Proton Beam Therapy and Standard Radiation Therapy – Which Is Better?

The answer to the question above would possible be provided in the next five years. This would be when a new study initiated by the Massachusetts General Hospital is going to determine which of the above treatments for prostate cancer offers better care and quality of life for patients.

There have been controversies in the medical field about the overall effects of Proton Beam Therapy compared to the use of standard radiation treatments. The former treatment is also a very expensive one and many still wonders if undergoing this therapy is really worth the costs, efforts, and time for it. All these questions are expected to be answered after the conclusion of the five-year massive research.

An online excerpt to the above topic provides you more details are highlighted below:

Massachusetts General Hospital in the next few weeks will launch a large, long-awaited test of whether a controversial cutting-edge proton beam therapy is more effective than standard radiation treatment for prostate cancer.

Proton beam therapy, a targeted and controlled way to administer radiation to a tumor, has become a flashpoint in the debate over health care reform.

The expensive therapy is being used across the country and in some cases advertised directly to the general public before it has been deemed superior to standard radiation treatment, which costs about half as much. For years, doctors and federal health agencies have called for a scientific study like the one led by Mass. General, which will enroll its first patients by early June.

The five-year study will take place at a half-dozen centers across the country, including the University of Pennsylvania.

During that span, the number of therapy facilities, each of which can cost as much as $200 million to build, is projected to at least double across the country.

“Is the additional cost for proton beam therapy worth it?’’ said Dr. Jason Efstathiou, an assistant professor of radiation oncology at Harvard Medical School and Mass. General. “Ultimately, we need to figure out if these new emerging high-technology therapies being introduced into medical care provide a benefit. . . . This trial will determine whether or not the more expensive therapy leads to a better quality of life.’’

Proton therapy has theoretical advantages: It allows doctors to precisely target radiation to reach a certain depth in the body, which can reduce exposure and possibly mitigate side effects. But there is little consensus on whether that translates to better care, except in a handful of rare cancers – including pediatric cancers of the brain and nervous system or cancers in delicate areas such as the eye.

“By exposing less normal tissue to radiation, you will ultimately cause fewer secondary malignancies; that’s one of the serious, devastating late effects of radiation in children,’’ said Dr. Karen Marcus, a pediatric radiation oncologist at the Dana-Farber/Children’s Hospital Cancer Center.

But thus far, studies of proton therapy in prostate cancer – far more common than those rare cancers – have had limitations and provided mixed results. And it costs significantly more: around $48,000, or double that of standard radiation therapy, according to a 2008 report from the Institute for Clinical and Economic Review.

The American Society for Radiation Oncology’s emerging technology committee published a review earlier this year that said proton beam therapy was effective in treating prostate cancer, but found no evidence it was better than standard radiation therapy. Click here to read the full excerpt.

The above details on the research work to be conducted by the Massachusetts General Hospital are sure to bring results that would truly be useful in prostate cancer treatments. This clinical trial is going to be expensive but it is expected to yield better results after the next five years.

Finally, the application of Proton Beam Therapy and standard radiation treatment on prostate cancer victims are most often recommended. We are going to wait for the result of the study to know which of these two actually offer the best health care for patients. Good Luck in advance to the researcher at MGH!

How the Various Stages of Prostate Cancer Are Treated

Cancer cells that form on the prostate gland grow slowly and can easily affect other parts of the body. For this reason, doctors ensure they discover the stages the growth is so that the right treatment can be provided for the patient.

Staging or grading for this type of cancer that affects only men is carried out through a system known as the Gleason Grading System. Through this system, various different patterns of the cancer cells taken after biopsy are investigated and scores are provided for each group.

That being said, there are about four stages of prostate cancer. Each of these stages has its peculiar features, and there are effective treatments suitable for each stage. The four stages of prostate cancer that can be diagnosed in a man are: Stage I, Stage II, Stage III, and Stage IV.

These stages determine treatments as they already embody the size, location, spread and aggressiveness of the cancer. what each stage looks like and the common treatments doctors prescribe for victims are described in the following paragraphs.

Treating Stage I Prostate Cancer – When cancer cells form in the prostate gland at this stage, the cells may still appear like normal prostate cells. The cancers are slow growing and most often do not show any significant symptoms that can be used to recognize it. Since cancerous cells in this stage are still localized and less aggressive, the following treatments can be applied to get rid of them completely: Radiation therapy, radical prostatectomy, and watchful waiting.

