What Treatments Are Used In Focal Therapy For Localized Prostate Cancer
Focal therapy uses ablation, which is the use of extreme temperatures to destroy tissue. In focal ablation, the area of the prostate that contains the index lesion is targeted, rather than treating the entire prostate gland. Focal ablation techniques include:
- Cryotherapy: The use of very cold gases passed through needles to freeze and destroy cancer tissue.
- HIFU : The use of high-frequency sound waves directed at the tumor through an ultrasound probe inserted into the rectum. The high intensity waves cause the diseased tissue to heat up and die.
- : A drug called a photosensitizer is injected into the bloodstream. This drug then absorbs light rays directed at the tumor, and produces an active form of oxygen that destroys cancer cells.
- Laser ablation: The use of laser radiation energy pinpointed to a very small area to burn away cancerous tissue. Some laser ablation has the advantage of being able to be performed at the same time as magnetic resonance imaging , allowing very specific targeting and also real-time views of results.
What To Expect With Proton Therapy
The first step in your care is a consultation. During consultation, we review your medical history, perform a physical exam, decide if any additional tests are needed, discuss all radiation options that may be appropriate for your treatment plan, make recommendations, and answer questions.
Patients with prostate cancer typically undergo a minor procedure to place three small markers in the prostate, called fiducial markers. These markers allow the treatment team to accurately align the treatment each day to the location of the prostate. Your doctor will also determine if you are also eligible for placement of a special hydrogel between the prostate and rectum , which creates additional space between the prostate and the rectum to further reduce radiation exposure to the rectum and dissolves after a few months.
After placement of the markers , most patients return another day for a simulation or planning session. During this visit our radiation therapists will help position you the way you will be treated each day. A CT scan will be done to create a picture of you in the treatment position to design your radiation plan. Some patients also undergo an MRI during this visit to help identify the target for treatment. It normally takes 10 days for the team to design the proton treatment plan and perform the quality assurance checks before treatment begins.
How Proton Therapy Works
Proton therapy can treat prostate cancer precisely while lowering the risk for side effects during and after treatment.
Proton therapy uses charged particles rather than x-rays to destroy cancer cells. Protons can be focused directly on the tumor and stop at that target in the body. With extreme accuracy, proton therapy results in excellent rates of cancer control with a lower risk for side effects than other forms of radiation therapy.
The controlled delivery and dosage of proton energy allows direct, customized targeting of the tumor, for the maximum prescribed dosage of radiation. These characteristics of proton therapy can benefit the patient:
- Improved quality of life, during and after treatment, from greater precision in treating the tumor.
- Lower risk of side effects and impact to bodily functions, as unnecessary radiation to nearby healthy tissue and vital organs is prevented.
- Cancer in critical areas or close to organs and structures that could be damaged by radiation can be safely targeted and treated.
- Patients with cancer recurrence, who have previously been treated with radiation can often safely and effectively be retreated with proton therapy to achieve local control.
The physical properties of protons, described by the Bragg-Peak , and the increased conformality of pencil beam scanning to conform to the exact shape of the cancer, make it possible to spare healthy surrounding organs from exposure to unnecessary radiation.
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A Healthcare Actuarys Survey Of 100 Focal Laser Ablation Patients
Background:Until recently, newly diagnosed PCa patients often had an all or nothing choice. Assuming there was no evidence of spread outside the capsule, the patient was told that he could have either: definitive treatment, which includes prostatectomy or some type of radiation or Active Surveillance, which entails monitoring the situation indefinitely. For men with more aggressive PCa, the Option 1 would be suggested, perhaps in some combination with Androgen Deprivation Therapy. For patients who appear to have low risk factors including Gleason Score 6, Option 2 Active Surveillance might be considered.
What about men with low-to-intermediate risk? The Prostate Cancer Intervention Versus Observation Trial has showed no statistically significant improvement in longevity, based on 12 years follow-up. âThe chance of recurrence is significant according to the meta-analysis of 31,000+ prostate studies performed by the Prostate Cancer Results Study Group, chaired by Peter Grimm, DO, Seattle, WA.And there is almost certain reduction in Quality of Life due to risks of impotence, wearing pads and other side effects and complications. Clearly, Option1 is over-treatment for these men.
But what about Option 2? The Urologist is often not supportive, and there is fear that AS could lead to progression and metastasis. So, Option 2 is viewed by many as Under-treatment.
2) Patients are well educated, higher socio-economic group, and have low-to-intermediate risk
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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Choosing Your Treatment Options
Once your diagnostic tests are complete, we will know more about your condition. You may have:
- Clinically localized disease
- Rising PSA after treatment, such as surgery or radiation
- Metastatic disease
Each has different treatment goals and treatment options for best managing the disease.
