Proton therapy - Was Re: Cryoablation-- a good, if not solid, bet?

[Guest guest]

Alan Brought up some good points, but all I can attest to is my experience.

First knowing 3 persons personally who went through IMRT and 1 who went through

Calypso - All 4 stated that Fatigue played a major role during treatmet with

increaded problems voiding. Post they had no real issues though the ones who

were on Lupron certainly felt the affects.

I for one after 20 treatements and with a couple of Alieve on Treatment day

don't feel a thing. Sex life normal, urination 95% same as befor treatment, play

golf, execercise drink my wine & have lived a normal life so far. Let us hope

its succesful and the long term effects are the same as the current and we are

all good.

Just my personal experience.

>

> > I am in the middle of Proton Therapy and so far no issues.

>

> > This was on just the other night regarding other uses for

> > proton where they state they need more data I believe they are

> > speaking to the data on brain tumors not prostate as it is well

> > into its second decade of use.

>

> > Great video though and I can personally attest to its ease of

> > being treated with hope that when its all said and done I am

> > cancer free.

>

> > http://www.cbsnews.com/video/watch/?id=6522160n

>

> That was an interesting video.

>

> As I understood the article citations posted here earlier, the

> biggest controversy over proton therapy involves prostate cancer,

> not pediatric cancers. The controversy is not over whether it's

> safe and effective, but whether it is any safer or more effective

> than x-ray radiation.

>

> Proton therapy does seem safe and effective for prostate cancer,

> but it costs more than x-rays, perhaps twice or even three times

> as much. What do you get for the extra cost?

>

> The idea behind proton therapy is that a very high percentage of

> the radiation energy is deposited in the target region, whereas

> with x-ray beams, a lot is deposited in healthy tissue in front

> of and behind the prostate target.

>

> All of that is true, but x-ray techniques are much better than

> they were 20 years ago. Brachytherapy puts radioactive seeds

> right in the target area and relatively little gets out of it. 3

> dimensional conformal radiation and it's many variants (e.g.,

> IMRT, IGRT, Cyberknife) use many different angles and intensities

> in order to be sure that the prostate gets much more radiation

> than any particular tissues outside it. Furthermore, for some

> patients, radiation is directed outside the prostate on purpose

> in order to treat the area around the prostate and the seminal

> vesicles - something that is done with x-rays even when protons

> are the main treatment modality for the prostate itself.

>

> Finally, some of the key side effects of radiation have nothing

> to do with damage to tissue outside the prostate, but with damage

> to the prostate itself. Impotence and urinary restrictions are

> both due to prostate radiation and, even in theory, proton

> radiation offers no advantages over x-radiation in that area.

> Both saturate the prostate with high energy radiation. Both kill

> of tissue inside the prostate and cause inflammation and damage.

> If they didn't, they wouldn't be effective.

>

> Prostate cancer is the bread and butter of proton radiation

> clinics. The number of prostate cancers is far greater than the

> number of other types of tumor for which proton radiation is

> essential - such as pediatric brain tumors and eye tumors. A

> couple of 150 million dollar proton centers would presumably be

> enough to treat all such tumors in the U.S. Spending another 1-2

> billion to build centers for treatment of prostate cancer may not

> be warranted if x-radiation clinics can be built for 10% or less

> of the cost. But now that we have so many proton centers, with

> more under construction, the hospitals and clinics are under

> great financial pressure to pay off the loans and pay operating

> expenses. The only way they can do that is by convincing

> prostate cancer patients to be treated with protons.

>

> As a patient, choosing proton therapy is a perfectly fine choice

> - if you have money or insurance to pay for it. If you don't,

> and you prefer radiation over surgery, then there are many x-ray

> modalities that should be equally fine choices. You can pick a

> good one from a good clinic and not be concerned that your chance

> of success or your side effects will be measurably worse.

>

> For the insurance companies and for Medicare however the

> situation is more complicated. Should they pay $100,000 for

> treatment when there is evidence that a $40,000 treatment will

> work just as well and be just as safe? Should premiums be raised

> on all patients to cover it? Is this an example of why costs of

> medical care are skyrocketing while results are not improving

> commensurately?

>

> A lot of insurance companies have doubts about the cost

> effectiveness of proton therapy for prostate cancer, but they

> haven't wanted to go through the battles to fight it. However as

> the number of PCa patients demanding proton therapy increases,

> the insurance company incentives to fight go up too.

>

> That is my understanding of the controversy.

>

> Alan

>