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RT and HT for PCa

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User
Posted 16 Dec 2016 at 17:04

As mentioned before I had my first dose of HT on 12th Dec, 2016. My specialists here  may start IMRT anywhere after 2 monthSs

Do we have better than IMRT in europe or UK, like proton treatment or IGRT?

My doctor says that proton treatment is still not proven especially for cases like mine.

Can any of friends tell their experience if they had  undrgone IMRT.

Thanks and regards

User
Posted 16 Dec 2016 at 20:36

I answered your question in a thread which now comes up as 'Page not found', so I will try copy and paste. "
Man with PC
Posted: 11 December 2016 21:20:33

There have been considerable advances in the way RT is has been delivered in recent years in the UK. I would expect that with few exceptions hospitals would have IMRT (Intensity Modulated Radio Therapy) but some have the next development IGRT (Image Guided Radio Therapy). Then there are more advanced linear accelerators being introduced such as 'Rapid Arc'. To ascertain who has the most cutting edge you would need to inquire of an expert who has a detailed knowledge of radiotherapy equipment and what medical facilities have it and furthermore, would this be suitable for you. Cyberknife is an advanced form of RT for example but is not best suited for everyone.

Proton Therapy to the best of my knowledge is not available presently for treating any cancer in the UK other than eyes. Whist it's superiority for some cancers is generally acknowledged, there are doubts about whether it's theoretical advantage over Photons for PCa makes a significant difference to results. This link details the Proton Beam facilities being built in the UK. https://www.england.nhs.uk/commissioning/spec-services/highly-spec-services/pbt/

  In true British tradition they will not only be late but unable to treat with other ions like the one iin Heidelberg which was inaugurated in 2009, as shown here :- https://www.youtube.com/watch?v=LeApaY7ctMo A similarly principled but further developed one followed in Pavia, Italy."

Edited: by member 12 December 2016 11:38:16
Barry

Edited by member 17 Dec 2016 at 18:06  | Reason: Not specified

Barry
User
Posted 16 Dec 2016 at 19:51

There is data about proton therapy as a salvage treatment but not very much on its usefulness as a primary treatment I think. IGRT is becoming a bit more widely available but my husband had IMRT when that was quite new 5 years ago and had no ill effects. 

Edited by member 16 Dec 2016 at 20:35  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 18 Dec 2016 at 01:10

When I had the IMRT element of my RT back in 2008 I did note that the make and model of the particular linear accelerator (LINAC) I was treated on. It was nearly 10 years old and looked it! These machines are subject to very heavy use. There was a failure at one fraction so instead of the machine operating automatically, it had to be reset manually for each of the 5 set angles of delivery but the full dose was fully delivered. (Although they had IGRT LINACS, these were not suitable to take the frame supporting me inside my body cast).

So as with any machine, particularly one that is old, and well used, there is the possibility of a failure but I believe most hospitals have more than one and in need a patient could be transferred to another. It is correct that apart from weekends it is preferable for treatment to follow on for each weekday. One of my fractions was delayed by a day due to it being a public holiday.

I can understand why men want to be treated with the most advanced machines to get greatest impact with least collateral damage to other organs, particularly, when one of the best known UK oncologists said this year :-"We know that the average quality of British radiotherapy is poor with a huge need to upgrade the routine delivery machines many of which are more than a decade old. Capital is short as the NHS heads for a £20bn deficit by 2020. Imaginative new ways of funding state of the art cancer care are urgently needed in the UK and in many other countries."

The above quote is from an article primarily about 3 Proton Beam machines being built privately in the UK but that will also treat NHS patients. So that with the two NHS funded ones this will make 5. It is estimated that 12 -18 machines will be needed depending on how shifts enable usage. For anybody that is interested, the full article is here :- http://www.hippocraticpost.com/cancer/the-proton-controversy-the-legacy-of-aysha-king/

 

PS The article talks of a cyclotron which indeed is a cheaper way of producing the Proton Bean but to take full advantage of other Hadron Therapy possibilities, a synchrotron is required which is much bigger and more expensive.  

Edited by member 18 Dec 2016 at 01:22  | Reason: Not specified

Barry
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User
Posted 16 Dec 2016 at 19:51

There is data about proton therapy as a salvage treatment but not very much on its usefulness as a primary treatment I think. IGRT is becoming a bit more widely available but my husband had IMRT when that was quite new 5 years ago and had no ill effects. 

Edited by member 16 Dec 2016 at 20:35  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 16 Dec 2016 at 20:36

I answered your question in a thread which now comes up as 'Page not found', so I will try copy and paste. "
Man with PC
Posted: 11 December 2016 21:20:33

There have been considerable advances in the way RT is has been delivered in recent years in the UK. I would expect that with few exceptions hospitals would have IMRT (Intensity Modulated Radio Therapy) but some have the next development IGRT (Image Guided Radio Therapy). Then there are more advanced linear accelerators being introduced such as 'Rapid Arc'. To ascertain who has the most cutting edge you would need to inquire of an expert who has a detailed knowledge of radiotherapy equipment and what medical facilities have it and furthermore, would this be suitable for you. Cyberknife is an advanced form of RT for example but is not best suited for everyone.

