Re: New Proton Centers Coming

June 11, 2007

Another quote, with comment following:

" Orlando Regional among first to get new cancer technology

....

ORLANDO BUSINESS JOURNAL - DECEMBER 8, 2006

BY Lundine

ASSOCIATE MANAGING EDITOR "

ORLANDO -- " In 2009, Orlando Regional Healthcare will become one of

the first five hospitals in the nation to have a smaller version of a

new technology many consider the gold standard for treating certain

cancers -- especially in children.

If all goes according to plan, that's when the local hospital system

will get a single-room proton beam radiation therapy system for use by

doctors at its M.D. Cancer Center Orlando.

Currently, just four [should read five] U.S. health care facilities --

including one in ville -- have large-scale proton beam

radiation therapy systems weighing more than 440,000 pounds that

require almost 100,000 square feet of space, with a price tag upward

of $120 million for the equipment and building.

" The technology is among the best on the market for treating cancers

in the head and neck, chest, brain and abdomen, " says Orlando Regional

spokeswoman ez. " It is also the preferred radiation

treatment for pediatric patients. "

The beauty of the technology is that it allows the radiation treatment

to be focused more on the cancer and less on the surrounding healthy

tissue, says Orlando radiation oncologist Dr. Wayne , medical

director of M.D. -Orlando.

" This is a huge evolution in radiation, " says Dr. Sameer Keole,

pediatric radiation oncologist at the University of Florida Proton

Therapy Institute at Shands ville, which began operating in

August and expects to treat as many as 150 patients a day when it's

fully operational by 2008.

But because of the cost and space requirements, few can afford the

systems currently available. Thus, there are long waiting lists to use

them, so patients must be prioritized by type of cancer and degree of

illness -- leaving more than half of them to be turned away.

That's why Orlando Regional officials are happy about the chance to

join four other sites that will lease and install a much smaller

version -- dubbed the Clinatron-250 proton beam radiation therapy

system -- for a total project cost of less than $20 million each in 2009.

But first, the system -- currently under development by Still River

Systems in Littleton, Mass [in conjunction with MIT] -- must gain

approval from the U.S. Food & Drug Administration, a process that can

take years depending on thetechnology in question.

Once that hurdle is cleared, the nonprofit Orlando Regional will build

a new $18 million facility on Orange Avenue next to M.D.

-Orlando, with the design phase starting in 2007, says

Matthias, radiation oncology business manager at the cancer

center.

No details are available yet on the size of the building, she says,

but construction should be done in 2009. The system will be leased

from San Francisco-based American Shared Hospital Services (AMEX: AMS). "

" It will be a few years before we begin treating patients with the new

technology, " says ez, " but we're really excited to get the ball

rolling. "

-----------------------------

Comment: When this smaller system is perfected and approved, a sudden

" quantum leap " in the number of proton Beam Radiation Therapy

facilities can be expected. These two that I have just mentioned in

this and the the previous post, (Ft. Lauderdale and Orlando) and the

ground breaker, -Jewish Hospital in St. Louis, are the " tip of

the iceberg. " I would expect to see at least one hundred of these

smaller units scattered around the U. S. within the next ten to

fifteen years. Yes, and even that bastion of " Surgery for Prostate

Cancer First, " s Hopkins, will be one of them.

Remember you heard it here first! One more thing, I did not say " gold

standard, " the author of the article did.

Fuller

(Proton Beam Advocate & " True Believer " )

>

> Quote without comment:

>

> (From the South Florida Sun-Sentinel, May 4, 2007.)

>

> " A Fort Lauderdale hospital moved Wednesday to buy a sophisticated

> cancer radiation system now found in only five U.S. cities, greatly

> expanding the treatment options for South Florida patients, especially

> children.

>

June 11, 2007

Tufts New England Medical Center is joining the Proton Parade:

I missed this one somehow.

I will not post anymore of these, since they will not reach

operational status until late 2008 or so. But I am compiling a list,

and if anyone is interested, contact me either on forum or off forum

at cnsjones@....

------------------------------------------------------

" With the addition of a proton beam, Tufts-NEMC will be able to offer

patients the latest in radiation therapy technology, " said

Wazer, MD, Radiation Oncologist-in-Chief at Tufts-New England Medical

Center. " We look forward to this exciting and unique opportunity to

provide state-of-the-art radiation treatment for our patients. "

...

