Limitations Of The Studys Design
The study leaders and other experts noted several limitations to the studys design.
For instance, this observational study cant establish a cause-and-effect relationship between proton therapy and fewer side effects. In addition, all of the study participants were treated at a single institution, which can make it difficult to generalize the findings to a larger population.
Those are very significant limitations that shouldnt be understated, Dr. Buchsbaum emphasized.
Although single-institution studies have inherent limitations, Dr. Baumann noted, all patients in this study received high-quality treatment at a large academic medical center, regardless of whether it was proton or traditional radiation therapy, which suggests that the benefit of proton therapy that we saw is meaningful.
Also, because patients were not randomly assigned to treatment groups, there were differences between patients who got proton and traditional radiation, and that may have skewed the results.
For instance, patients who received proton therapy were, on average, older and had more health issues.
The proton therapy group may also have included more patients from privileged backgrounds, Drs. Park and Yu noted. Socioeconomic status and social support can affect treatment outcomes, they wrote.
In addition, fewer people with head and neck cancerwho are more likely to suffer from radiation-associated side effectswere included in the proton therapy group, the editorialists added.
An Alternative To Traditional Prostate Cancer Treatment
Proton radiation for prostate cancer delivers precise doses of radiation with a lower risk of side effects. The difference is in the protons themselves. Since physicians have greater control over the distribution of the proton radiation dose, higher, more effective doses can be used.
And since proton therapy lacks an exit dose, and has a lower entrance dose than conventional X-rays, damage to critical tissue near the prostate is reduced, potentially lessening the likelihood of prostate cancer side effects like impotence, incontinence and gastrointestinal disorders. The figure to the right demonstrates the difference in radiation dose distribution between a conventional IMRT plan on the bottom and a proton plan on the top.
As apparent, much less of the pelvis is exposed to radiation with the proton plan, likely leading to a lower risk of secondary cancers in prostate cancer survivors. Also apparent is a lower dose of radiation to the rectum, which may lead to a lower risk of rectal injury with proton therapy.
Proton Therapy For Brain Orbit And Head And Neck Cancers
For cancers of the brain, orbit and head and neck, proton therapy provides effective treatment while minimizing the radiation dose to vital structures. For brain cancer, proton therapy delivers high doses of radiation while protecting normal brain structures and minimizing impact on physical and mental function. For cancers of the head and neck, proton therapy minimizes the radiation dose to vital structures such as the brain, eyes, mouth and throat, which is important in reducing pain when swallowing so that patients can eat. For orbital tumors, proton therapy may significantly lower radiation dose to the ocular structures and optic nerve, improving vision preservation and limiting the impact on healthy tissues, such as the pituitary gland and brain, decreasing the risk of hormone deficiencies and neurocognitive impairment.
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The University Of Florida Health Proton Therapy Institute Is A World
From our first patient treated in 2006 to today, we are a regional resource for high-quality, effective proton therapy in Jacksonville, which is why thousands of patients trust us with their care.
We are on a mission to help patients in Jacksonville and around the world beat cancer and live life to the fullest.
what sets us apart:
an effective cancer treatment alternative
Proton therapy for cancer is an advanced form of radiation that uses protons, rather than X-rays. Protons can be precisely controlled, allowing our physicians to closely target your tumor and deliver powerful doses of radiation with:
- Less damage to healthy tissue
- Fewer side effects
- Low risk of secondary cancers
- Better quality of life during and after treatment
Is Proton Therapy Safer Than Traditional Radiation
Traditional radiation therapy delivers radiation to the tumor and to healthy tissues around the tumor. With proton therapy , the majority of the radiation is delivered to the tumor.
A type of radiation treatment called proton beam radiation therapy may be safer and just as effective as traditional radiation therapy for adults with advanced cancer. That finding comes from a study that used existing patient data to compare the two types of radiation.
Traditional radiation delivers x-rays, or beams of photons, to the tumor and beyond it. This can damage nearby healthy tissues and can cause significant side effects.
Plus, proton therapy is more expensive than traditional radiation, and not all insurance companies cover the cost of the treatment, given the limited evidence of its benefits. Nevertheless, 31 hospitals across the country have spent millions of dollars building proton therapy centers, and many advertise the potential, but unproven, advantages of the treatment.
In the new study, patients treated with proton therapy were much less likely to experience severe side effects than patients treated with traditional radiation therapy. There was no difference in how long the patients lived, however. The results were published December 26 in JAMA Oncology.
These results support the whole rationale for proton therapy, said the studys lead investigator, Brian Baumann, M.D., of the Washington University School of Medicine in St. Louis and the University of Pennsylvania.
