RE: Re: Comparative Effectiveness Research

[Guest guest]

Jon,

I certainly think your idea has merit, but

the big drawback would be in dealing with the side effects that often accompany

new treatments until they are tested and, perhaps, modified. I have read some

of the early studies on HIFU in Europe and it

is clear that in the early days the levels of urinary problems was very high

indeed. It seems these were associated with the sloughing of material from the

bladder following collateral damage caused by overheating, or perhaps

over-shooting the intended treatment area. Insurers would presumably have to

pick up costs associated with such side effects on the basis that they would

meet the costs of similar side effects from, say, radiation therapy.

No doubt a way could be found around such

issues to encourage the safe development of new treatments, but there would

certainly be risks and costs involved that would be difficult for an insurer to

assess without adequate data.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers :

" As a physician, I am painfully aware that most of the decisions we make

with regard to prostate cancer are made with inadequate data "

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of ccnvw@...

Sent: Sunday, 23 November 2008

3:06 AM

To:

ProstateCancerSupport

Subject:

Re: Comparative Effectiveness Research

The problem I have with the example presented is that the only criteria

given for 'cost effectiveness " was that 3D conformal radiation had a

higher risk of procritis than IMRT. Nothing was said about the relative

effectiveness on treating prostate cancer. And, other potential effects

of the larger 3D conformal radiation field were not mentioned. Like

so many aspects of our disease, the results of a 'cost effectiveness' analysis

depends so much on the assumptions and parameters of the study.

With respect to insurance companies and Medicare limiting payments,

seems to me that an effective alternative would be to not deny payment for new

more expensive treatments such as Cyberknife because there is insufficient data

on relative effectiveness but rather limit payment to the level of payment for

'approved' treatments. That way there would be equal cash subsidy for the

new treatments to encourage those who can afford the difference to pursue the

new treatments, thereby building up case histories for evaluation of

effectiveness. It also would be an incentive for the purveyers of the new

technologies to try and reduce costs. The way it is now is 'all or

nothing'.

The Best to You and Yours!

Jon in Nevada

In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time,

ProstateCancerSupport writes:

Posted

by: " Kathy Meade " mailto:kmeadelistaec225?Subject=

Re%3AComparative%20Effectiveness%20Research%20from%20a%20blog merrywidow225

Fri

Nov 21, 2008 4:23 am (PST)

You should be aware of discussions like this that are going on now. If

you

have a problem with this type of discussion with the potential outcome of

limiting payment for treatments then patients need to get involved now

before changes happen. Patients need to be at meetings like this to speak

about the value of QOL. Now is the time to get involved before coverage's

are limited.

Kathy

*******************

Steve does do cost-benefit analysis, and used as one of his examples a study

his group did on the cost-effectiveness of IMRT (Intensity Modulated

Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation

therapy - old way) for treating prostate cancer. The old way does lead, on

occasion, to proctitis (bowel inflammation) in some patients, while the new

way can reduce the likelihood of this side effect. Proctitis is

uncomfortable, but pretty treatable, and certainly not life threatening.

Check out smokin' hot deals on laptops,

desktops and more from Dell. Shop

Deals

[Guest guest]

is it really just a shot in the dark no matter what you do? if that is the case we just want the cancer gone no matter what the side effects. We are strong and can deal with the rest of itdebby theiler

Subject: RE: Re: Comparative Effectiveness ResearchTo: ProstateCancerSupport Date: Saturday, November 22, 2008, 9:33 PM

Jon,

I certainly think your idea has merit, but the big drawback would be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.

No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za

Dr “Snuffy” Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"

From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...Sent: Sunday, 23 November 2008 3:06 AMTo: ProstateCancerSuppo rtyahoogroups (DOT) comSubject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research

The problem I have with the example presented is that the only criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.

With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'.

The Best to You and Yours!

Jon in Nevada

In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:

Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225

Fri Nov 21, 2008 4:23 am (PST)

You should be aware of discussions like this that are going on now. If youhave a problem with this type of discussion with the potential outcome oflimiting payment for treatments then patients need to get involved nowbefore changes happen. Patients need to be at meetings like this to speakabout the value of QOL. Now is the time to get involved before coverage'sare limited.Kathy************ *******Steve does do cost-benefit analysis, and used as one of his examples a studyhis group did on the cost-effectiveness of IMRT (Intensity ModulatedRadiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiationtherapy - old way) for treating prostate cancer. The old way does lead, onoccasion, to proctitis (bowel inflammation) in some patients, while the newway can reduce the likelihood of this side effect.

Proctitis isuncomfortable, but pretty treatable, and certainly not life threatening.

Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals

[Guest guest]

Debby,

There is simply no way of being certain of

the outcome of any of the current options for men diagnosed with prostate

cancer. That makes things very difficult for everyone, but it has to be faced. There

seems to be little doubt that the best predictor for the best outcome is having

treatment carried out by the best and most experienced operator you can find

and/or afford.

