Entrance And Exit Dose Defined
Entrance dose: The dose of radiation that inadvertently makes contact with normal cells before it reaches the cancerous tissue.
Exit dose: Imagine the radiation hitting the tumor, but then continuing on beyond it, taking out normal cells in its path.
The primary difference between proton therapy and Cyberknife is that protons do not have an exit dose, says Dr. Cavanaugh. Both modalities deliver entrance and target dose.
Many insurers have been unimpressed with the differences in outcomes with proton therapy and have declined to pay.
For many patients I prefer HDR brachytherapy to both proton and Cyberknife therapy. HDR stands for high dose rate.
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.
Exams For Women Who Have Had A Hysterectomy
If youve have had a hysterectomy, but have not had cervical cancer or severe cervical dysplasia, you should:
- Speak with your doctor about whether you should continue screening if your hysterectomy included removal of the cervix.
- Get a Pap test and HPV test every five years if your hysterectomy didnt include removal of the cervix.
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.
Who Can I Contact If I Have Personal Concerns About My Treatment
Many hospitals and clinics have a staff social worker who can help you during your treatment. Check with your doctor to see if this is available to you.
The social worker can discuss any emotional issues or other concerns about your treatment or your personal situation and provide information about resources. The social worker can also discuss housing or transportation needs if necessary.
People dealing with certain medical issues find it helpful to share experiences with others in the same situation. Your doctor can provide a list of support groups if you are interested. Your social worker can provide additional information, and you can look online for support group resources.
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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”
- How to structure each section of your article for maximum impact
- How to build your article around effective hypothesis or purpose statements
- How to use the “funnel” technique to introduce your study
- 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
- Cohesion and Clarity
Exams For Women Whove Had Cervical Cancer
If youve had cervical cancer, you need a different plan to check for cancer recurrence.
Print and share MD Andersons cervical cancer survivorship chart with your doctor. Your doctor can use this chart to develop a more tailored plan for you.
The screening plans on this page apply to women expected to live for at least 10 years. Theyre not for women who have a health condition that may make it hard to diagnose or treat cervical cancer.
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How Does External Beam Radiation Therapy Work
External beam radiation therapy, or EBRT, uses a machine to direct high-energy X-rays at the cancer in daily doses. The radiation beam is generated by a machine called a linear accelerator or LINAC. Using treatment planning computers and software, your treatment team controls the size and shape of the beam as well as how it is directed at your body to most effectively treat your tumor and minimize damage to surrounding normal tissue.
To minimize side effects, the treatments are typically given five days a week over a six-to-nine week period. The break in days allows the doctors to get enough radiation into the body to kill the cancer while giving healthy cells time to recover.
Watch our expert medical oncologist, Dr. Alicia Morgans from Vanderbilt-Ingram Cancer Center, discuss external beam radiation therapy:
Ocular Cancers & Other Eye Conditions
Due to the unique physical characteristics of proton beams, proton therapy is clinically advantageous compared to standard radiation therapy when treating ocular cancers and other eye conditions such as macular degeneration. Because of the location of the eye in relation to the optic nerve and surrounding brain tissue, proton therapy can limit harmful radiation doses to these critical structures and organs.
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Recovery From Proton Therapy
After being treated with the proton beam, most people can go home and resume their activities. For certain tumors, your doctor might order tests to see how the treatment is affecting the tumor, and adjust your treatment if necessary.
The Johns Hopkins Proton Therapy Center
Located at Sibley Memorial Hospital in Washington, D.C., our center combines advanced proton therapy technology, the latest research and caring specialists who provide tailored treatments for a variety of adult and pediatric cancers.
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Pioneers Of Proton Therapy
Working with the Harvard Cyclotron Laboratory , Mass General physicians became the first in the world to discover how to harness the extraordinary physical characteristics of high energy protons for medical care. By using protons rather than conventional x-rays , physicians could increasingly concentrate radiation energy in tumors and intended targets, reducing radiation dose and damage to nearby healthy tissue.