About Tufts-New England Medical Center

Tufts-NEMC is a world-class, academic medical institution that is home

to both a full-service hospital for adults and the Floating Hospital

for Children and has long been recognized as a leader in cancer care,

cardiology, organ transplantation and pediatrics. Founded in 1796 as

the Boston Dispensary to care for sick and needy Bostonians, Tufts-New

England Medical Center is the oldest health care facility in New

England. It serves as the primary clinical and teaching affiliate of

Tufts University School of Medicine. For more information on

Tufts-NEMC, access our web site, www.tufts-nemc.org. "

--------------------------------------------------------

Fuller

---

June 11, 2007

Fuller, good detective work. I discovered many similar articles while doing my proton research. The key is in the smaller machines. Lawrence Livermore Lab and UC are collaborating on a prototype machine for protons that would be far less expensive and would allow all major medical centers to have one. Sounds as though someone may have beat them to the punch. You keep spreading the word.

LaurelSee what's free at AOL.com.

June 11, 2007

Fuller -

What is your background in all of this discussion on the Proton

radiation technology? Medical? Vendor? Patient? Facilities

person? Developer of the machine?

Fred, FL

> >

> > Quote without comment:

> >

> > (From the South Florida Sun-Sentinel, May 4, 2007.)

> >

> > " A Fort Lauderdale hospital moved Wednesday to buy a

sophisticated

> > cancer radiation system now found in only five U.S. cities,

greatly

> > expanding the treatment options for South Florida patients,

especially

> > children.

> >

>

June 11, 2007

>

> Fuller -

>

> What is your background in all of this discussion on the Proton

> radiation technology? Medical? Vendor? Patient? Facilities

> person? Developer of the machine?

-------------------------------------------------

Fred,

I am a 74 year old prostate cancer patient (Retired NASA engineer)

that discovered Proton Beam Radiation Therapy while searching for the

treatment that was right for me. I completed my treatment March 8,

2007 at Loma University Medical Center in California. As I have

tried to explain on this forum AND in the emails that I sent to you

off forum, I am not trying to say that PBRT is right for everyone; we

each must make up our own mind, based on our own research, beliefs,

disease characteristics, and physical condition. I am simply trying

to let everyone know that PBRT is a viable option that has published

results equal to or better than other modalities, and should be

considered when trying to determine the modality right for them. I

make no apologies for being a " Proton Beam Advocate, " and the reason

is because I discovered that the mainstream urologists and surgeons

will NOT even mention PBRT. I have explained my suppositions as to

why that is in previous posts. My complete story is also on the

" Mentor's Experiences " section of the YANA Website.

Thanks for " stirring it up " again, the more folks that question this

the better! E-mail me off line if you wish to continue this, I feel

that I have taken enough of the forum's space on this subject over the

past few days.

But I will respond with answers for those that need them,

OR when questioned or challenged as you have done.

Fuller

>

June 11, 2007

Fuller -

My urologist, once finding my early ProCa via my biopsy -

recommended I consult with a Radiation Oncologist (EBRT)

which I did. I am a retired EE engineer - also from

another " agency " in land. Closest I've gotten to

medical training - is my spouse, an RN of some 45 years.

And once I took a semester's masters course in most of the

radiation technologies in use in hospitals, in the early 90's,

given by practicing MDs. It was a practical - how to,

problems, technology employed course - week after week,

for 23 weeks. I recall I got a B, we did our term paper at

end, on the Cat Scan technology.

It seems like individual need, is the basis for some patients

going with radiation treatments. Be it Seeding, Proton (I

guess), and EBRT. Or they make the treatment preference

decision on their own.

I suspect there are very good health, and medical reasons

for ProCa patients to go with radiation treatment as their

first choice. Some may employ it for secondary

recurrent cancer treatment.

(3) Cancer treatment MD experts, recently indicated to me -

that radiation treatment may not always be the chosen

or best treatment for all patients.

Last I heard, radical & more recently robotic surgeries -

are the predominant treatment for ProCa. 53% I heard.

It would be interesting to see a ranking of treatment type

by percentage of patients being treated. (seeding, surgery,

radiation, do-nothing, cyro, chemo, etc.) That would make

it clearer, for us patients trying to home in on a wise

decision for ourselves - to learn what everyone else is

doing. Maybe they could also show cancer cure success vs

treatment type vs time after treatment.

Proton radiation treatment apparently is in short

supply, and possibly patients get accepted or not, based

on the severity of their treatment need. I guess this is

true for all types of cancer treatment. I suspect it may

take a while, years?, to build up a meaningful data base

of proton treatment vs results vs problems - for it all to

settle out. Cyrotherapy also seems to have similiar introduction

factors facing it too.

All I know now, after doing some ProCa research for

treatments for myself - I want to find the very best

treatment type for me, and do it as my FIRST

TREATMENT. Hopefully I will be able to employ a

well known center too. I was leaning toward seeding,

or more cautiously seeding w/some pre-radiation to ensure

nothing outside of the prostate. But very good results

from Robotic surgery - are causing me to also look there.

Concerns for radiation effects on one's body tissues -

causes me some concern. MD's have told me this too.

