the-> media/a-contr> > oversy-about- cyberknife- radiation- for-prostate- cancer/>> > > > www.prostatevideos. . com/prostate- reports-in- the-media/ a-controversy-> about-cyb> > erknife-radiation- for-prostate- cancer/> > > > > > Minimally Invasive

Radical Prostatectomy- Robotic and> > Laparoscopic<http://www.prostate videos.com/ prostate-> cancer/treatment- options> >

/radical-prostatect omy-retropubic- and-perineal/ robotic-laparosc opic-> prostate> > ctomy/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options/ radical-> prostatecto> > my-retropubic- and-perineal/ robotic-laparosc opic-prostatecto my/> > > > > > An Update of Immediate Radiation after Radical> > Prostatectomy<http://www.prostate videos.com/ prostate-> cancer/treatment- option> > s-for-locally- advanced- disease/radiatio n-therapy- after-radical-> prostatectomy> > -an-update/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options- for-> locally-advance> > d-disease/radiation -therapy- after-radical- prostatectomy- an-update/> > > > > > Proton Beam> > Therapy<http://www.prostate videos.com/ prostate-

cancer/treatment -> options/prot> > on/>> > > > www.prostatevideos. com/prostate- cancer/treatment -options/

proton/> > > > Treatments for Impotence after Prostate Cancer> > Therapy<http://www.prostate videos.com/ managing- side-effects- of-> cancer-therap> > y/impotence/ >> > > > www.prostatevideos. com/managing- side-effects- of-cancer-> therapy/impotence/> > > > Focal and Total Cryotherapy for Localized> > Disease<http://www.prostate videos.com/ prostate- cancer/treatment -> options/cryo> > surgery/>> > > > www.prostatevideos. com/prostate- cancer/treatment -> options/cryosurgery /> >>

[Guest guest]

My comments ******

________________________________

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Fuller

Sent: Friday, December 12, 2008 10:31 PM

To: ProstateCancerSupport

Subject: Re: FW: New Prostate Cancer Videos

His proton video leaves one with the impression that there is almost no data

supporting the use of proton beam, and further that there is no evidence

that the side effects of proton therapy are minimal when compared to other

treatment modalities.

*****Unfortunately at this time most of the proton evidence is theoretical

rather than clinical. The only study I have seen recently has been the head

to head study of IMRT to protons that concluded that survival with the two

modalities are similar. They said there may be QOL differences but did not

look at that. I wish that both groups had published more outcome papers but

unfortunately they are lacking. That is what I think Dr Chodak is talking

about. We need to differentiate between the types of research because

unfortunately we have found that what we thought based on theoretical models

or even through animal models has not been proven true when tested in

humans. Another factor in research is that findings have to be validated

because unfortunately it may not prove to be true when tested with different

researchers. There were a couple of studies recently where when there was an

attempt to validate they could not be repeated by different researchers so

this part of the process is important.

As you know from my earlier postings, Loma University Medical Center

has been using protons since the early 1990s, and Massachusetts General

Hospital for about ten years. The other centers are now well on their way

to establishing their own records. The Japanese proton centers have

contributed to the available records, as has the Scherrer Institute in

Switzerland.

To say that good longer-term data is limited is therefore inaccurate, as I

stated. It is out there!

****Unfortunately clinical data from these groups has not been published or

else I am sure you would have sent it to us as part of these discussions.

There is a great deal of anecdotal information but not research information.

As Dr Chodak said we need information that compares patients with similar

statistics and we can't just get them all lumped together. If the bulk of

the patients are Gleason 6 then the outcomes can expected to be better than

Gleason 8 patients. I am not the expert that you are so if this information

is available please send the links.

There are many references to learn about proton therapy. All it takes is

time, patience, and perseverance.

Dr. Chodak says the data is " limited. " I say it is not, and as a doctor, he

has for better access to these records. He says PSA is not an accurate

indication of long-term survivability. I say reaching a PSA nadir and

maintaining it is as good an indication as we have right now for being

cancer free after therapy (any treatment modality for prostate cancer).

****Clinically you are correct but the PSA has been rejected as a surrogate

for survival for research purposes. When looked at in a scientific study the

correlation is not strong enough. I wish it could be used because then it

would be easier and faster to get drugs approved by the FDA. PSA rise, etc

is the best we have right now but far from perfect.

The other factor that is seemingly overlooked in all discussions of pros and

cons of proton therapy is the immensely important work done in treating

other forms of cancer, especially pediatric cancers.

****Dr Chodak's videos are for people learning about prostate cancer so

other cancers are not relevant in his videos. The issues are different for

the other cancers from what I have read. They do not have other options.

Dr. Chodak is doing a worthwhile service with his videos, but the proton

video does not represent the present state of the art in proton therapy.

Since Dr. Chodak is in Chicago, I have suggested to him that he contact one

of the lead radiation oncologists at Northern Illinois University, where a

new proton center is now under construction, to get a physician-to-physician

viewpoint on the latest in proton beam therapy knowledge.

***I contacted Dr. Chodak about some issues related to his videos and he

redid them. He is a scientist and you need to communicate to him with

scientific data that is up to accepted scientific standards. As the

point/counterpoint that I recently recently posted a link to said there are

discussion points on both sides. It is unfortunate that the proton

facilities did not begin clinical trials earlier in the process. Then we

would not be having this discussion right now.

I do not think that Dr Chodak is trying to put down on proton therapy. Have

you considered sending a link to the videos to some of the proton clinicians

for their comments/suggestions?

Kathy