Re: ProstRcision?

[Guest guest]

A paper produced last year pointed out

that there were about 200 definitions of failure. The definition used by

most radiologists now is what is termed as the Phoenix Definition - biochemical

failure should be defined as any increase of at least 2 ng/mL from the lowest

PSA reading. This replaced what was termed the ASTRO definition in about 2007.

I think you need to do a bit more reading.

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of VH

Sent: Saturday, 10 April 2010 3:07

PM

To:

ProstateCancerSupport

Subject:

ProstRcision?

Have any of you heard of this therapy? It's only offered in Georgia, and it

combines both external beam and seeds, at lower radiation levels. They

claim they have the best 10-year cure rate of ANY treatment. Their

definition of cure is a PSA of >.2. They go on to claim that the cure

rate of brachytherapy is only 30%!! Pat Walsh claims BT is comparable to

surgery... I find their claims very suspect, since it seems to be commonly

accepted that the cure rate with BT is measured by a doubling of baseline PSA,

not just by some magical PSA number. Any thoughts?

Best,

Van

From: Steve Jordan

<mycroftscj1>

To: ProstateCancerSupport

Sent: Fri, April 9, 2010 4:29:35

PM

Subject: Re:

High-dose brachytherapy?

> Have any of you had the high-dose brachytherapy? How did you elect that

> treatment, and how has it been for you? I've had 2 docs recommend the

> regular brachytherapy, but I just spoke with a doc's asst. who said most

> seeds are high-dose now...

It sounds to me as if the asst did not comprehend what was being

asked.

There are two forms of brachytherapy:

(1) Insertion of so-called (seeds) into the gland. These apply

radiation directly to the gland and such PCa cells as there are.

They eventually decline in radioctivity.

(2) Insertion through the perineum of highly-radioactive rods or

needles for a limited time over the course of a few days.

Details are found on the encyclopedic site of the Prostate Cancer

Research Institute. Specifically, here:

http://www.prostate-cancer.org/pcricms/node/359

Just about any PCa topic can be found on the PCRI site.

Regards,

Steve J

> Thank you in advance,

> Van

>

>

>

>

[Guest guest]

A paper produced last year pointed out

that there were about 200 definitions of failure. The definition used by

most radiologists now is what is termed as the Phoenix Definition - biochemical

failure should be defined as any increase of at least 2 ng/mL from the lowest

PSA reading. This replaced what was termed the ASTRO definition in about 2007.

I think you need to do a bit more reading.

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of VH

Sent: Saturday, 10 April 2010 3:07

PM

To:

ProstateCancerSupport

Subject:

ProstRcision?

Have any of you heard of this therapy? It's only offered in Georgia, and it

combines both external beam and seeds, at lower radiation levels. They

claim they have the best 10-year cure rate of ANY treatment. Their

definition of cure is a PSA of >.2. They go on to claim that the cure

rate of brachytherapy is only 30%!! Pat Walsh claims BT is comparable to

surgery... I find their claims very suspect, since it seems to be commonly

accepted that the cure rate with BT is measured by a doubling of baseline PSA,

not just by some magical PSA number. Any thoughts?

Best,

Van

From: Steve Jordan

<mycroftscj1>

To: ProstateCancerSupport

Sent: Fri, April 9, 2010 4:29:35

PM

Subject: Re:

High-dose brachytherapy?

> Have any of you had the high-dose brachytherapy? How did you elect that

> treatment, and how has it been for you? I've had 2 docs recommend the

> regular brachytherapy, but I just spoke with a doc's asst. who said most

> seeds are high-dose now...

It sounds to me as if the asst did not comprehend what was being

asked.

There are two forms of brachytherapy:

(1) Insertion of so-called (seeds) into the gland. These apply

radiation directly to the gland and such PCa cells as there are.

They eventually decline in radioctivity.

(2) Insertion through the perineum of highly-radioactive rods or

needles for a limited time over the course of a few days.

Details are found on the encyclopedic site of the Prostate Cancer

Research Institute. Specifically, here:

http://www.prostate-cancer.org/pcricms/node/359

Just about any PCa topic can be found on the PCRI site.

Regards,

Steve J

> Thank you in advance,

> Van

>

>

>

>

[Guest guest]

This sounds like “if something is

too good to be true…”. With that said, a combination of seeds

and radiation treatments was offered as a treatment option when I was first

diagnosed. I live in New York.

My urologist seemed to make it sound like it was a common thing to do. I

also feel a little uncomfortable choosing treatment options based on statistics

that sound like a sales pitch. My therapy choice was based on my scores, side

effects and how my doctors and I felt were my best chances of success.

I am not knocking any therapy or

combination of. Keep shopping and the correct choice will come to you.

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of VH

Sent: Saturday, April 10, 2010

1:07 AM

To:

ProstateCancerSupport

Subject:

ProstRcision?

Have any of you heard of this therapy? It's only offered in Georgia, and it

combines both external beam and seeds, at lower radiation levels. They

claim they have the best 10-year cure rate of ANY treatment. Their

definition of cure is a PSA of >.2. They go on to claim that the cure

rate of brachytherapy is only 30%!! Pat Walsh claims BT is comparable to

surgery... I find their claims very suspect, since it seems to be commonly

accepted that the cure rate with BT is measured by a doubling of baseline PSA,

not just by some magical PSA number. Any thoughts?