In other words, the best radiologist is

likely to have better results than a poor surgeon: the best surgeon will have

better results than a poor radiologist. And so on through all the sub-sets of

treatment: laparoscopic surgery or open surgery? ; perineal or retropubic open

surgery? : manual or robotic laparoscopic surgery? ; proton beam radiation or

photon beam? : IMRT or CyberKnife? : HIFU or focused Cryotherapy? The list goes

on an on and there is simply no proof that one is better than the other.

Find out all you can about your options:

decided what suits your mind-set best: find the most accomplished medical team

to carry out your choice – and never look back.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers :

" As a physician, I am painfully aware that most of the decisions we make

with regard to prostate cancer are made with inadequate data "

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of debby theiler

Sent: Sunday, 23 November 2008

3:33 PM

To:

ProstateCancerSupport

Subject: RE:

Re: Comparative Effectiveness Research

is it really just a shot in the dark no matter what

you do? if that is the case we just want the cancer gone no matter what

the side effects. We are strong and can deal with the rest of it

debby theiler

From: Terry Herbert

<ghenesh_49optusnet.au>

Subject: RE: Re: Comparative Effectiveness

Research

To: ProstateCancerSupport

Date: Saturday, November 22, 2008, 9:33 PM

Jon,

I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until

they are tested and, perhaps, modified. I have read some of the early studies

on HIFU in Europe and it is clear that in

the early days the levels of urinary problems was very high indeed. It seems

these were associated with the sloughing of material from the bladder

following collateral damage caused by overheating, or perhaps over-shooting

the intended treatment area. Insurers would presumably have to pick up costs

associated with such side effects on the basis that they would meet the costs

of similar side effects from, say, radiation therapy.

No doubt a way could be found around such issues to encourage the

safe development of new treatments, but there would certainly be risks and

costs involved that would be difficult for an insurer to assess without

adequate data.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.

net and www.prostatecancerw

atchfulwaiting. co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSuppo

rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...

Sent: Sunday, 23 November 2008

3:06 AM

To: ProstateCancerSuppo

rtyahoogroups (DOT) com

Subject: [ProstateCancerSupp

ort] Re: Comparative Effectiveness Research

The problem I

have with the example presented is that the only criteria given for 'cost

effectiveness " was that 3D conformal radiation had a higher risk of

procritis than IMRT. Nothing was said about the relative effectiveness

on treating prostate cancer. And, other potential effects of the larger

3D conformal radiation field were not mentioned. Like so many

aspects of our disease, the results of a 'cost effectiveness' analysis

depends so much on the assumptions and parameters of the study.

With respect to

insurance companies and Medicare limiting payments, seems to me that an

effective alternative would be to not deny payment for new more expensive

treatments such as Cyberknife because there is insufficient data on relative

effectiveness but rather limit payment to the level of payment for 'approved'

treatments. That way there would be equal cash subsidy for the new

treatments to encourage those who can afford the difference to pursue the new

treatments, thereby building up case histories for evaluation of

effectiveness. It also would be an incentive for the purveyers of the

new technologies to try and reduce costs. The way it is now is 'all or

nothing'.

The Best to You

and Yours!

Jon in Nevada

In a message

dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo

rtyahoogroups (DOT) com writes:

Posted

by: " Kathy Meade " mailto:kmeadelist@

aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research%

20from%20a% 20blog merrywidow225

Fri

Nov 21, 2008 4:23 am (PST)

You should be

aware of discussions like this that are going on now. If you

have a problem with this type of discussion with the potential outcome of

limiting payment for treatments then patients need to get involved now

before changes happen. Patients need to be at meetings like this to speak

about the value of QOL. Now is the time to get involved before coverage's

are limited.

Kathy

************ *******

Steve does do cost-benefit analysis, and used as one of his examples a study

his group did on the cost-effectiveness of IMRT (Intensity Modulated

Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation

therapy - old way) for treating prostate cancer. The old way does lead, on

occasion, to proctitis (bowel inflammation) in some patients, while the new

way can reduce the likelihood of this side effect. Proctitis is

uncomfortable, but pretty treatable, and certainly not life threatening.

Check out smokin' hot deals on laptops, desktops and more from

Dell. Shop Deals

[Guest guest]

Debby,

There is simply no way of being certain of

the outcome of any of the current options for men diagnosed with prostate

cancer. That makes things very difficult for everyone, but it has to be faced. There

seems to be little doubt that the best predictor for the best outcome is having

treatment carried out by the best and most experienced operator you can find

and/or afford.