Good Luck,

Fred, NY for summer .... under hormonal treatment, to

shrink my gland. Lupron, casodex ... no side effects

> >

> > Fuller -

> >

> > What is your background in all of this discussion on the Proton

> > radiation technology? Medical? Vendor? Patient? Facilities

> > person? Developer of the machine?

> -------------------------------------------------

> Fred,

>

> I am a 74 year old prostate cancer patient (Retired NASA engineer)

> that discovered Proton Beam Radiation Therapy while searching for

the

> treatment that was right for me. I completed my treatment March 8,

> 2007 at Loma University Medical Center in California. As I

have

> tried to explain on this forum AND in the emails that I sent to you

> off forum, I am not trying to say that PBRT is right for everyone;

we

> each must make up our own mind, based on our own research, beliefs,

> disease characteristics, and physical condition. I am simply

trying

> to let everyone know that PBRT is a viable option that has

published

> results equal to or better than other modalities, and should be

> considered when trying to determine the modality right for them. I

> make no apologies for being a " Proton Beam Advocate, " and the

reason

> is because I discovered that the mainstream urologists and surgeons

> will NOT even mention PBRT. I have explained my suppositions as to

> why that is in previous posts. My complete story is also on the

> " Mentor's Experiences " section of the YANA Website.

>

> Thanks for " stirring it up " again, the more folks that question

this

> the better! E-mail me off line if you wish to continue this, I

feel

> that I have taken enough of the forum's space on this subject over

the

> past few days.

>

> But I will respond with answers for those that need them,

> OR when questioned or challenged as you have done.

>

> Fuller

>

> >

>

June 12, 2007

In reply to Fred's Post of Tues, Jun 12, 12:17 am:

Fred,

I invited you to address these issues with me off forum, but for some

reason you choose not to.

I still invite you to do so if you want to continue this discussion or

have additional questions. But you made some statements in your post

that I must address, because they seem to me to leave an incorrect

impression.

But first I want to reiterate that I was not a candidate for surgery

because I had a minor stroke in 2003, BUT that made absolutely no

difference in my choice of proton radiation. Even if I could have had

surgery, I would have chosen Protons. Surgery would have been and

still is my last choice and it would have to be the ONLY choice. But

that is ME talking! Certainly I was aware of all possible side effects

or complications of surgery, and would have chosen to avoid them

all. Others certainly have there own viewpoint and it will lead to the

correct decision for them!

I will break these up into two or three posts to avoid them being too

long.

-------------------------------------

You say (The numbered items below):

1. " It seems like individual need, is the basis for some patients

going with radiation treatments. "

For normal photon (X-ray) radiation, there may be some element of

need, based on the extent of disease and whether or not it has

metastasized, what other treatments have occurred, etc., but for

proton patients with early stage disease, this is more of an element

of choice.

Proton radiation is DIFFERENT from standard photon radiation. There is

very little damage to tissue or organs near the prostate because of

the physics of the proton particles. I CHOSE it because I had no wish

to deal with even the remote possibility of treatment caused

incontinence, impotence, catheters, or other such issues that would

affect my quality of life. I had a " Radiation Vacation " in CA in every

sense of the word vacation. I have had ZERO side effects and ZERO

recovery time from proton treatment. I engaged in strenuous exercise,

long walks, and other activities the entire nine weeks of my proton

therapy treatments. At 74, I now look forward to at least another 10

or 15 years of " Life is good, " As opposed to the two years my first

urologist gave me if I did nothing. (GS was a aggressive 8).

2. " (3) Cancer treatment MD experts, recently indicated to me - that

radiation treatment may not always be the chosen or best treatment for

all patients. "

No doubt that is true, but I submit to you that you can go to six

different medical specialists and you will each time receive a

recommendation for the treatment that they each provide. This I

learned from experience. Your key word here is chosen; YOU should make

the choice, not the MD! And the " best " is what YOU determine to be the

best for YOU. The choice should be your decision based on all the

facts available to you and your disease and physical characteristics,

needs and beliefs. You must be comfortable with your decision.

And I can almost guarantee that the " MD experts " did not include

Proton Beam Therapy in their definition of radiation. If they did,

they did not fully understand proton therapy.

3. " Last I heard, radical & more recently robotic surgeries - are the

predominant treatment for ProCa. 53% I heard. "

There are indeed more urologists that are surgeons--- That is how they

were trained, and how they make their living. And as expressed in

other postings, many newly diagnosed just want to " Get it out, " and go

with their surgeon's first recommendation. That explains the high

figure-- AND the mainstream urological profession does not choose to

make their patients aware of the Proton option for PCa. I have

expressed my thoughts on that elsewhere.

There are only five proton " Centers of Excellence " in the U.S. today,

but that is changing! Those of us that chose PBRT seem unwilling to

" follow the crowd, " or accept everything that an MD tells us at face

value. As an engineer, I wanted facts and a basis for my decision, so

pursued a path to get those facts. It turned out that led to an

unconventional conclusion, but the facts supported it, so that was it.

