Potential Disadvantages Of Proton Therapy
Depending on techniques compared, there may be disadvantages in dose distribution with proton therapy compared with IMRT. For example, Trofimov et al found that IMRT provided better conformality of the high-dose volume to the target than double-scattered proton therapy did. The average conformality index was 2.73 with IMRT and 3.11 with the double-scattered proton therapy plans . Similarly, in a comparison of IMRT to double-scattered proton therapy, Underwood et al found that IMRT provided better high-dose conformality than proton therapy did when evaluating prescription isodose lines. In addition, IMRT provided lower volumes of both rectum- and bladder-receiving doses in the range of V50 to V70 compared with double-scattered proton therapy. This shortfall of double-scattered proton therapy can be eliminated by using IMPT, which is a more refined delivery method of proton particles using PBS. Trofimov et al found that IMPT provided a better conformality index than IMRT did when delivering high-dose radiation therapy to the prostate.
Time Needed For Each Treatment
In general, a proton radiation treatment lasts about 15 to 30 minutes, starting from the time you enter the treatment room. The time will depend on the part of the body being treated and the number of treatments. It will also depend on how easily the team can see the tumor site with x-rays or CT scans during the positioning process.
Ask your health care team how long each treatment will take. Sometimes, the doctor will need to give treatment from different gantry angles. Ask your team if this will happen for your treatment. Find out if they will come back into the room during treatment to move the gantry or if the gantry will be rotated around you.
It is also important to know that total time in the treatment room may vary from day to day. This is because the doctor may target different areas that require other radiation âfields.â This may require using various kinds of proton beam segments. For example, one treatment may deliver a part of the total radiation dose to lymph nodes and healthy tissues around the tumor that may contain tiny amounts of tumor. Another treatment may deliver a radiation dose to the main tumor.
Other factors can also affect the total time needed, such as waiting for the proton beam to be moved after another personâs treatment is finished. Most proton treatment centers have only one proton machine.
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K Gold Earrings Price
Appropriate treatment, if necessary. Counseling with a dietitian. Development of lifestyle strategies, including diet modification and exercise recommendations. Access to prostate cancer clinical research trials. For appointments within 24 hours, call 844-323-1227..
Aerobic exercise, such as brisk walking, jogging, and swimming. This kind of exercise burns calories and helps you lose weight. Aerobic exercise also builds cardiovascular.
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Prostate Cancer Stages& Treatment
The stage of prostate cancer is one of the most important factors in selecting treatment. Depending on the stage, combined treatments of surgery, radial prostatectomy, brachytherapy, hormone therapy, chemotherapy and radiation therapy may be needed for some prostate tumors. Treatment options also are affected by the type of prostate cancer, age, overall health and personal preferences.
Communicate With Your Doctor
The most critical recommendation to reduce your risk is to keep in communication with your doctor. Your case is different from any other, and you deserve personalized treatment. These recommendations should adapt to your case, too. Thus, talk to your doctor and follow recommendations. If your doctor considers it appropriate to screen with PSA testing, talk about the pros and cons with him. And if you need treatment, discuss the benefits and drawbacks of your treatment options. Ask questions and inform yourself about prostate cancer and what to do about it.
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Reirradiation For Recurrent Cancer
For patients who develop local or regional recurrences after their initial radiation therapy, physicians are limited in their treatment options due to their reluctance to deliver additional photon radiation therapy to tissues that have already been irradiated. Re-irradiation is a potentially curative treatment option for patients with locally recurrent head and neck cancer. In particular, pencil beam scanning may be ideally suited for reirradiation. Research has shown the feasibility of using proton therapy with acceptable side effects, even in patients who have had multiple prior courses of photon radiation.
Controversies In Proton Therapy For Prostate Cancer
Curtis Bryant, Randal H. Henderson, Bradford S. Hoppe, William M. Mendenhall, R. Charles Nichols, Zhong Su, Zuofeng Li, Nancy P. Mendenhall
Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA
Contributions: Conception and design: C Bryant Administrative support: NP Mendenhall Provision of study materials or patients: C Bryant Collection and assembly of data: C Bryant Data analysis and interpretation: C Bryant Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to:
Keywords: Particle therapy genitourinary cancer
Submitted Jul 26, 2016. Accepted for publication Aug 03, 2016.
doi: 10.21037/cco.2016.08.02
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Questions To Ask Your Doctor Radiographer Or Nurse
- Will I have a planning session at a different time to the treatment, or immediately before?
- Will I have external beam radiotherapy or hormone therapy as well?
- What side effects might I get?
- How will we know if the treatment has worked?
- What should my PSA level be after treatment and how often will you test it?
- If my PSA continues to rise, what other treatments are available?
Positioning For Proton Beam Treatment
Positioning the body is very important. It can take several minutes for the team to adjust both you and the instruments to make sure the proton beam will reach the exact spot of the tumor.
While the treatment is happening, you must be very still on the table. The team will work with you to help keep you in place. For example, a custom-fitted mask can help those who are getting treatment for brain tumors. The mask is made of mesh that allows patients to see and breathe.