In other words, the best radiologist is

likely to have better results than a poor surgeon: the best surgeon will have

better results than a poor radiologist. And so on through all the sub-sets of

treatment: laparoscopic surgery or open surgery? ; perineal or retropubic open

surgery? : manual or robotic laparoscopic surgery? ; proton beam radiation or

photon beam? : IMRT or CyberKnife? : HIFU or focused Cryotherapy? The list goes

on an on and there is simply no proof that one is better than the other.

Find out all you can about your options:

decided what suits your mind-set best: find the most accomplished medical team

to carry out your choice – and never look back.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers :

" As a physician, I am painfully aware that most of the decisions we make

with regard to prostate cancer are made with inadequate data "

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of debby theiler

Sent: Sunday, 23 November 2008

3:33 PM

To:

ProstateCancerSupport

Subject: RE:

Re: Comparative Effectiveness Research

is it really just a shot in the dark no matter what

you do? if that is the case we just want the cancer gone no matter what

the side effects. We are strong and can deal with the rest of it

debby theiler

From: Terry Herbert

<ghenesh_49optusnet.au>

Subject: RE: Re: Comparative Effectiveness

Research

To: ProstateCancerSupport

Date: Saturday, November 22, 2008, 9:33 PM

Jon,

I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until

they are tested and, perhaps, modified. I have read some of the early studies

on HIFU in Europe and it is clear that in

the early days the levels of urinary problems was very high indeed. It seems

these were associated with the sloughing of material from the bladder

following collateral damage caused by overheating, or perhaps over-shooting

the intended treatment area. Insurers would presumably have to pick up costs

associated with such side effects on the basis that they would meet the costs

of similar side effects from, say, radiation therapy.

No doubt a way could be found around such issues to encourage the

safe development of new treatments, but there would certainly be risks and

costs involved that would be difficult for an insurer to assess without

adequate data.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.

net and www.prostatecancerw

atchfulwaiting. co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSuppo

rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...

Sent: Sunday, 23 November 2008

3:06 AM

To: ProstateCancerSuppo

rtyahoogroups (DOT) com

Subject: [ProstateCancerSupp

ort] Re: Comparative Effectiveness Research

The problem I

have with the example presented is that the only criteria given for 'cost

effectiveness " was that 3D conformal radiation had a higher risk of

procritis than IMRT. Nothing was said about the relative effectiveness

on treating prostate cancer. And, other potential effects of the larger

3D conformal radiation field were not mentioned. Like so many

aspects of our disease, the results of a 'cost effectiveness' analysis

depends so much on the assumptions and parameters of the study.

With respect to

insurance companies and Medicare limiting payments, seems to me that an

effective alternative would be to not deny payment for new more expensive

treatments such as Cyberknife because there is insufficient data on relative

effectiveness but rather limit payment to the level of payment for 'approved'

treatments. That way there would be equal cash subsidy for the new

treatments to encourage those who can afford the difference to pursue the new

treatments, thereby building up case histories for evaluation of

effectiveness. It also would be an incentive for the purveyers of the

new technologies to try and reduce costs. The way it is now is 'all or

nothing'.

The Best to You

and Yours!

Jon in Nevada

In a message

dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo

rtyahoogroups (DOT) com writes:

Posted

by: " Kathy Meade " mailto:kmeadelist@

aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research%

20from%20a% 20blog merrywidow225

Fri

Nov 21, 2008 4:23 am (PST)

You should be

aware of discussions like this that are going on now. If you

have a problem with this type of discussion with the potential outcome of

limiting payment for treatments then patients need to get involved now

before changes happen. Patients need to be at meetings like this to speak

about the value of QOL. Now is the time to get involved before coverage's

are limited.

Kathy

************ *******

Steve does do cost-benefit analysis, and used as one of his examples a study

his group did on the cost-effectiveness of IMRT (Intensity Modulated

Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation

therapy - old way) for treating prostate cancer. The old way does lead, on

occasion, to proctitis (bowel inflammation) in some patients, while the new

way can reduce the likelihood of this side effect. Proctitis is

uncomfortable, but pretty treatable, and certainly not life threatening.

Check out smokin' hot deals on laptops, desktops and more from

Dell. Shop Deals

[Guest guest]

Fuller

That is how we feel because we get a different answer from everyone and no two results seem to be the same, we have not explored radiation because the urologists, who are surgeons seem to be in favor of surgery of course. We will join your group. Is proton beam therapy the same as cyber knife?debby theiler

Subject: Re: Comparative Effectiveness ResearchTo: ProstateCancerSupport Date: Sunday, November 23, 2008, 6:25 AM