We have deep experience in finding prostate cancer and helping our patients understand their options. Some risk factors mean you have a higher chance of developing prostate cancer. If youre worried about prostate cancer, contact our Bendheim Prostate Cancer Diagnostic Center. Through testing, they can tell you if you have the disease and your level of risk. MSK offers the following diagnostic tests:
- Blood tests for prostate-specific antigen levels
- Digital rectal examination
- Family history analysis
- Diagnostic imaging studies
If tests show you may have prostate cancer, our doctors can talk with you about your treatment options.
Welcome To Sperling Prostate Center
Our advanced diagnosis and treatment systems in Florida offer effectiveness and quality of life unattainable with conventional methods. Our patients experience minimal side effects, low recurrence rates, and virtually no risk of incontinence or impotence.
Our MRI-guided detection methods utilize the worlds most advanced 3T MRI system along with multiparametric software to create a vivid, 3D prostate map revealing a 360° view of the gland and any irregularities. This technology allows us to perform more accurate biopsies with up to 80% fewer needle samples than conventional biopsies.
Patients also have access to epigenetic screening that detects DNA changes associated with prostate cancer, making the biopsy more effective and conclusive.
If a tumor is detected, our prostate laser center offers a revolutionary focal laser therapy for prostate cancer that dramatically reduces the risk of impotence and incontinence associated with conventional treatments. This minimally-invasive outpatient procedure eradicates tumors in a single one hour treatment, leaving patients ready for everyday life by the next day. Focal laser therapy also offers a superior therapy for benign prostatic hyperplasia or BPH.
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What Is Proton Therapy
Proton therapy, also known as proton beam therapy, is a form of radiation treatment used to destroy tumor cells. Instead of using x-rays like regular radiation treatment, it uses protons to sends beams of high energy that can target tumors more precisely than X-ray radiation.
When treating a patient, doctors and physicists work together to focus the proton beam on the exact size and shape of the tumor. The beam kills the tumor cells layer by layer, sparing surrounding healthy tissue.
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How Is Proton Therapy Delivered
Proton therapy is delivered by a device called a cyclotron, which sends a high-energy beam of protons through the skin toward the tumor. At Memorial Sloan Kettering, the first step is a CT or MRI scan to map the tumor in three dimensions. Then our radiation oncologists, in close collaboration with medical physicists, use computer programs to calculate how to deliver the treatment at the precise dose and location.You will receive proton therapy in a special treatment room, where you will be positioned on a treatment table. An immobilization device will make sure you stay in the exact position on the table.
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Sperling Prostate Center Joins Mr
DELRAY BEACH, Fla., May 2, 2017 /PRNewswire-USNewswire/ â The Sperling Prostate Center is pleased to announce its participation as a new study site for a clinical study of MR-guided focused ultrasound for the focal treatment of localized low and intermediate risk prostate lesions. They are now recruiting patients.
The Sperling Prostate Center is a diagnosis and treatment center with locations in Florida and New York City. The Center is headed by Dan Sperling, M.D., D.A.B.R., a renowned expert in the use of Magnetic Resonance Imaging technology for the diagnosis and treatment of prostate lesions.
âWe are excited to join this study to evaluate MR-guided focused ultrasound as a non-invasive and non-radiation treatment option for prostate cancer patients who may currently be on watchful waiting or active surveillance,â states Dr. Sperling.
The multi-center FDA-approved clinical study is sponsored by INSIGHTEC, the developer and manufacturer of the Exablate Prostate system.
The Exablate Prostate system is based on INSIGHTECâs proven MRI-guided focused ultrasound technology which received its CE mark in December 2016. It uses focused ultrasound waves to precisely ablate the identified prostate lesion. The treatment is done under MRI for visualization of the patientâs anatomy as well as real-time temperature monitoring. The treatment does not require incisions and is performed in a single session, allowing patients to quickly return to normal activity.
Effectiveness And Toxicity: Reviewing The Literature
Although PBT has generated much enthusiasm, its utility can be best confirmed by clinical trials. Unfortunately, there are no randomized trials completed that directly compare 3D-CRT or IMRT with PBT, and thus we must rely mainly on single-arm studies.
Loma Linda University Medical Center was the first center to open a hospital-based proton facility in 1990, and reported the first large single-arm experience. The authors analyzed 1255 patients, 731 of whom received 3D-CRT plus a boost with PBT and 524 of whom received PBT only. Included were patients with low-, intermediate-, and high-risk prostate cancer. Using American Society for Therapeutic Radiology Oncology consensus criteria, the 5- and 8-year biochemical failure free survival was 75% and 73%, respectively. More importantly, there were very low rates of Radiation Therapy Oncology Group grade 3 or higher morbidity: 1% genitourinary and 0.2% GI. To put these numbers in perspective, patients treated with IMRT at our institution had 6% GU and 1% GI grade 3 or higher morbidity.