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Proton Vs Photon Radiation
Proton radiation is different from other types of radiation, which rely on photons. Photon radiation comes in three types: intensity-modulated radiation therapy , radioactive seed radiation , and stereotactic body radiation therapy . Sometimes a combination of brachytherapy in conjunction with one of the other types of beam radiation is used.
All types of radiation are effective, resulting in the death of cancer cells. All can potentially cause side effects if the radiation touches adjacent normal organs, such as the bladder, rectum, and urethra.
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Whats The Procedure Like
Since delivering the protons to the cancer cells is the goal of therapy, a lot of time is spent on positioning your body and adjusting the equipment before each session.
Youll have to remain perfectly still while the proton beam is delivered, but it will only take about 1 to 3 minutes. Its noninvasive, and you wont feel anything. Youll be able to leave right away and continue your normal activities.
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Why Choose Memorial Sloan Kettering For Proton Therapy
- MSK radiation oncologists have vast experience in using proton therapy. Over the last five years, our specialists have used proton therapy to treat more than 2,000 MSK patients with a range of cancers. This is far more than anyone else in the New York City region. MSKs radiation oncology group has been at the forefront of developing the treatment guidelines and training specialists at other institutions how to properly use protons.
- Patients at MSK are cared for by a multidisciplinary team of cancer experts which includes radiation oncologists, medical physicists, oncologists, and surgeons that is among the most experienced in the world. This team will ensure that each patient receives the optimal treatment for his or her unique case.
- The MSK radiation oncologists who will practice at NYPC specialize in each type of cancer that can be treated effectively with proton therapy.
- Our experts are currently using pencil beam scanning technology, which is the most advanced form of proton therapy delivery. Pencil beam scanning allows proton therapy to be delivered in the most-focused form, reducing exposure to nearby healthy tissues in some cases more than any other form of radiation. The New York Proton Center offers pencil beam scanning with the smallest diameter and highest precision.
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Who Are They Looking For
This study is looking for people who have been diagnosed with adenocarcinoma of the prostate within the last year. Only patients with early stage tumors will be accepted.
Patients with cancer spread beyond the prostate, who already underwent surgery, radiation therapy or chemotherapy cannot take part in this trial. Patients who received hormone therapy will also be excluded. Other conditions, such as autoimmune diseases , HIV infection, inflammatory bowel disease and previous hip replacement surgery also represent exclusion criteria.
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Comparative Studies Of Proton Therapy Versus Photon
Hoppe et al compared prospectively collected patient-reported QOL data for patients treated with proton therapy or photon radiation therapy for localized prostate cancer. The investigators analyzed prospective patient-reported QOL data from men with prostate cancer who received high-dose photon-based therapy through the PROST-QA study. Those patients were treated with IMRT and received doses between 75.6 and 79.2 Gy delivered at 1.8 to 2 Gy per fraction. Patients treated with proton therapy were from a single institution , and patient-reported outcomes were measured prospectively as well as after radiation therapy of 78 to 82 GyRBE delivered at 1.8 to 2 GyRBE per fraction. At 2 years of follow-up, there were no differences in EPIC bowel, urinary irritative/obstructive, or sexual summary scores between the 2 groups. On multivariate analysis, the patients treated with IMRT had significantly more moderate or big problems with rectal urgency and bowel frequency than did those treated with proton therapy.
Risk Factors And Prevention
Risk factors such as age, ethnicity, and family history have been known to influence the chances of a person developing prostate cancer. However, it should be noted that risk factors dont have a direct impact on the development of cancer.
Men over the age of 50 are more likely to develop prostate cancer. In fact, 80% of people who are diagnosed with prostate cancer are over the age of 65.
According to the CDC, African American men are more likely to be at risk for prostate cancer and are more likely to develop aggressive tumors. On the other hand, Caucasian men are just under the average rate of prostate cancer diagnoses. Likewise, Hispanic men also have a lower risk. People of Asian and Pacific Islander descent have the lowest risk of developing prostate cancer.
A family history of prostate cancer can also have an impact on your chances of developing cancer. Only 5% of prostate cancer cases are inherited, but up to 20% of cases are familial, meaning common lifestyle factors and shared genes may have had an influence on the development of cancer.
While risk factors dont have a direct impact on the development of prostate cancer, they can motivate you to monitor your lifestyle more closely. To lower your risk of developing prostate cancer, its recommended to eat a low-fat diet and exercise regularly. However, its best to monitor your health by receiving routine checkups and prostate screenings from your doctor.
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How Does Proton Therapy Work
Proton therapy uses a special machine called a cyclotron or synchrotron to accelerate protons. Protons are extracted from the particle accelerator and directed with magnetic fields directly to the tumor for proton therapy. The depth of penetration of the protons is related to their energy and can be precisely controlled to match the location of the tumor, limiting radiation exposure elsewhere.
Protons deliver most of their energy to a narrow volume within the body. This unique dose delivery property of protons is known as the Bragg Peak. We can manipulate the Bragg Peak region to deliver the desired radiation dose to the tumor itself without any exit dose beyond the tumor. Conventional external beam radiation therapy uses photons, also referred to as x-rays, that enter and exit through the body. The special properties of protons generally reduce the radiation dose to the normal tissues surrounding the treatment site.