Debbie,NO! It is NOT a "shot in the dark!"Treatments, including surgery, are improving with increased experience, techniques, and new drugs; and even combinations of different therapies.The trick is to find the most experienced and knowledgable specialist in prostate cancer. And one that "stays on top" of new developments.Having said all that, please do not neglect to look into proton beam radiation therapy if you are truly interested in a treatment that is as effective as any other with usually far less side effects, and when there are side effects, they are minimal.To find out more, join our group at:http://health. groups.yahoo. com/group/ protoninfo/FullerFuller> > From: Terry Herbert <ghenesh_49@ ...>> Subject: RE: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Date: Saturday, November 22, 2008, 9:33 PM> > > > > > > > > Jon,> > I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.> > No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.> > >

> > All the best> > Terry Herbert > I have no medical qualifications but I was diagnosed in `96: and have learned a bit since then. > My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za > Dr "Snuffy" Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"> > > > > > From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...> Sent: Sunday, 23 November 2008 3:06 AM> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> > > > > > > The problem I have with the example presented is that the only

criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.> > > > With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage

those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'. > > > > The Best to You and Yours!> > > > Jon in Nevada> > > > In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:> > > Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225 > Fri Nov 21, 2008 4:23 am (PST) > > You should be aware of discussions like this that are going on now. If you> have a problem with this

type of discussion with the potential outcome of> limiting payment for treatments then patients need to get involved now> before changes happen. Patients need to be at meetings like this to speak> about the value of QOL. Now is the time to get involved before coverage's> are limited.> > Kathy> > ************ *******> > Steve does do cost-benefit analysis, and used as one of his examples a study> his group did on the cost-effectiveness of IMRT (Intensity Modulated> Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation> therapy - old way) for treating prostate cancer. The old way does lead, on> occasion, to proctitis (bowel inflammation) in some patients, while the new> way can reduce the likelihood of this side effect. Proctitis is> uncomfortable, but pretty treatable, and certainly not life

threatening.> > > > > > > > Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals>

[Guest guest]

Fuller

That is how we feel because we get a different answer from everyone and no two results seem to be the same, we have not explored radiation because the urologists, who are surgeons seem to be in favor of surgery of course. We will join your group. Is proton beam therapy the same as cyber knife?debby theiler

Subject: Re: Comparative Effectiveness ResearchTo: ProstateCancerSupport Date: Sunday, November 23, 2008, 6:25 AM

Debbie,NO! It is NOT a "shot in the dark!"Treatments, including surgery, are improving with increased experience, techniques, and new drugs; and even combinations of different therapies.The trick is to find the most experienced and knowledgable specialist in prostate cancer. And one that "stays on top" of new developments.Having said all that, please do not neglect to look into proton beam radiation therapy if you are truly interested in a treatment that is as effective as any other with usually far less side effects, and when there are side effects, they are minimal.To find out more, join our group at:http://health. groups.yahoo. com/group/ protoninfo/FullerFuller> > From: Terry Herbert <ghenesh_49@ ...>> Subject: RE: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Date: Saturday, November 22, 2008, 9:33 PM> > > > > > > > > Jon,> > I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.> > No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.> > >

> > All the best> > Terry Herbert > I have no medical qualifications but I was diagnosed in `96: and have learned a bit since then. > My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za > Dr "Snuffy" Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"> > > > > > From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...> Sent: Sunday, 23 November 2008 3:06 AM> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> > > > > > > The problem I have with the example presented is that the only

criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.> > > > With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage

those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'. > > > > The Best to You and Yours!> > > > Jon in Nevada> > > > In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:> > > Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225 > Fri Nov 21, 2008 4:23 am (PST) > > You should be aware of discussions like this that are going on now. If you> have a problem with this

type of discussion with the potential outcome of> limiting payment for treatments then patients need to get involved now> before changes happen. Patients need to be at meetings like this to speak> about the value of QOL. Now is the time to get involved before coverage's> are limited.> > Kathy> > ************ *******> > Steve does do cost-benefit analysis, and used as one of his examples a study> his group did on the cost-effectiveness of IMRT (Intensity Modulated> Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation> therapy - old way) for treating prostate cancer. The old way does lead, on> occasion, to proctitis (bowel inflammation) in some patients, while the new> way can reduce the likelihood of this side effect. Proctitis is> uncomfortable, but pretty treatable, and certainly not life

threatening.> > > > > > > > Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals>

[Guest guest]

Fuller

That is how we feel because we get a different answer from everyone and no two results seem to be the same, we have not explored radiation because the urologists, who are surgeons seem to be in favor of surgery of course. We will join your group. Is proton beam therapy the same as cyber knife?debby theiler

Subject: Re: Comparative Effectiveness ResearchTo: ProstateCancerSupport Date: Sunday, November 23, 2008, 6:25 AM