[Guest guest]

>

> Have any of you heard of this therapy? It's only offered in Georgia, and it

combines both external beam and seeds, at lower radiation levels. They claim

they have the best 10-year cure rate of ANY treatment.

I haven't heard of this myself. I wonder if it has actually been performed on a

large scale basis to even get a ten year history? Without knowing more it would

make sense that the two mode treatment would have better results than either

alone.

[Guest guest]

VH wrote:

> Have any of you heard of this therapy? It's only offered in

> Georgia, and it combines both external beam and seeds, at lower

> radiation levels. They claim they have the best 10-year cure

> rate of ANY treatment. Their definition of cure is a PSA of

> >.2. They go on to claim that the cure rate of brachytherapy

> is only 30%!! Pat Walsh claims BT is comparable to surgery...

> I find their claims very suspect, since it seems to be

> commonly accepted that the cure rate with BT is measured by a

> doubling of baseline PSA, not just by some magical PSA number.

> Any thoughts?

The website for ProstRcision is misleading, irritating, and

self-serving. In short, it's about like all the websites from

all of the prostate cancer treatment centers.

Perhaps the group in Georgia is the only group that calls their

treatment " ProstRcision " , but I can testify that a combination of

brachytherapy and external beam conformal radiation is available

*everywhere*. I was offered it in Baltimore and in Rockville,

MD, and I know you can get it in many, many places.

Is it better than all other approaches? I doubt it.

Is it as good as other approaches? I think it is. I think it's

one of the best for intermediate and high risk cancers, but

overkill for low risk cancers - for which plain old brachytherapy

may be just about as good. But there are other very good

treatments for high risk cancers - to the extent that any are

very good. As I understand it, the best treatments get maybe 50%

cure rates for high risk PCa. The problem with high risk PCa is

that it is highly possible that the cancer has escaped the

prostate before treatment, so no local treatment of the prostate

area can kill it.

The " cure " rate for brachytherapy is way higher than 30%, except

maybe for Gleason 8 and 9 cases. I believe that the " cure " rate

for brachy plus EBRT is way lower than 88% (claimed on the

website) for those same Gleason 8 and 9 cases. I suspect the

cure rate for brachy + EBRT is better than brachy alone for

intermediate and high risk, and I would expect it to be at least

equal to surgery because, more than surgery, it treats the area

around the prostate as well as the prostate itself - though

surgery has some benefits too.

Now having said all that, I have no reason to think that choosing

the group in Georgia offering you the treatment is a bad choice.

One advantage of them may be that, if they specialize in this

stuff and do a lot of it, they'll be more experienced than

surgeons or rad oncs who do a little of this, a little of that,

and oh yes, treat a dozen cases of prostate cancer each year.

I suggest you toss out the hype and interview the doctor who will

do your treatment. Has he done a lot of these? Is he caring?

Does he answer questions honestly and forthrightly? Is he

patient? If so, he may be a good choice. If not, you may be

able to find a better choice, maybe with the same treatment, or

maybe a different treatment that's just as good.

Good luck.

Alan

[Guest guest]

I tried to look into ProstRcision and RCOG. None of

the RO’s I spoke with at mainstream Cancer Centers held them in high

regard, but some of the guys they have treated seem to be near fanatic cult

like advocates for ProstRcision and Dr. Critz, the founder of RCOG. Apparently

they hold annual re-union seminars.

ProstRcision is a trademarked name for Simultaneous

Irradiation (SI) Brachytherapy + EBRT and it is sort of a small franchise. Dr

Critz seems to have been well regarded in the early development of modern

Brachytherapy (1990’s) and has published a number of articles. He

pioneered their current SI process in 1992 and presented a paper some ten year

later in 2003 to the American Urological Association. That presentation was

an update on their SI protocol to include some patients that had been treated

up to 10 years.

Of 1457 patients in this study, the number that had been

treated 10 years is not stated, nor is the staging of those “10 year”

patients, but it wouldn’t be very many. The Study’s overall

staging is T1T2NxM0 LOCALIZED PCa. The study indicates staging is

consistent with the 1992 criteria and all men were treated 5 or more year

ago. Localized PCa risk groups are reported as Low(50%), Inter(31%),

Hi(19%). Contact me if you would like a copy of this Study (which I couldn’t

find on the ProstRcison site – or much else they referenced).

The 10 year disease free cure rates they currently advertise

seem to be based on this old study and they go on to compare their results to

published studies that are also real old (hard to find) and are not reflective

of current treatment protocols.

Keep in mind that eight year old EBRT (IMRT, Proton) comparisons

are from an era when targeting was comparatively poor and limited to about 65Gy.

Today it is precisely targeted with IGRT at about 80Gy. It is hard to get

good 10 year data because the technology becomes obsolete in about half that

time. Mainstream Centers seem to be moving away from combo approaches like SI

since their studies have not shown it to be more effective than current mono-therapy

approaches.

Personally I am leery of treatment centers that ‘hawk’

their cure with dubious claims and discredit other protocols that are well

supported by major accredited Cancer Center, NIH, NCI, NCCN, ASTRO, AUA,

etc... Nevertheless ProstRcision is probably still a good approach for

Localized PCa – low and Intermediate risk groups (as is EBRT,

Brachytherapy, RP).