Treating Stage II Prostate Cancer – This stage would still have the cancers localized (that is, still forming within prostate cells). However, there could be slight change in their patterns or structure and certain symptoms may start to affect the person. Likewise, if treatments had already been applied on stage I cells and some affected cells still survive, then these are considered stage II. Similar treatment options as in stage I can still be applied to treat stage II but more precisely: Radical prostatectomy( to remove the prostate gland and pelvic lymph nodes), Brachytherapy and external beam radiation, Cryosurgery, or a combination of these treatments can work to deal with this stage of prostate cancer.

Treating Stage III Prostate Cancer – This stage indicates that the cancer could have spread beyond the prostate gland. In spite of this, organs like the lymph nodes, bladder, rectum, and other distant organs are not yet affected. The possible treatments for this stage may include: Radiation and surgery could be considered (since they may not be effective at this stage), Hormone therapy, watchful waiting (for older with no serious symptoms), radical prostatectomy in some areas, or a combination of radiation treatments and hormone therapy.

Treating Stage IV Prostate Cancer – This is the most dangerous stage of prostate cancer because major vital organs in the body are now affected by the cancer. The Lymph nodes, rectum, bladder, bones, and other distant organs are affected. The chances of this stage to get cured are very slim. However, the following treatments can be applied to relieve the symptoms: Hormone therapy, Transurethral Resection of the Prostate (TURP), External beam radiation in combination of hormone therapy in certain areas, and chemotherapy.

Finally, understanding the stages of prostate cancer and the treatments for each would go a long way to help you get the best treatments. However, you need to know that some factors like age, risk or recurrence, life expectancy, can affect the choice of treatments the doctor may prescribe.

A New Test Can Predict the Level Of Relapse In Prostate Cancer

A recent study from researchers at the University Of Pittsburgh School Of Medicine shows that detection of certain abnormalities in genes can predict if the prostate cancer can relapse after treatment. More so, the study can also show the stage or how aggressive the relapse can be.

Various procedures were used in arriving in the conclusion, and more studies are conducted in research. Biopsy, measuring of the CNV (copy number variation), and analyses of about 238 genome samples were used. The measurements, analsis, and trials carried out in the process are described in the following paragraphs:

The findings, published online in The American Journal of Pathology, show that the test also can indicate how aggressive or mild the relapse will be.

Currently, prostate-specific antigen, or PSA, blood levels are tested to monitor the status of prostate tumors, said senior investigator Jian-Hua Luo, associate professor in the department of pathology at the University of Pittsburgh School of Medicine.

But measuring copy number variation (CNV), which is the deletion or increased redundancy of areas of DNA within chromosomes, in the tumor, neighboring tissues, or blood better reflects the state of the cancer.

“Our method will allow us to determine at the time of, or after biopsy or prostate removal, whether the cancer is likely to come back and, if so, how aggressively,” he says. “It promises to more accurately predict the progression of the disease.”

For the study, the researchers analyzed the genomes of 238 samples obtained from men whose prostate glands were surgically removed; 104 prostate tumor samples; 85 blood samples from prostate cancer patients, and 49 samples of disease-free prostate tissues neighboring the tumors.

A third of the samples were from patients whose cancer had recurred and whose PSA level had doubled in less than four months, which is associated with lethal prostate cancer. A third of the samples came from patients with disease recurrence with a slowly increasing PSA level that doubled in more than 15 months, and a third with no relapse more than five years after surgery. The researchers also examined an additional 25 samples from prostate cancer patients to validate their findings.

They found that deletion and increased redundancy of DNA occurred in all chromosomes in prostate cancer samples. Some of these changes occurred with high frequency. Deletion and increased redundancy of DNA also occurred in benign neighboring tissue and blood samples of the cancer patients.

Gene-specific tumor CNV could correctly predict 73 percent of cases that had relapsed and 75 percent of cases in which PSA levels rapidly doubled. The CNV model from disease-free neighboring tissue correctly predicted 67 percent of cases for relapse and 77 percent of cases for short PSA doubling time. A specific tumor CNV from blood could correctly predict 81 percent of relapse cases and 69 percent of the cases for short PSA doubling time.

The consistency of the associations across specimen types suggest that CNV analysis could reliably indicate what the likelihood of recurrence is either at the time of biopsy of a suspicious mass, when the tumor is removed, or in post-treatment blood monitoring, and could help doctors decide early in the disease process whether an individual’s cancer warrants additional therapy, says Luo.

Additional researchers from the University of Pittsburgh co-authored the study, which was funded by the National Cancer Institute and the University of Pittsburgh Cancer Institute. Source.

So,this could be another breakthrough in prostate cancer research. If this research is validated, then it becomes possible to predict the course which prostate cancer is going to take. And this will provide direction for the right treatment.

The most significant area in which this treatment is going to be of benefit for people is in the area of early diagnosis of this early diagnosis. If the test helps to detect cancer early, then the chances of extending the life of individuals would be increased.

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