Debbie,NO! It is NOT a "shot in the dark!"Treatments, including surgery, are improving with increased experience, techniques, and new drugs; and even combinations of different therapies.The trick is to find the most experienced and knowledgable specialist in prostate cancer. And one that "stays on top" of new developments.Having said all that, please do not neglect to look into proton beam radiation therapy if you are truly interested in a treatment that is as effective as any other with usually far less side effects, and when there are side effects, they are minimal.To find out more, join our group at:http://health. groups.yahoo. com/group/ protoninfo/FullerFuller> > From: Terry Herbert <ghenesh_49@ ...>> Subject: RE: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Date: Saturday, November 22, 2008, 9:33 PM> > > > > > > > > Jon,> > I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.> > No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.> > >

> > All the best> > Terry Herbert > I have no medical qualifications but I was diagnosed in `96: and have learned a bit since then. > My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za > Dr "Snuffy" Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"> > > > > > From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...> Sent: Sunday, 23 November 2008 3:06 AM> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> > > > > > > The problem I have with the example presented is that the only

criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.> > > > With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage

those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'. > > > > The Best to You and Yours!> > > > Jon in Nevada> > > > In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:> > > Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225 > Fri Nov 21, 2008 4:23 am (PST) > > You should be aware of discussions like this that are going on now. If you> have a problem with this

type of discussion with the potential outcome of> limiting payment for treatments then patients need to get involved now> before changes happen. Patients need to be at meetings like this to speak> about the value of QOL. Now is the time to get involved before coverage's> are limited.> > Kathy> > ************ *******> > Steve does do cost-benefit analysis, and used as one of his examples a study> his group did on the cost-effectiveness of IMRT (Intensity Modulated> Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation> therapy - old way) for treating prostate cancer. The old way does lead, on> occasion, to proctitis (bowel inflammation) in some patients, while the new> way can reduce the likelihood of this side effect. Proctitis is> uncomfortable, but pretty treatable, and certainly not life

threatening.> > > > > > > > Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals>

[Guest guest]

Debby,Think very carefully about the treatment plans. I do not know if you remember an ancient ad campaign "Investigate before you invest", but the principle is applicable here. I had robotic RP on Aug 6 08 and still have some incontinence and ED. Each of the radiation treatments MAY have a residual side effect. My Dad had IMRT and they literally burned his bladder out with too strong of a dose. I was dead set against it when I was diagnosed, but looked into it. I was told by the radiation and medical oncologists that they felt brachytherapy was not my best option. I asked about protons and got the deer in the headlight routine, so I researched it. I would have gone through the treatments had my insurance company approved it. The drawbacks were the limited places for treatment and

expense. I am just a preacher with limited income, so I could not afford it. I am a strong advocate of proton therapy and will continue to push here in Arkansas for at least one treatment facility in the state.Join Fuller's group and get your education on it.Steve S in ArkansasTo: ProstateCancerSupport Sent: Monday, November 24, 2008 7:04:18 AMSubject: Re:

Re: Comparative Effectiveness Research

Fuller

That is how we feel because we get a different answer from everyone and no two results seem to be the same, we have not explored radiation because the urologists, who are surgeons seem to be in favor of surgery of course. We will join your group. Is proton beam therapy the same as cyber knife?debby theiler

From: Fuller <cnsjonesyahoo (DOT) com>Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness ResearchTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, November 23, 2008, 6:25 AM

Debbie,NO! It is NOT a "shot in the dark!"Treatments, including surgery, are improving with increased experience, techniques, and new drugs; and even combinations of different therapies.The trick is to find the most experienced and knowledgable specialist in prostate cancer. And one that "stays on top" of new developments.Having said all that, please do not neglect to look into proton beam radiation therapy if you are truly interested in a treatment that is as effective as any other with usually far less side effects, and when there are side effects, they are minimal.To find out more, join our group at:http://health. groups.yahoo. com/group/ protoninfo/FullerFuller> > From: Terry Herbert <ghenesh_49@ ...>> Subject: RE: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Date: Saturday, November 22, 2008, 9:33 PM> > > > > > > >

> Jon,> > I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.> > No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.> > >

> > All the best> > Terry Herbert > I have no medical qualifications but I was diagnosed in `96: and have learned a bit since then. > My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za > Dr "Snuffy" Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"> > > > > > From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...> Sent: Sunday, 23 November 2008 3:06 AM> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> > > > > > > The problem I have with the example presented is that the only

criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.> > > > With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage

those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'. > > > > The Best to You and Yours!> > > > Jon in Nevada> > > > In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:> > > Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225 > Fri Nov 21, 2008 4:23 am (PST) > > You should be aware of discussions like this that are going on

now. If you> have a problem with this

type of discussion with the potential outcome of> limiting payment for treatments then patients need to get involved now> before changes happen. Patients need to be at meetings like this to speak> about the value of QOL. Now is the time to get involved before coverage's> are limited.> > Kathy> > ************ *******> > Steve does do cost-benefit analysis, and used as one of his examples a study> his group did on the cost-effectiveness of IMRT (Intensity Modulated> Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation> therapy - old way) for treating prostate cancer. The old way does lead, on> occasion, to proctitis (bowel inflammation) in some patients, while the new> way can reduce the likelihood of this side effect. Proctitis is> uncomfortable, but pretty treatable, and certainly not life

threatening.> > > > > > > > Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals>

