Proton therapy was: Comparative Effectiveness Research

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For a current look at proton therapy research click here.

Kathy

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of wonderwhatSent: Monday, November 24, 2008 8:16 AMTo: ProstateCancerSupport Subject: Re: Re: Comparative Effectiveness Research

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 Arkansas

From: debby theiler <debbylndrn1>To: 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]

Agreed and should look at both a survival benefit and also at SE's. BTW I am having difficulty deleting the bottom of the email so that people on digest do not have to see everything repeatedly. Sorry to those on digest.

Kathy

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of MetcalfSent: Monday, November 24, 2008 10:21 AMTo: ProstateCancerSupport Subject: Re: Proton therapy was: Comparative Effectiveness Research

The best trails would be comparative not placebo vs protons

B

[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>