To Cut Or Not To Cut: Radiation Vs Surgery For Prostate Cancer
Ishaan Sangwan Nov 16, 2021 5 hits
Since prostate cancer is a slow growing disease, the value of treatment is often questionable. While many patients can be managed with active surveillance, those who do require treatment often have radiation and surgery presented as their two options. This article discusses the risks and benefits of these two treatments, with unique insights from Dr. Jeff Caddedu on the BackTable Urology Podcast. Weve provided the highlight reel in this article, but you can listen to the full podcast below.
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Writing And Publishing Scientific Articles
Writing and Publishing Scientific Articles is an in-depth writing-education program designed primarily for postdoctoral fellows, clinical trainees, and novice authors. Now offered online, this series of six modules offers practical advice on writing the sections of a biomedical research manuscript.
Registration is required and is limited to 75 participants per module. Each module requires separate registration. The series will be repeated every few months.
What You Will Learn
- How to streamline the writing process and get around “writer’s block”
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- What to include and what not to include in each section
- Writing an effective title
- How to highlight the significance of your work and place it in the context of scientific knowledge
- How to make your article stand out with an effective abstract
Modules
- Cohesion and Clarity
Additional Information And Declarations
Conflicts of Interest: Nancy P. Mendenhall, MD, and William M. Mendenhall, MD, are Editor-in-Chief and Operating Editor, respectively, of the International Journal of Particle Therapy . Bradford S. Hoppe, MD, MPH, and Neha Vapiwala, MD, are IJPT Associate Editors. The authors have no additional conflicts of interest to disclose.
Funding: The authors have no funding to disclose.
Ethical Approval: This review did not involve human subjects or participants and was exempt from institutional review board approval.
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Treatment Options For Prostate Cancer
Early-stage prostate cancer is often slow-growing. Here, it is hard to balance treatment benefits against its side effects. Therefore, delaying treatment until there is evidence of cancer progression is one way to avoid unnecessary side effects.
In some cases, a doctor may recommend watchful waiting or active surveillance to avoid unnecessary treatments.
Proton Therapy Treatment For Prostate Cancer Patients
Proton therapy is a form of radiation treatment for cancer patients. Also called proton beam therapy, proton therapy involves focusing proton particles into a beam, which is then delivered to the cancer cells in a non-surgical procedure. The positively charged particles can be controlled to stop at the tumor site, enabling the cancerous tissues to be destroyed with high levels of radiation without causing damage to nearby healthy tissue and vital organs. Proton therapy is considered more precise than other types of radiation therapy. It is also non-surgical, non-invasive, and has minimal side effects. Proton therapy treatment requires little to no recovery time, and the radiation has very little impact on a patients energy level compared to other cancer treatment options.
Proton therapy exhibits higher success rates in prostate cancer patients.
According to a study published by the University of Florida, prostate cancer patients who received proton therapy treatment were found to be free of cancer progression for five years after their treatment. Patients with low to medium risk prostate cancer experienced a success rate of 99%, while those with high risk prostate cancer experienced a success rate of 76%.
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Proton Therapy Has Proven Clinical Results
Unlike X-ray radiation from traditional treatments like IMRT, TomoTherapy, and Cyberknife, protons can be stopped inside the tumor, which can lower the exposure to excess radiation to the bladder, rectum, and other healthy tissue. This reduces the risk of side effects such as erectile dysfunction and incontinence. The painless and noninvasive nature of proton therapy will allow you to continue on with an active lifestyle throughout treatment. Proton therapy also has a higher overall survival outcome compared to traditional radiation treatment in some instances.
- REDUCTION IN URINARY-, SEXUAL- AND BLADDER-RELATED SIDE EFFECTS
- % INCREASE IN SURVIVAL WHEN COMPARED TO IMRT FOR INTERMEDIATE RISK PROSTATE CANCER
- % CANCER FREE AT 5.5 YEARS*
Delivery Of Postprostatectomy Radiation Therapy
Postprostatectomy radiation therapy is indicated in the adjuvant or salvage setting after surgery, depending on the pathologic risk factors of recurrence after surgery. With conventional radiation therapy doses, biochemical disease control is achieved in only 50% to 60% of patients requiring radiation therapy as salvage treatment for prostate-specific antigen progression after prostatectomy . Meanwhile, tumor control probability curves have consistently shown that doses > 70 Gy when delivering conventional fractionation may be needed to prevent recurrence or progression of prostate cancer . Proton therapy may offer the potential for safe dose escalation in this setting. Deville et al recently reported outcomes for patients treated with proton therapy to the prostate bed after prostatectomy. Patients were treated to 70.2 GyRBE at 1.8 GyRBE per fraction. The median follow-up was 55 months. The 5-year biochemical relapse-free survival rate was 56%. Toxicity was not reported. Additional studies will soon be reported evaluating the outcomes after adjuvant and salvage proton therapy for prostate cancer. These studies along with the findings of Deville et al will further inform the medical community on the role of postprostatectomy proton therapy.
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