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University Of Florida Health Proton Therapy Center
The five-year results of over 1,300 men treated at UF Health Proton Therapy Institute for prostate cancer were recently published in a peer-reviewed medical journal.1 As reported by UF researchers, the results revealed that the majority of these men are living cancer-free with minimal to no side effects. The five-year survival rates for low, intermediate, and high-risk prostate cancer are 99%, 94%, and 74% respectively with less than 1% having experienced any bowel issues and less than 3% having experienced any urinary issues.
Because of the comparatively low occurrence of side effects such as incontinence, impotence, and fatigue, prostate cancer patients receiving proton therapy are able to continue working, playing, and living relatively normal lives both during and after treatment. Thats why more and more patients with prostate cancer are choosing proton therapy.
What Is The Difference Between Proton Therapy And Sbrt Srs And Imrt
Depending on the number of treatments and the precision and intensity of radiation, radiation therapy has different names, including stereotactic radiosurgery , stereotactic body radiation therapy and intensity-modulated radiation therapy . Traditionally, these terms describe photon radiation. There are certain differences between these treatments and proton therapy:
- SRS and SBRT, such as gamma knife and CyberKnife therapy, use numerous photon radiation beams pointed at the tumor from many angles to combine their effect at the point of intersection. Proton therapy typically uses fewer beams that move to hit the tumor from different angles. Importantly, proton therapy concentrates radiation on the tumor and has a smaller exit dose than photon radiation.
- SRS is usually delivered in a single high-dose treatment, and is often used to treat brain tumors. Proton therapy usually takes multiple treatments, even for brain tumors.
- SBRT refers to treating tumors outside of the brain . The radiation is delivered in multiple high-dose treatments. The term SBRT can be used to describe photon or proton therapy.
- IMRT splits a single radiation beam into smaller beams of varying intensity, which makes it possible to target the radiation to the shape of the tumor and deliver it more precisely. IMPT is the equivalent of IMRT using proton therapy. IMPT has virtually no exit dose, and exposes less normal tissue to radiation than photon IMRT.
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Advisory On Coronavirus Disease 2019
Advisory On Coronavirus Disease 2019
We encourage all patients who are afflicted by upper respiratory symptoms which include coughing, wheezing, and shortness of breath along with a fever to please contact your Primary Care Physician. If you have an upcoming appointment at Terk Oncology and are experiencing any of those symptoms please contact our office at 904-520-6800 for further instructions before arriving to your appointment.
The best way to prevent illness is to avoid being exposed to the virus
- Wash your hands often with soap for at least 20 seconds
- Avoid close contact with people who are sick
- Practice social distancing
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In 2022 approxinately 268,490 men will be diagnosed with Prostate Cancer, making it one of the most common cancer in the United States.
With improvements in PSA screening and recent advances in non-surgical treatment, men experience an incredible treatment success rate of this disease and still maintain an excellent quality of life.
Our recent long-term studies have shown that at 10 years, more than 98% of men with early-stage prostate cancer can be successfully treated with a simple one-time out-patient prostate seed implant , results far superior to proton beam radiation, robotic surgery, and other treatment modalities.
How Proton Therapy Effectively Treats Prostate Cancer
Proton therapy treats prostate cancer with high doses of radiation that are more accurate, and potentially more effective, than traditional radiation. Our targeted proton beams focus most of their destructive energy at the tumor site, therefore causing less damage to healthy surrounding tissue as they enter the body. Because of this, proton therapy patients dont have to worry about many of the side effects and additional healthy tissue damage that is commonly associated with X-ray therapy.
an effective cancer treatment alternative
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What Happens During Proton Beam Treatment
Proton therapy is an outpatient procedure performed in a specialized center. Most patients are treated over a course of several sessions, and some treatments take longer than others. The proton treatment takes place in a special room equipped with a large mechanical arm called a gantry that moves the proton beam around you as you lie on a table.
During a proton therapy treatment session:
Open Radical Prostatectomy For Prostate Cancer
During a radicalretropubic prostatectomy, an incision is made in the lower abdomen to remove the entire prostate gland, some tissues and/or seminal vesicles. If there is a reasonable chance the cancer has spread outside of the prostate, your surgeon may perform a lymph node biopsy to test the area before continuing with the surgery as its unlikely it can be cured with surgery alone and the removal of the prostate could lead to other serious side effects. In a radical perineal prostatectomy operation, your surgeon will make an incision between the anus and scrotum to access the prostate. While this operation is shorter, may result in less pain and is an easier recovery, its more likely to lead to erection problems.
