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Proton Treatment For Prostate Cancer

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Proton Beam Radiation Therapy

Proton Therapy for Prostate Cancer

Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.

Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.

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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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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Lifesaving Proton Therapy Close To Home

If you are receiving cancer treatment, you want the latest, most innovative therapies available.

The Proton Therapy Center at The University of Kansas Cancer Center offers the most advanced form of radiation therapy available for cancer today. Ours is the first proton center in Kansas and in the Kansas City region. If you or a loved one is facing cancer, you no longer need to travel out of the region to receive this innovative treatment.

Children Benefit From Reduced Radiation Exposure

Proton Beam Therapy for Prostate Cancer

Since proton therapy is targeted, it can be particularly effective in treating children, who are more sensitive to the effects of radiation. The precision of protons means children have a reduced chance of radiation side effectssuch as growth and developmental problems, as well as secondary tumors later in life. The center has radiation oncologists who specializes in proton therapy treatment for children.

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Proton Therapy Versus Prostatectomy

Early-stage prostate cancer can sometimes be treated by removing all of the prostate gland along with some nearby tissues a surgery called radical prostatectomy. This comes with numerous risks and potential complications, including infertility, erectile dysfunction and urinary incontinence.

Proton therapy, in comparison, is a noninvasive procedure that does not remove the prostate or the tumor. It precisely targets radiation at the tumor to disrupt its DNA, so that it cannot grow or spread, and eventually it is eliminated. Proton therapy for prostate cancer also carries risks of erectile dysfunction and bowel and urinary problems, but its less likely to cause urinary incontinence and complete impotence.

Your doctor will discuss pros and cons of proton therapy, prostatectomy and other treatments for your prostate cancer type and stage.

Which Treatments Are Best In Keeping Men In Remission

Here is your opportunity to compare prostate cancer treatments. Over 129,000 patients underwent PSA monitoring after treatment to see which treatments were most effective at keeping the cancer in remission. The charts show which treatments are more likely to leave patients Prostate Cancer Free, for how many years. Share this data, talk with your Doctor, or multiple Doctors and make an informed decision. Select the treatment option, that is best for you.

Compare Prostate Cancer Treatments by gathering information about your own Prostate Cancer Diagnosis. Your Doctor will provide three elements that describe your prostate cancer. Your PSA, Stage and Gleason Score. These three elements help you determine your risk group. Find and select your Risk Group in the table below. This will take you to the comparing prostate cancer treatments page, where you can select different prostate cancer treatments on an interactive chart and graphically see their effectiveness over time.

The treatments included in this study are Prostate Surgery or Prostatectomy, , Brachytherapy or Seeds, High Dose Rate Radiation, HDR, External Beam Radiation Therapy or EBRT, Androgen Deprivation Therapy, ADT, or Hormone Treatment, Proton Therapy, High-Intensity Focused Ultrasound, HIFU, Cryotherapy, Cryo and Hypo-Fractionated External Beam Radiation Therapy. For more advanced prostate cancer, treatments are combined to increase effectiveness.

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Ideas For Future Studies Of Proton Therapy

Despite the studys limitations, these intriguing findings raise questions that should inform future prospective phase 3 trials, Dr. Buchsbaum said, although there are barriers to large studies of proton therapy.

For instance, it is particularly encouraging that proton therapy appeared to be safer in a group of older and sicker patients who typically experience more side effects, Dr. Baumann noted.

Dr. Buchsbaum agreed that proton therapy may be especially helpful for older and sicker patients, but he noted that ongoing phase 3 trials were not designed to analyze this group of patients.

And because proton therapy may cause fewer side effects, future trials could also explore whether combining proton therapy with chemotherapy might be more tolerable for patients, the authors wrote.

For example, both chemotherapy and traditional radiation for lung cancer can irritate the esophagus, making it painful and difficult for patients to eat. But proton therapy might limit damage to the esophagus, making it easier for a patient to tolerate the combination, Dr. Baumann explained.

Future studies could also explore whether combining proton therapy with higher doses of chemotherapy might increase cures without causing more side effects, he added.

Dr. Buchsbaum agreed, saying that it would be worthwhile to explore this possibility. Just asking the question: Is more effective? might not be giving it a fair opportunity to demonstrate its benefit to society, he said.

A Goal Of Sparing Healthy Tissue To Help Speed Recovery

Proton Therapy Intermediate-Risk (Teal) Prostate Cancer | Prostate Cancer Staging Guide

Proton therapy is a powerful treatment for cancer and a highly effective alternative to standard X-ray radiation therapy. Due to improved dose distribution with proton therapy, doctors can better conform radiation to the tumor site, which means less healthy tissue is exposed to radiation, and which in turn is expected to result in fewer short- and long-term side effects.

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What Should Patients Know About Msks Approach To Treating Prostate Cancer

At MSK, we manage prostate cancer in a very comprehensive way, tailored to each patients disease. There is no one specific therapy that is best for everyone.

Our initial assessment includes a carefully evaluated biopsy and a very detailed MRI to show the location of the disease, the integrity or soundness of the capsule surrounding the prostate, and the amount of disease. We will often obtain next-generation imaging and do genomic testing. Then, based on that information and with input from the urologist, the radiation oncologist, and the medical oncologist we can provide a comprehensive recommendation.