[Guest guest]

Debby,Think very carefully about the treatment plans. I do not know if you remember an ancient ad campaign "Investigate before you invest", but the principle is applicable here. I had robotic RP on Aug 6 08 and still have some incontinence and ED. Each of the radiation treatments MAY have a residual side effect. My Dad had IMRT and they literally burned his bladder out with too strong of a dose. I was dead set against it when I was diagnosed, but looked into it. I was told by the radiation and medical oncologists that they felt brachytherapy was not my best option. I asked about protons and got the deer in the headlight routine, so I researched it. I would have gone through the treatments had my insurance company approved it. The drawbacks were the limited places for treatment and

expense. I am just a preacher with limited income, so I could not afford it. I am a strong advocate of proton therapy and will continue to push here in Arkansas for at least one treatment facility in the state.Join Fuller's group and get your education on it.Steve S in ArkansasTo: ProstateCancerSupport Sent: Monday, November 24, 2008 7:04:18 AMSubject: Re:

Re: Comparative Effectiveness Research

Fuller

That is how we feel because we get a different answer from everyone and no two results seem to be the same, we have not explored radiation because the urologists, who are surgeons seem to be in favor of surgery of course. We will join your group. Is proton beam therapy the same as cyber knife?debby theiler

From: Fuller <cnsjonesyahoo (DOT) com>Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness ResearchTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, November 23, 2008, 6:25 AM

Debbie,NO! It is NOT a "shot in the dark!"Treatments, including surgery, are improving with increased experience, techniques, and new drugs; and even combinations of different therapies.The trick is to find the most experienced and knowledgable specialist in prostate cancer. And one that "stays on top" of new developments.Having said all that, please do not neglect to look into proton beam radiation therapy if you are truly interested in a treatment that is as effective as any other with usually far less side effects, and when there are side effects, they are minimal.To find out more, join our group at:http://health. groups.yahoo. com/group/ protoninfo/FullerFuller> > From: Terry Herbert <ghenesh_49@ ...>> Subject: RE: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Date: Saturday, November 22, 2008, 9:33 PM> > > > > > > >

> Jon,> > I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.> > No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.> > >

> > All the best> > Terry Herbert > I have no medical qualifications but I was diagnosed in `96: and have learned a bit since then. > My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za > Dr "Snuffy" Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"> > > > > > From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...> Sent: Sunday, 23 November 2008 3:06 AM> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> > > > > > > The problem I have with the example presented is that the only

criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.> > > > With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage

those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'. > > > > The Best to You and Yours!> > > > Jon in Nevada> > > > In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:> > > Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225 > Fri Nov 21, 2008 4:23 am (PST) > > You should be aware of discussions like this that are going on

now. If you> have a problem with this

type of discussion with the potential outcome of> limiting payment for treatments then patients need to get involved now> before changes happen. Patients need to be at meetings like this to speak> about the value of QOL. Now is the time to get involved before coverage's> are limited.> > Kathy> > ************ *******> > Steve does do cost-benefit analysis, and used as one of his examples a study> his group did on the cost-effectiveness of IMRT (Intensity Modulated> Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation> therapy - old way) for treating prostate cancer. The old way does lead, on> occasion, to proctitis (bowel inflammation) in some patients, while the new> way can reduce the likelihood of this side effect. Proctitis is> uncomfortable, but pretty treatable, and certainly not life

threatening.> > > > > > > > Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals>

[Guest guest]

Debby,Think very carefully about the treatment plans. I do not know if you remember an ancient ad campaign "Investigate before you invest", but the principle is applicable here. I had robotic RP on Aug 6 08 and still have some incontinence and ED. Each of the radiation treatments MAY have a residual side effect. My Dad had IMRT and they literally burned his bladder out with too strong of a dose. I was dead set against it when I was diagnosed, but looked into it. I was told by the radiation and medical oncologists that they felt brachytherapy was not my best option. I asked about protons and got the deer in the headlight routine, so I researched it. I would have gone through the treatments had my insurance company approved it. The drawbacks were the limited places for treatment and

expense. I am just a preacher with limited income, so I could not afford it. I am a strong advocate of proton therapy and will continue to push here in Arkansas for at least one treatment facility in the state.Join Fuller's group and get your education on it.Steve S in ArkansasTo: ProstateCancerSupport Sent: Monday, November 24, 2008 7:04:18 AMSubject: Re:

Re: Comparative Effectiveness Research

Fuller

That is how we feel because we get a different answer from everyone and no two results seem to be the same, we have not explored radiation because the urologists, who are surgeons seem to be in favor of surgery of course. We will join your group. Is proton beam therapy the same as cyber knife?debby theiler

From: Fuller <cnsjonesyahoo (DOT) com>Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness ResearchTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, November 23, 2008, 6:25 AM

Debbie,NO! It is NOT a "shot in the dark!"Treatments, including surgery, are improving with increased experience, techniques, and new drugs; and even combinations of different therapies.The trick is to find the most experienced and knowledgable specialist in prostate cancer. And one that "stays on top" of new developments.Having said all that, please do not neglect to look into proton beam radiation therapy if you are truly interested in a treatment that is as effective as any other with usually far less side effects, and when there are side effects, they are minimal.To find out more, join our group at:http://health. groups.yahoo. com/group/ protoninfo/FullerFuller> > From: Terry Herbert <ghenesh_49@ ...>> Subject: RE: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Date: Saturday, November 22, 2008, 9:33 PM> > > > > > > >

> Jon,> > I certainly think your idea has merit, but the big drawback would

be in dealing with the side effects that often accompany new treatments until they are tested and, perhaps, modified. I have read some of the early studies on HIFU in Europe and it is clear that in the early days the levels of urinary problems was very high indeed. It seems these were associated with the sloughing of material from the bladder following collateral damage caused by overheating, or perhaps over-shooting the intended treatment area. Insurers would presumably have to pick up costs associated with such side effects on the basis that they would meet the costs of similar side effects from, say, radiation therapy.> > No doubt a way could be found around such issues to encourage the safe development of new treatments, but there would certainly be risks and costs involved that would be difficult for an insurer to assess without adequate data.> > >

> > All the best> > Terry Herbert > I have no medical qualifications but I was diagnosed in `96: and have learned a bit since then. > My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za > Dr "Snuffy" Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"> > > > > > From: ProstateCancerSuppo rtyahoogroups (DOT) com [mailto:ProstateCan cerSupport@ yahoogroups. com] On Behalf Of ccnvw@...> Sent: Sunday, 23 November 2008 3:06 AM> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Subject: [ProstateCancerSupp ort] Re: Comparative Effectiveness Research> > > > > > > The problem I have with the example presented is that the only

criteria given for 'cost effectiveness" was that 3D conformal radiation had a higher risk of procritis than IMRT. Nothing was said about the relative effectiveness on treating prostate cancer. And, other potential effects of the larger 3D conformal radiation field were not mentioned. Like so many aspects of our disease, the results of a 'cost effectiveness' analysis depends so much on the assumptions and parameters of the study.> > > > With respect to insurance companies and Medicare limiting payments, seems to me that an effective alternative would be to not deny payment for new more expensive treatments such as Cyberknife because there is insufficient data on relative effectiveness but rather limit payment to the level of payment for 'approved' treatments. That way there would be equal cash subsidy for the new treatments to encourage

those who can afford the difference to pursue the new treatments, thereby building up case histories for evaluation of effectiveness. It also would be an incentive for the purveyers of the new technologies to try and reduce costs. The way it is now is 'all or nothing'. > > > > The Best to You and Yours!> > > > Jon in Nevada> > > > In a message dated 11/22/2008 1:15:19 AM Pacific Standard Time, ProstateCancerSuppo rtyahoogroups (DOT) com writes:> > > Posted by: "Kathy Meade" mailto:kmeadelist@ aec225.com? Subject= Re%3AComparative% 20Effectiveness% 20Research% 20from%20a% 20blog merrywidow225 > Fri Nov 21, 2008 4:23 am (PST) > > You should be aware of discussions like this that are going on

now. If you> have a problem with this

type of discussion with the potential outcome of> limiting payment for treatments then patients need to get involved now> before changes happen. Patients need to be at meetings like this to speak> about the value of QOL. Now is the time to get involved before coverage's> are limited.> > Kathy> > ************ *******> > Steve does do cost-benefit analysis, and used as one of his examples a study> his group did on the cost-effectiveness of IMRT (Intensity Modulated> Radiation Therapy - new way) vs. 3D-CRT (3-dimensional conformal radiation> therapy - old way) for treating prostate cancer. The old way does lead, on> occasion, to proctitis (bowel inflammation) in some patients, while the new> way can reduce the likelihood of this side effect. Proctitis is> uncomfortable, but pretty treatable, and certainly not life

threatening.> > > > > > > > Check out smokin' hot deals on laptops, desktops and more from Dell. Shop Deals>

[Guest guest]

debby theiler wrote:

> Is proton beam therapy the same as cyber knife?

I didn't notice whether anyone has answered this yet.

The answer is No. Cyberknife is the brand name of a particular

machine used for delivering x-ray radiation under real-time

image guidance. I found a pretty good description of it at:

http://www.sdcyberknife.com/.