Often Recommended for:
- Stage 1 or stage 2 prostate cancer
Possible Side Effects of Open Radical Prostatectomy:
- Erectile dysfunction or sexual impotence
- Urinary incontinence
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What You Need To Know About The Prostate What Is The Success Rate Of Proton Therapy For Prostate Cancer
The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Proton Therapy Advantages And Disadvantages
Proton radiation may represent an incremental improvement over IMRT due to the reduced exposure of surrounding normal body tissues to radiation. Therefore, in the situations outlined above where IMRT would normally be considered, men may prefer to choose proton radiation over IMRT. The purported advantages of proton radiation over IMRT remain theoretical and clinically unproven. No head to head studies comparing the IMRT and proton radiation exist.
Disadvantages associated with proton radiation are related to its high cost and the fact that not all insurance programs cover proton radiation. In addition, there are relatively few centers doing proton radiation, so geographic inconvenience can be a major factor considering that numerous visits are required over a 5 to 9-week period.
Men considering treatment for prostate cancer need to do their homework. Side effects from radiation can be irreversible. The selection of optimal radiation varies with patient circumstances. Many factors need to be considered when radiation is contemplated.
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Who Can Have Permanent Seed Brachytherapy
On its own
Permanent seed brachytherapy on its own may be suitable for men with low risk localised prostate cancer. This is because the radiation from the radioactive seeds doesnt travel very far, so will only treat cancer that is still inside the prostate.
It may also be suitable for some men whose cancer has an intermediate risk of spreading.
With other treatments
If you have high risk localised prostate cancer, you may have brachytherapy together with external beam radiotherapy and hormone therapy. This is sometimes called a brachytherapy boost. Having these other treatments at the same time as permanent seed brachytherapy can help make the treatment more effective. But it can also increase the risk of side effects.
Some men with intermediate risk localised prostate cancer or locally advanced prostate cancer may be offered a brachytherapy boost.
When is permanent seed brachytherapy not suitable?
Permanent seed brachytherapy wont be suitable if your cancer has spread to other parts of your body .
It may not be suitable if you have a very large prostate. If you do have a large prostate you may be able to have hormone therapy before treatment to shrink your prostate.
Not all hospitals offer permanent seed brachytherapy. If your hospital doesnt do it, your doctor may refer you to one that does.
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Proton Therapy Achieves High Efficacy With A Shorter Course Of Treatment
Typically, proton therapy for prostate cancer is given over an eight-week period with 39 treatments. There is new evidence from the UF Health Proton Therapy Institute that a six-week, 28-treatment course of proton therapy is highly effective and achieves excellent prostate cancer patient outcomes.
The article, Five- and seven-year outcomes for image-guided moderately accelerated hypofractionated proton therapy for prostate cancer published in Acta Oncologica, details outcomes of the first 582 men treated between 2008 and 2015 on a prospective outcomes tracking trial at the UF Health Proton Therapy Institute for either low-risk or intermediate-risk prostate cancer. The study was led by principal investigator Randal Henderson, MD, MBA, Associate Medical Director of the UF Health Proton Therapy Institute and Professor of Radiation Oncology, University of Florida College of Medicine.
Notably, at five years after treatment, the rate of freedom from biochemical progression overall was 96.8%. At seven years after treatment, the rate was 95.2%. FFBP is measured by the level of prostate-specific antigen in the blood a persistently low PSA following treatment with no worrisome rise indicates there is no evidence of active prostate cancer at that time.
For low-risk prostate cancer patients, the FFBP rates at five- and seven-years were both 98.8%. For intermediate-risk prostate cancer patients, the FFBP rates at five- and seven-years were, respectively, 95.0% and 91.9%.
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What Side Effects Will I Have
During your treatment, radiation must pass through your skin. You may notice some skin changes in the area exposed to radiation. Your skin may become red, swollen, warm, and sensitive, as if you have a sunburn. It may peel or become moist and tender. Depending on the dose of radiation you receive, you may notice a loss of hair or decreased perspiration within the treated area.
These skin reactions are common and temporary. They will subside gradually within four to six weeks of completing treatment. If skin changes appear outside the treated area, inform your doctor or primary nurse.
Long-term side effects, which can last up to a year or longer after treatment, may include a slight darkening of the skin, enlarged pores, increased or decreased sensitivity of the skin, and a thickening of tissue or skin.
Another possible side effect is erectile dysfunction and urinary symptoms such as frequency, bleeding, or, rarely, incontinence. Keep these side effects in mind when considering your treatment options. If you have any concerns, donât hesitate to talk to your doctor about them.
Proton Therapy Versus Carbon Ion Therapy
Carbon ion radiotherapy is similar to proton therapy, except it uses carbon ions instead of protons. Carbon ions are heavier than protons, so they can deliver more radiation to the tumor and cause more damage to cancer cells. International research shows promising results in cancer survival rates with carbon ion therapy. However, there are presently no centers in the U.S. that offer CIRT.
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