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Spaceoar Hydrogel: Reducing Radiation Exposure
The prostate and rectum are located very close to each other and are separated only by a small space. When undergoing proton therapy for prostate cancer, your doctor will determine if you are eligible for placement of a special hydrogel between the prostate and rectum . The SpaceOAR hydrogel creates additional space between the prostate and the rectum to further reduce radiation exposure to the rectum, thereby minimizing unwanted side effects and potential injury to the rectum during treatment. More than 50,000 patients worldwide have been successfully treated with SpaceOAR Hydrogel.
The placement of the hydrogel is a minimally invasive procedure done within our center and the hydrogel remains inside the body throughout treatment. The material that the SpaceOAR Hydrogel is made from has been used in other implants such as surgical sealants used in the eye, brain and spine. The biodegradable material naturally dissolves after a few months and is cleared in your urine.
Proton Treatment And Research Center
What our patients are saying
I came in every day for two weeks, was there for about a half-hour each time, then went home or to work… Everyone was just wonderful: very professional, yet very warm. At Loma Linda, people get it they know how a patient feels. They have empathy here, and sensitivity.
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We’re Building The Future Of Cancer Care
UW Health Eastpark Medical Center will be a destination medical center with multiple specialties in a single location, allowing patients to receive all of their care during a single visit. From consultative and supportive services to clinical research and treatment available no where else, patients will receive the personalized care they expect in an environment they deserve.
The new facility will bring experts in adult and pediatric oncology together in a single, accessible location making it easier for patients to receive the care they need in an efficient and convenient manner.
A history of cancer innovation
Fewer Side Effects And Complications
Many patients treated with proton therapy experience fewer side effects. Complications that do occur can also be milder and take less time to resolve. Most patients are able to maintain a busy, active schedule with less interruption from cancer treatments and their daily life. Opting for this type of radiation may increase your chances of an improved, more enjoyable quality of life.
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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.
Want To Share Your Story
In the search for the best cancer therapy option, knowledge is power. Our goal is to help patients and their families by sharing the stories of people that know about Proton Therapy. If you have had experience as a patient, a family member, a caregiver, please share it with our readers. It will give hope. It may save a life. Share if you care.
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Why Choose Proton Treatment
- Precise and effective: Our experts have unmatched expertise in proton therapy, providing radiation treatment precise and effective enough to pinpoint tumors and minimize damage to healthy tissue.
- Minimal side effects: Treatment is non-invasive and painless many patients even continue their day as normal after their appointment.
- Quick procedure: Your procedure will last only a few minutes, and you can expect your visit to last about an hour.
- Proven results: Proton therapy has provided positive outcomes to patients like you for decades and weve provided proton therapy longer than any other hospital in the world.
Quick Facts
What Is Cyberknife Versus Proton Therapy
CyberKnife is a brand name for one of several available radiosurgery devices called linear accelerators, which deliver stereotactic body radiation therapy or stereotactic radiosurgery . MSK uses a similar device, made by a company called Varian, that destroys tumors with extremely precise, very intense doses of radiation. Proton therapy delivers a beam of proton particles that stops at the tumor.
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Advantages Of Proton Therapy For Prostate Cancer
Proton therapy has proven to show remarkable promise and advantages over conventional therapy-especially in the treatment of prostate cancer. Proton radiation therapys accuracy and the control it gives physicians in terms of adapting treatment make it a non-invasive and low-risk option for prostate cancer treatment.
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
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What Is Proton Therapy For Prostate Cancer
Proton therapy for prostate cancer is a treatment option that involves using a focused ray of proton particles to destroy cancerous tissues. The treatment is capable of delivering precise, high doses of radiation to accurately target cancer cells without causing damage to healthy tissue surrounding the prostate.
Cancers Treated With Proton Therapy
Proton therapy is useful for treating tumors that have not spread and are near important parts of the body. For instance, cancers near the brain and spinal cord. It is also used for treating children because it lessens the chance of harming healthy, growing tissue. Children may receive proton therapy for cancers of the brain and spinal cord. It is also used for cancer of the eye, such as retinoblastoma and orbital rhabdomyosarcoma.
Proton therapy also may be used to treat these cancers:
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Central nervous system cancers, including chordoma, chondrosarcoma, and malignant meningioma
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Eye cancer, including uveal melanoma or choroidal melanoma
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Head and neck cancers, including nasal cavity and paranasal sinus cancer and some nasopharyngeal cancers
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Spinal and pelvic sarcomas, which are cancers that occur in the soft-tissue and bone
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Noncancerous brain tumors
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