LLUMC Medical and Cancer Treatment and Research

[Guest guest]

Hi Terry, Laurel and all:

Allan is spot on. Past posts have indicated the fact that proton

treatment at LLUMC conforms to the gland with an approximate 5

mm " margin. " When the cancer is more advanced, a combo of photon and

protons is used to expand to the pelvic bed, and sometimes with ADT

as a supplement.

Just to echo Laurel's statement that Loma University Medical

Center should not be thought of as just a proton center, all should

recognize that almost every facet of medical and dental practice and

research is done there. It is where the very first infant heart

transplant in the world was done; the current Heart Transplant Unit

has one of best (and fastest responding) teams anywhere, and the

LLUMC Children's Hospital is recognized as one of the finest in the

world.

To answer someone's question, the LLUMC proton protocol has been and

is still being improved. There have been many improvements since the

unit first started in late 1990. Using the LLUMC techniques and

protocol, rectal toxicity is minimal and urinary toxicity is almost

non-existent. I completed my proton treatment in March of 2007,

(protons only with Lupron as additive)and I like many others have

experienced no rectal or urinary problems.

And Terry, about forty different forms of cancer are being treated

with protons, not just prostate cancer. Many of these are what may be

termed " high grade " cancers.

" LLUCI investigators are developing innovative in-house proton-beam

treatment for various cancers and benign diseases, such as acoustic

neuroma, meningioma, and arteriovenous malformations of the brain. "

But protons are not the only cancer treatment being done, as Laurel

said. They do surgery and also have the robotic systems for prostate

cancer.

And in addition there is a constant and ongoing cancer research

effort. In addition to the Proton Center, there is a completely

separate Cancer Research Center:

" Medical oncologists, radiation oncologists, and oncologic surgeons

develop multidisciplinary plans for the treatment of various types of

cancer, including those of the breast, prostate, lung, head and neck,

GI tract, female genital tract, skin (melanoma), and other body

sites. "

Best to all,

Fuller

> ...

> > The one negative reported was an increase in rectal

> > toxicity in higher-grade tumours. Perhaps these men

> > should not have been radiated at all?

> ...

>

> I'm certainly no expert, but I would think that the higher

> rectal toxicity could only be caused by delivering more

> radiation to the rectum.

>

> I presume that, when the patient has a higher grade tumor,

> the radiation oncologists will expand the radiation delivery

> field and the amount of radiation delivered to that expanded

> field. The decision to do that is probably independent

> of whether protons or photons are used, though as another

> poster pointed out, it may be that photons are used for this

> expanded field even when protons are used on the prostate

> itself.

>

> What to do in these situations is a tough call. From the

> numbers given (61.4% vs. 80.4% PSA failure rates), it

> appears that one can significantly improve the chances for

> a cure by accepting the higher risk of toxicity. In the

> lower risk cases, the higher toxicity is probably not needed.

> In the higher risk cases, it may become a more acceptable

> risk.

>

> Curiously, I'll bet that most radiation oncologists never

> discuss these issues with their patients. They make the

> decision for the patient based on their own idea about what

> is best.

>

> Alan

>

> Alan Meyer

> ameyer2@...

>

>

>

______________________________________________________________________

______________

> Looking for last minute shopping deals?

> Find them fast with Yahoo! Search.

http://tools.search.yahoo.com/newsearch/category.php?category=shopping

>