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Recently by Andrew Lee, M.D.

Lee_PTC.jpgNo man wants to hear the sentence, "You have prostate cancer," but more than 190,000 men in the United States will be told that this year.

Prostate cancer is the second-leading cause of cancer deaths in this country, but the good news is that the death rate is decreasing. In fact, when prostate cancer is detected early and treated properly, men have a five-year survival rate of nearly 99%. But choosing the right therapy remains a daunting task for men facing this disease and their families.

Trying to learn about the diagnosis and the treatment options can be difficult. Choosing between external beam radiation therapy (proton therapy and IMRT), surgery (open vs. robotic-assisted) and brachytherapy (radioactive seed implant) can create anxiety for even the most informed patient.  

One size does not fit all
As a prostate cancer specialist, I would say that there is no one perfect therapy for every single patient, but I do try to give each patient all the information he needs to make the right decision for his case. While I want to effectively treat my patient's cancer, I also want to preserve his quality of life - during and after treatment - as much as possible.  

All definitive treatments for prostate cancer carry the chance of side effects, which vary depending on the actual therapy and the patient. But we are always striving to minimize these effects by selecting the appropriate treatment for each patient.  

External beam radiation therapy is one of the most effective and flexible treatments for a wide range of prostate cancers. It can effectively treat localized disease, as well as more locally-advanced tumors, with good results.

Proton therapy a good option
Technologic advances also have improved our ability to deliver higher radiation doses to the prostate, while decreasing the risk of normal tissue damage. Proton therapy is one example of how advanced technology can be used to help treat patients, since the unique physical properties of protons allow higher radiation doses to be deposited at the tumor while minimizing unnecessary exposure to surrounding normal organs. This may result in improved cure rates with fewer side effects and can be done using just a few beams (one right-sided and one left-sided beam), which is something that cannot be done with even the most advanced X-ray techniques.

MD Anderson is fortunate to be one of a few centers in the world with proton therapy available for our patients.

Proton treatments typically take only 15 to 20 minutes each day and are delivered five days a week for approximately seven to eight weeks. Most patients tolerate the treatments extremely well and are able to continue to work and exercise during their treatment course and immediately after treatment is complete.

Proton therapy is one of the most flexible treatment options available for prostate cancer. At MD Anderson Proton Therapy Center, we've treated a wide range of tumor stages of prostate cancer as well as a variety of patients with proton therapy. So, it may indeed be an excellent option for many men, depending on their unique situation.
 
No matter what you decide to do, begin by talking with your oncologist. And don't be afraid to ask and get in-depth details about all of your options.



Resources


The Proton Therapy Center at MD Anderson Cancer Center www.mdanderson.org/proton

ProtonPals, a support group for patients at the MD Anderson Proton Therapy Center
www.protonpals.net

"Should I get proton therapy?" is a question that my patients often ask me, and you may be thinking about it right now. The short answer is that "it depends." Only you and your oncologist should be making this decision.  

Before deciding IF you should receive proton therapy, you need to know WHAT it is. Proton therapy is a form of external beam radiation that uses particles (i.e. protons) instead of photons (i.e. X-rays) to treat tumors. Both forms of radiation can destroy cancer cells by messing up their genetic blueprint (DNA). This makes it difficult for cancer cells to continue to grow and divide, and they ultimately die.

Lee_Proton_small.jpgIn general, the higher the radiation dose, the better the tumor control will be. However, such high radiation doses  can affect normal tissue near the tumor, which is what we all want to avoid.  

Photons (x-rays) deposit the majority of their dose within the first inch after they hit the skin, and they continue to deposit dose after they reach the tumor.  Hitting a deep tumor with just one or two x-ray beams is hard (that would be like trying to power-wash your driveway with a water pick).  We often need to use many different beams to cover the tumor and this can result in more radiation exposure to normal tissues.  This is where proton therapy has the edge. Protons deposit most of their dose at the tumor and more importantly stop traveling after they hit the tumor. This reduces the radiation dose beyond the tumor, allows the use fewer beams, and subsequently greater sparing of normal tissue.

Proton treatment requires sophisticated machinery and expert professionals to deliver it. The synchrotron will accelerate protons to almost the speed of light for maximal penetration. Inside the synchrotron they may travel 300,000 miles, which is equivalent to circling the earth 12-13 times. The protons are then fed to the treatment gantry, which is a massive 190-ton device that directs the proton beam before it enters the patient. Despite its large size (over 40 feet in diameter), the gantries have a precision of 1mm. We also have a highly trained, dedicated group of professionals who operate and maintain the Proton Therapy Center to ensure that everything works to its best level.

Proton therapy is currently available in only seven centers in North America. M. D. Anderson has one of the largest and technically advanced centers in the world. We have four treatment rooms, including one of the only centers with spot-scanning  (a.k.a. pencil-beam scanning) capabilities.

The first patient was treated with proton therapy at M. D. Anderson on May 4, 2006, and since then we have treated more than 1,700 patients. We have a lot of experience treating patients with lung cancer, esophageal cancer, brain tumors and prostate cancer, as well as various other tumor sites. Also, we're one of the most active centers in the world for treating children  with proton therapy.

Since the Proton Therapy Center is part of M. D. Anderson Cancer Center, we can provide our patients not only with outstanding proton therapy but also outstanding cancer therapy.

So, should you receive proton therapy? Please consult with your radiation oncologist or check out our website for more information.

Other Resources

ProtonPals is a support and outreach group for those who choose proton therapy treatment at The University of Texas M. D. Anderson Cancer Center Proton Therapy Center 




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