As part of the largest hospital-based research program in the country, we have led, and continue to lead, many studies to define the best use of proton therapy for clinical care. Learn more about our groundbreaking proton therapy research.
External Beam Radiation Therapy
In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.
You will usually go for treatment 5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given. Each treatment is much like getting an x-ray. The radiation is stronger than that used for an x-ray, but the procedure typically is painless. Each treatment lasts only a few minutes, although the setup time getting you into place for treatment takes longer.
Newer EBRT techniques focus the radiation more precisely on the tumor. This lets doctors give higher doses of radiation to the tumor while reducing the radiation exposure to nearby healthy tissues.
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Proton Therapy For Prostate Cancer: Side Effects
Many patients experience fewer side effects from proton therapy for prostate cancer than from traditional radiation. When side effects do occur, they may be less severe but can last several weeks or months after treatment. They include:
- Bladder irritation
- Feeling of the need to urinate or have a bowel movement often or urgently
- Skin irritation at the radiation beam entry point
Other side effects that can occur after proton therapy for prostate cancer may not show up right away. These long-term effects include:
- Erectile dysfunction
- Rectal bleeding
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Obesity And Dietary Habits
High-fat intake, the Western diet, obesity, and sedentary behavior are all associated with a higher incidence of prostate cancer. High calcium intake and a diet high in milk products can increase the risk. After being diagnosed with prostate cancer, calcium can increase the risk of aggressive types. On the other hand, whole milk increases the risk of recurrence of prostate cancer. Obese and overweight men are particularly prone to this increase in recurrence. Another dietary risk factor is vitamin D insufficiency. Meat consumption increases cancer risk, while fish consumption lowers the mortality rate.
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How Can I Request Someone To Serve As My Advocate
At registration, every patient is assigned a patient advocate whoserves as a liaison between the patient and MD Anderson. Patientadvocates provide an opportunity in a confidential setting to voice acomplaint, concern or problem, or to seek a resolution. They alsoprovide information about resources and services available to patientsand families, as well as education about patient rights and responsibilities.
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What Are The Pros And Cons Of Proton Therapy For Cancer
The pros of proton therapy for cancer include that it is more accurate than alternative treatments and less likely to cause damage to surrounding tissues. Proton therapy also can be precisely targeted to the exact depth of the tumor, minimizing damage to other parts of the body. The treatment can cause the same side effects as other forms of radiation treatment, however, and also is expensive.
One of the main advantages of proton therapy is that it has a lower chance of causing severe side effects than other forms of therapy. This is because protons are larger and heavier than the particles used in other types of radiation therapy. The larger mass means the protons dont scatter into other parts of the body as much, reducing collateral damage to surrounding tissue.
It also is easier to target protons to tissue of a certain depth. If other types of radiation are used, such as X-rays, it is difficult to get the radiation to stop at the precise depth of the cancer. This means the radiation continues on and can affect other parts of the body. The energy of protons, on the other hand, can be adjusted so most cant penetrate any farther than required.
Possible Side Effects Of Ebrt
Some of the side effects from EBRT are the same as those from surgery, while others are different.
Bowel problems: Radiation can irritate the rectum and cause a condition called radiation proctitis. This can lead to diarrhea, sometimes with blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases normal bowel function does not return. To help lessen bowel problems, you may be told to follow a special diet during radiation therapy to help limit bowel movement during treatment. Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum.
Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Urinary problems usually improve over time, but in some men they never go away.
Some men develop urinary incontinence after treatment, which means they cant control their urine or have leakage or dribbling. As described in the surgery section, there are different levels and types of incontinence. Overall, this side effect occurs less often with radiation therapy than after surgery. The risk is low at first, but it goes up each year for several years after treatment.
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Proton Therapy Vs Other Prostate Cancer Treatments
Is proton therapy superior to hormone therapy or chemotherapy? The answer might not be that simple because it depends on what you need.
