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

[Guest guest]

Just so we are clear I have not have had ANY side effects with the Proton it is

my friends who went throught the IMRT / Lupron / Calypso that had the fatigue /

Voiding issues.

With the proton just some frequency but other than that A OK

> >

> > > 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

> >

>