" x-rays " are electromagnetic waves, like radio waves or light

waves, but with a high frequency and therefore high energy. The

x-rays treat the cancer by elevating the energy levels of

electrons in the molecules in the tumors to the point that they

become unstable and " ionize " , damaging the biological function

of the molecules.

Proton beam therapy uses a stream of protons. Protons are

particles with a positive electric charge found in the nucleus

of all atoms. The effect of the protons on the molecules in the

tumor cells is similar to the effect of x-rays, but the

mechanism is different in that it is the mass and positive

charge of the particle, rather than the electromagnetic energy,

that ionizes the molecules.

Both techniques are very, very sophisticated, doing very precise

damage to the cancer while sparing surrounding tissue more

effectively than earlier forms of radiation. Both are very

effective at treating cancer.

I know the arguments that are made for one or the other of these

techniques and some other highly advanced radiation techniques,

but I'm not aware of solid evidence that one is more effective

than the others or has significantly fewer side effects.

If it were me, I'd want to be treated with one of the most

advanced techniques, but rather than choosing the specific

technique, I'd be more inclined to choose the people who I

thought were the best doctors - careful, highly experienced,

clearly concerned about the patient, willing to answer questions

patiently, and working in company with good staff and

facilities.

As many others have said and as scientific studies have shown,

it's the best doctors with the most experience that get the best

results.

Good luck.

Alan

[Guest guest]

debby theiler wrote:

> Is proton beam therapy the same as cyber knife?

I didn't notice whether anyone has answered this yet.

The answer is No. Cyberknife is the brand name of a particular

machine used for delivering x-ray radiation under real-time

image guidance. I found a pretty good description of it at:

http://www.sdcyberknife.com/.

" x-rays " are electromagnetic waves, like radio waves or light

waves, but with a high frequency and therefore high energy. The

x-rays treat the cancer by elevating the energy levels of

electrons in the molecules in the tumors to the point that they

become unstable and " ionize " , damaging the biological function

of the molecules.

Proton beam therapy uses a stream of protons. Protons are

particles with a positive electric charge found in the nucleus

of all atoms. The effect of the protons on the molecules in the

tumor cells is similar to the effect of x-rays, but the

mechanism is different in that it is the mass and positive

charge of the particle, rather than the electromagnetic energy,

that ionizes the molecules.

Both techniques are very, very sophisticated, doing very precise

damage to the cancer while sparing surrounding tissue more

effectively than earlier forms of radiation. Both are very

effective at treating cancer.

I know the arguments that are made for one or the other of these

techniques and some other highly advanced radiation techniques,

but I'm not aware of solid evidence that one is more effective

than the others or has significantly fewer side effects.

If it were me, I'd want to be treated with one of the most

advanced techniques, but rather than choosing the specific

technique, I'd be more inclined to choose the people who I

thought were the best doctors - careful, highly experienced,

clearly concerned about the patient, willing to answer questions

patiently, and working in company with good staff and

facilities.

As many others have said and as scientific studies have shown,

it's the best doctors with the most experience that get the best

results.

Good luck.

Alan

[Guest guest]

debby theiler wrote:

> Is proton beam therapy the same as cyber knife?

I didn't notice whether anyone has answered this yet.

The answer is No. Cyberknife is the brand name of a particular

machine used for delivering x-ray radiation under real-time

image guidance. I found a pretty good description of it at:

http://www.sdcyberknife.com/.

" x-rays " are electromagnetic waves, like radio waves or light

waves, but with a high frequency and therefore high energy. The

x-rays treat the cancer by elevating the energy levels of

electrons in the molecules in the tumors to the point that they

become unstable and " ionize " , damaging the biological function

of the molecules.

Proton beam therapy uses a stream of protons. Protons are

particles with a positive electric charge found in the nucleus

of all atoms. The effect of the protons on the molecules in the

tumor cells is similar to the effect of x-rays, but the

mechanism is different in that it is the mass and positive

charge of the particle, rather than the electromagnetic energy,

that ionizes the molecules.

Both techniques are very, very sophisticated, doing very precise

damage to the cancer while sparing surrounding tissue more

effectively than earlier forms of radiation. Both are very

effective at treating cancer.

I know the arguments that are made for one or the other of these

techniques and some other highly advanced radiation techniques,

but I'm not aware of solid evidence that one is more effective

than the others or has significantly fewer side effects.

If it were me, I'd want to be treated with one of the most

advanced techniques, but rather than choosing the specific

technique, I'd be more inclined to choose the people who I

thought were the best doctors - careful, highly experienced,

clearly concerned about the patient, willing to answer questions

patiently, and working in company with good staff and

facilities.

As many others have said and as scientific studies have shown,

it's the best doctors with the most experience that get the best

results.

Good luck.

Alan