Proton Therapy to the best of my knowledge is not available presently for treating any cancer in the UK other than eyes. Whist it's superiority for some cancers is generally acknowledged, there are doubts about whether it's theoretical advantage over Photons for PCa makes a significant difference to results. This link details the Proton Beam facilities being built in the UK. https://www.england.nhs.uk/commissioning/spec-services/highly-spec-services/pbt/

  In true British tradition they will not only be late but unable to treat with other ions like the one iin Heidelberg which was inaugurated in 2009, as shown here :- https://www.youtube.com/watch?v=LeApaY7ctMo A similarly principled but further developed one followed in Pavia, Italy."

Edited: by member 12 December 2016 11:38:16
Barry

Edited by member 17 Dec 2016 at 18:06  | Reason: Not specified

Barry
User
Posted 17 Dec 2016 at 07:09


This forum happens tobe reassuring and very helpful with the presence of wonderful people and their prompt response.
Unfortunately my conversation /thread is lost, so I need to start again.
Do Any body did IGRT or SBRT. Since I dont have much options other than RT, now I am researching a procedure
which gives me minimum side effects, without much problem to rectum or bladder.ED is confirmed in all so no escape from it.
shoukath

User
Posted 17 Dec 2016 at 12:48

I think you have perhaps misunderstood the ED thing. ED is not guaranteed as a side effect of IMRT - my husband hasn't had any problems. You could confuse ED with loss of libido but they are quite separate issues and again, while many men lose libido on HT it doesn't happen to everyone. RT does not affect libido and HT does not cause ED.

Manwith, you make a good point. Our onco only ever discussed John's treatment as IMRT but I am fairly sure it was actually done with a RapidArc machine - I guess that the medical people won't always make a big fuss about which computer programme they are using as all the newer RT delivery models are IMRT of one kind or another.

I do find it interesting that newer members are so bothered about which kind of machine is available where. When John was preparing for RT I was more interested in data like how many sessions were cancelled each month at the hospital due to break-downs, how many machines were running each day, whether it was possible to pre-book all the sessions for the same time rather than have to scrum for available slots from week to week, etc.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 18 Dec 2016 at 01:10

When I had the IMRT element of my RT back in 2008 I did note that the make and model of the particular linear accelerator (LINAC) I was treated on. It was nearly 10 years old and looked it! These machines are subject to very heavy use. There was a failure at one fraction so instead of the machine operating automatically, it had to be reset manually for each of the 5 set angles of delivery but the full dose was fully delivered. (Although they had IGRT LINACS, these were not suitable to take the frame supporting me inside my body cast).

So as with any machine, particularly one that is old, and well used, there is the possibility of a failure but I believe most hospitals have more than one and in need a patient could be transferred to another. It is correct that apart from weekends it is preferable for treatment to follow on for each weekday. One of my fractions was delayed by a day due to it being a public holiday.

I can understand why men want to be treated with the most advanced machines to get greatest impact with least collateral damage to other organs, particularly, when one of the best known UK oncologists said this year :-"We know that the average quality of British radiotherapy is poor with a huge need to upgrade the routine delivery machines many of which are more than a decade old. Capital is short as the NHS heads for a £20bn deficit by 2020. Imaginative new ways of funding state of the art cancer care are urgently needed in the UK and in many other countries."

The above quote is from an article primarily about 3 Proton Beam machines being built privately in the UK but that will also treat NHS patients. So that with the two NHS funded ones this will make 5. It is estimated that 12 -18 machines will be needed depending on how shifts enable usage. For anybody that is interested, the full article is here :- http://www.hippocraticpost.com/cancer/the-proton-controversy-the-legacy-of-aysha-king/

 

PS The article talks of a cyclotron which indeed is a cheaper way of producing the Proton Bean but to take full advantage of other Hadron Therapy possibilities, a synchrotron is required which is much bigger and more expensive.  

Edited by member 18 Dec 2016 at 01:22  | Reason: Not specified

Barry
User
Posted 18 Dec 2016 at 11:44

I finished 7.5 weeks of IGRT in November and everything seems to have gone easy. A little early to tell if it's worked yet. Not sure of the difference between IGRT and IMRT but IGRT seemed to be the one to go for. A mini CT scan before radio, you can feel the table reposition , and then the radio.
I was a bit worried about having 40 CT scans, but was told they added up to about half a proper CT scan.
Just waiting now for the hormone treatment to finish to see if any ED.

My IGRT was done at Worcester Royal. New facility with 3 new IGRT machines, and great radiographers.

Edited by member 18 Dec 2016 at 11:49  | Reason: Not specified

 
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