BUT it was MY decision! And I can assure you that I remain comfortable

and confident that for me it was the correct decision.

Note to all: Getting to that point was NOT EASY!!!! As Laurel said

earlier, " the waters are murky, " and misconceptions along with what I

can only call " half-truths " abound.

Arriving at a decision for prostate cancer treatment, after going

through the initial shock and dismay, is extremely difficult. I

wouldn't wish it on my worst enemy. Nevertheless, those of us with the

disease must make the decision in the way that we find works for us.

In the final analysis, I think that the treatments all end up with

approximately the same percentage rates for " cures, " (which we all

know is an indeterminate until probably ten years later). So we try to

evaluate which one is " best " for us. For me, it all boiled down to

" quality of life " issues. For others it may well be something else.

(Stepping down from soap-box for a break)

----------------------------------------------------

Continued next post----

June 12, 2007

Continued from previous post,

In reply to Fred's Post of Tues, Jun 12, 12:17 am:

(Stepping back up on soap-box):

Fred,

You say: (numbers below)

4. " Maybe they could also show cancer cure success vs treatment type

vs time after treatment. "

Such studies exist! They are peer reviewed and published in medical

journals. Careful research will find and identify these studies. One

ten year study results show that PBRT has equal or better results as

surgery, in every respect. One such study (there are others) shows a

comparison of over 2,000 radical prostatectomy procedures done at

s Hopkins with over 1,000 PBRT treatments at LLUMC over a ten year

period. The study shows a strong dependency of lower pre-treatment PSA

levels to better long-term results. This is a published peer-reviewed

study, and the patients were not " cherry-picked. " See:

http://www.communityoncology.net/journal/articles/0404235.pdf and

download the PDF file. The title is: " Conformal proton beam radiation

therapy for prostate cancer: concepts and clinical results " by Dr.

Carl J. Rossi, LLUMC. (April 2007, Community Oncology, Volume 4,

Number 4, page 235.

One table that is pertinent is:

" Ten-year disease free survival rates in patients with T1-T2 prostate

cancer: proton beam therapy versus surgery.

---------------------------------------------------

Pre treatment PSA =< 4.0 Surgery 91% PBRT 92%

PSA 4.1 to 10.0 Surgery 79% PBRT 81%

PSA 10.1 to 20.0 Surgery 57% PBRT 64%

PSA > 20.0 Surgery 48% PBRT 53% "

---------------------------------------------------

These results are also shown in graphical form.

This study was done with a 74-75 Gy total dosage; the standard dosage

that is now used is 79.2 Gy, (which I received) and results will show

an appropriate increase in proton survival rate. There is now a

fifteen year study that confirms that also. Note that it does NOT say

that PBRT is 100%, but it does indicate " equal or better! " This study

WAS available when I made my choice, and is one of the reasons I chose

PBRT. One of the other reasons was reading the testimonials on the

www.protonbob.com Site.

As for cryotherapy, it is newer, there is less data, and it is not in

the same league as PBRT in my estimation. Unless focal cryotherapy is

done, impotence is a given. But the " cure " rates that are available

are similar. So once again, make your own decision.

5. " Proton radiation treatment apparently is in short supply, and

possibly patients get accepted or not, based on the severity of their

treatment need. "

I can tell you that the new M.D. Center has seen fit to NOT

accept patients with a Gleason Score higher than 7. (They in essence

are " stacking the deck " for good results since late stage PCa patients

are not accepted for protons) I know this because my GS was 8 when I

sent my records to them last October, and I was rejected. LLUMC and

the new center in ville (Shands) has no such restriction. They

will accept you for a consult, do a complete work-up of their own, and

then tell you if you are a candidate for PBRT. I have two very close

friends now receiving treatment at JAX, and one of them was Gleason 9.

He is having a combo of a new chemo and then protons. LLUMC strives

to help all patients, but also screens and does complete tests to

determine if the protocol will be all proton, proton and photon, or

some other combo of treatment. I had MRI Spectroscopy and endorectal

coil to make sure my PCa was still confined. It was and I received

all protons. When I left LLUMC in March, there was about a five-week

wait from date of application to beginning treatment, but this may

have improved. The JAX Shands situation as of last month when my

friends started treatment, was about a three or four week wait for a

consultation.

My recommendation to you given the early stage of your PCa, that I

sent you off-forum earlier, is, if you really want the facts, to make

an appointment at MGH Proton Center in Boston, or the ville

Shands Hospital on your way back to Florida this fall (if you have not

made a decision by then) and have a consultation with a Proton

oncologist, to get the facts.

At least then you will be better able to have a complete idea of what

protons and the associated treatment plans are all about. It is but a

consultation, right?

Best of luck to you,

Fuller

June 12, 2007