The radiotherapy we do here at MSK is state-of-the-art and unparalleled. We are one of the few centers in the world to do MRI-based treatment planning and one of the few centers in the US to offer MRI-guided treatment. When we give brachytherapy, we use computer software that provides us with real-time information about the quality and accuracy of the seed implant during the procedure. It requires a great deal of collaboration with our medical physics team to try to get the most accurate positioning of the prostate during the actual three or four minutes of the treatment.

We make adjustments while the patient is still under anesthesia, so that when the procedure is completed, we have been able to achieve ideal placement of the radiation seeds. This translates into improved outcomes.

Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy

When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.

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The Initial Causes How Much Does Proton Therapy For Prostate Cancer Cost

One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.

Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.

If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.

How Effective Is Proton Beam Therapy For Prostate Cancer

Proton Beam Therapy for Prostate Cancer

Studies show that success and survival rates of proton therapy for prostate cancer are similar to those of other types of radiation therapy. Some retrospective studies have shown that proton therapy has lower risk of prostate cancer returning and of secondary cancers developing after treatment. However, prospective studies are ongoing to compare results of proton therapy to those of other treatments among patients with different types and stages of prostate cancer.

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Proton Radiation Therapy For Prostate Cancer

Proton radiation is an enhanced type of radiation gaining in popularity for the treatment of prostate cancer. Men who are contemplating proton radiation need to compare and contrast it with all the other types of radiation to determine if proton therapy is advantageous for them in view of their specific circumstances.

A full course of proton radiation requires five treatments per week continued for eight or nine consecutive weeks. During each visit, patients are positioned in front of an invisible beam of protons that target the prostate gland.

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Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation

Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.

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Types Of Prostate Cancer Treated At The New York Proton Center

The New York Proton Center treats the following prostate cancers and genitourinary cancers with proton therapy.

Localized prostate cancer, which includes stage 1, stage 2, and stage 3 cancer, that has not grown into nearby tissues or more distant body parts. There are three types:

  • Very-low-risk and low-risk prostate cancer, each of which are unlikely to grow or spread for a long time, if at all.
  • Intermediate-risk prostate cancer, which may grow or spread in a few years.
  • High-risk prostate, which has the highest likelihood of spreading and, even after treatment, recurring.

Prostate cancer will sometimes grow quickly and spread to lymph nodes, pea-sized pieces of tissue that filter a waste product called lymph. When this happens, a larger area needs to be targeted for treatment that includes the prostate gland and the lymph nodes. Proton therapy is particularly beneficial when treating large areas in the pelvis.

Data suggest that men who have undergone prostatectomy for prostate cancer may benefit from follow-up treatment with proton therapy, depending on several factors:

  • Seminal vesicle and lymph nodes involvement

Bladder cancers have a high correlation to prostate cancer. The types are named for the cells they affect, usually in the bladder wall.

Kidney cancer is an abnormal growth of cells in kidney tissue that eventually forms a tumor. Cells can break off from the tumor and spread to other tissue and organs. The most common kidney cancer is renal cell carcinoma.

Potential Disadvantages Of Proton Therapy

Proton Therapy for Prostate Cancer

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.

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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

Researched And Perfected For More Than 60 Years

As of 2018, over 170,000 people worldwide have received proton therapy at centers in Europe, Asia and the United States. It was first used to treat patients in 1955 in a research setting, but its use was limited because imaging techniques at the time could not accurately pinpoint tumors. The FDA approved proton therapy in 1988, following advances in imaging technology, such as CT, MRI and PET scans. The first hospital-based treatment center opened in Loma Linda, California in 1990. Fred Hutchinson Cancer Center – Proton Therapy opened in 2013.

Highlights:

  • A goal of less radiation delivered to healthy tissue and critical structures adjacent to the treatment area
  • Ability to deposit a larger dose in the targeted area if needed
  • Fewer side effects and faster recovery due to precise delivery of radiation to target area
  • Precise application is ideal for a wide range of tumors
  • Precise targeting gives proton beam therapy a significant advantage over standard radiation therapy when treating tumors near vital organs

If you have a solid tumor near a vital organ, or a recurrent tumor, you are a prime candidate for proton therapy.

1895German physicist W.C. Roentgen discovers X-rays, making detection of tumors in the body much easier and non-invasive. Roentgen later wins the Nobel Prize in Physics for this discovery.

1919

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Why Choose Us For Prostate Cancer Care

  • Prostate cancer specialists: Because our team is subspecialized in prostate cancer, you get the most comprehensive, most personalized care plan available.
  • Unparalleled in proton therapy: Weâve treated over 10,000 prostate cancer patients using proton therapy more than any other center in the world.
  • Leaders in robotic surgery: Our surgeons perform more minimally-invasive robotic surgeries each year than those at any other teaching hospital in the West.
  • State-of-the-art tech: As the largest urology group in the region, we offer you access to the most advanced technology available.
  • Clinical trials: You have access to many clinical trials for prostate cancer, which may offer potential new treatments.

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