Each treatment method has its pros and cons. They also have specific applications, and using them or not in a determined patient depends on comprehensive studies that evaluate what works better for most.
However, for educative purposes, lets make a brief comparison between proton therapy and other prostate cancer treatments:
External Beam Radiation For Prostate Cancer
When most patients think of radiation therapy, they think of external beam radiation therapy , in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.
EBRT used to require 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.
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Common Types Of Prostate Cancer
The majority of prostate cancer diagnoses involve adenocarcinomas, or cancers which develop immediately within the gland cells. It is possible to develop other types of prostate cancer, including:
- Ductal adenocarcinoma begins in the ducts of the prostate gland
- Transitional cell cancer begins in the bladder and spreads to the urethra, prostate, and nearby tissues
- Squamous cell cancer begins in the flat cells of the prostate gland
- Small cell prostate cancer a type of neuroendocrine cancer made up of round, small cells
Additional types of prostate cancer such as sarcomas and carcinoid are considered extremely rare. Those who are diagnosed with prostate cancer are likely to have adenocarcinomas.
Consensus Statement On Proton Therapy For Prostate Cancer
Curtis M. Bryant, Randal H. Henderson, R. Charles Nichols, William M. Mendenhall, Bradford S. Hoppe, Carlos E. Vargas, Thomas B. Daniels, C. Richard Choo, Rahul R. Parikh, Huan Giap, Jerry D. Slater, Neha Vapiwala, William Barrett, Akash Nanda, Mark V. Mishra, Seungtaek Choi, Jay J. Liao, Nancy P. Mendenhall, the Genitourinary Subcommittee of the Particle Therapy Co-Operative Group Consensus Statement on Proton Therapy for Prostate Cancer. Int J Part Ther 1 September 2021 8 : 116. doi:
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Who Is A Good Candidate
In most cases, you will be a good candidate for proton therapy if you were initially offered radiotherapy as an option. Patients who receive radiotherapy usually have no problems being a candidate for proton treatment. They are usually patients in an early stage or those with localized prostate cancer. It is also useful to keep advanced cancer under control for as long as possible and treat recurrent prostate cancer cases.
However, some patients may not benefit from proton therapy if they have one of these problems :
- In patients with hip replacements, because proton beams often cant reach beyond the prosthesis. In some proton therapy centers, these patients can still get a session when a hip replacement is limited to one side. But bilateral replacement makes it impossible to treat the patient with proton beam therapy.
- In patients with advanced prostate cancer in which treating the pelvic lymph nodes is fundamental. Since proton beam radiation is less likely to reach other tissues than the prostate, it is not applicable when treating surrounding lymph nodes.
- In overweight patients, because the proton beam can only go through a determined depth. This depth depends on the beams energy, and some centers may have a higher energy device that solves the problem.
Proton Therapy: The Successful Treatment For Prostate Cancer You Should Be Getting
Prostate cancer is the second most common cancer in American men, behind only skin cancer. As of 2022, about one out of every eight men will be diagnosed with prostate cancer at some point during his lifetime. However, its rare for those who are younger than 40 to develop prostate cancer. Nearly six out of 10 prostate cancer patients are over the age of 65. In this article, well explain why proton therapy is an ideal treatment option for many prostate cancer patients.
The prostate surrounds the urethra and is located beneath the bladder. The gland secretes prostate fluid as one of the components for seminal fluid. Cancer begins to develop in the prostate when the cells of the gland begin to grow uncontrollably and form a malignant tumor. If left untreated, prostate cancer can spread to other parts of the body such as the bladder, rectum, bones, and lymph nodes, where it can become life-threatening.
Fortunately, modern medicine has made the survival rates of prostate cancer fairly high. The American Cancer Society reported in 2022 that more than 3.1 million Americans previously diagnosed with prostate cancer are still alive and well today.
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