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Less radiological visits to treat low and intermediate prostate cancer. ancer

User
Posted 24 May 2024 at 13:35

A new clinical trial offering men with high risk prostate cancer quicker radiotherapy treatment has begun at a Surrey hospital. The trial will offer radiotherapy treatment over a week and a half, rather than the current minimum of 20 treatments over four weeks or more.

The Beeb were reporting this at the end of last year, and it has been mentioned in a couple of conversations on here.

What I'd like to know is.......

Is it being trialled in other hospitals?

Is it done with HT?

Could it be used for salvage radiation treatment?

Your answers on a postcard please.

Edited by member 24 May 2024 at 15:03  | Reason: Link added

User
Posted 24 May 2024 at 13:35

A new clinical trial offering men with high risk prostate cancer quicker radiotherapy treatment has begun at a Surrey hospital. The trial will offer radiotherapy treatment over a week and a half, rather than the current minimum of 20 treatments over four weeks or more.

The Beeb were reporting this at the end of last year, and it has been mentioned in a couple of conversations on here.

What I'd like to know is.......

Is it being trialled in other hospitals?

Is it done with HT?

Could it be used for salvage radiation treatment?

Your answers on a postcard please.

Edited by member 24 May 2024 at 15:03  | Reason: Link added

User
Posted 24 May 2024 at 16:12

From what I remember reading it was trialled over about the last ten years, five fractions and no HT. It is suitable for low risk patients. The beeb reports were that it is as good or better than 37 or 20 fractions.

In theory it should be rolled out across the whole of the NHS, the problem would be that not all hospitals have the equipment, or if they have the equipment they are not operating it in the required mode at the moment.

I was treated in 2018 at the Christie using an Elekta VersaHD Linac. I read the product information leaflet, and it said it could do SABR, but on me they were just doing the normal low dose reasonably wide field RT.

I would guess that the Christie would have been involved in the trial along with the Royal Marsden. I would guess that by now they would be trained up to operate the machines in SABR mode which I believe is what is required for the five fraction course. I would guess that any hospital with the right equipment would now be switching to the new method, for suitable patients. I would guess that it will be ten years before all NHS hospitals have suitable Linacs.

As you can see I am only guessing as to how widespread the treatment is, but we are seeing it discussed on this site fairly often so it is definitely on the cards, unlike a lot of promising treatments which seem to fall by the wayside (Proton beam, immunotherapy, Lutitium 177 all good but never fully adopted).

I am going to guess that in a SRT situation no one knows exactly where the cancer is so a more wide beam lower dose and plenty of fractions approach would be more likely to hit the cells wherever they are.

As I like to point out I don't know anything other than what I read on the internet, and what I think I can deduce with common sense. However cancer does not always follow common sense logic.

 

Dave

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User
Posted 24 May 2024 at 16:12

From what I remember reading it was trialled over about the last ten years, five fractions and no HT. It is suitable for low risk patients. The beeb reports were that it is as good or better than 37 or 20 fractions.

In theory it should be rolled out across the whole of the NHS, the problem would be that not all hospitals have the equipment, or if they have the equipment they are not operating it in the required mode at the moment.

I was treated in 2018 at the Christie using an Elekta VersaHD Linac. I read the product information leaflet, and it said it could do SABR, but on me they were just doing the normal low dose reasonably wide field RT.

I would guess that the Christie would have been involved in the trial along with the Royal Marsden. I would guess that by now they would be trained up to operate the machines in SABR mode which I believe is what is required for the five fraction course. I would guess that any hospital with the right equipment would now be switching to the new method, for suitable patients. I would guess that it will be ten years before all NHS hospitals have suitable Linacs.

As you can see I am only guessing as to how widespread the treatment is, but we are seeing it discussed on this site fairly often so it is definitely on the cards, unlike a lot of promising treatments which seem to fall by the wayside (Proton beam, immunotherapy, Lutitium 177 all good but never fully adopted).

I am going to guess that in a SRT situation no one knows exactly where the cancer is so a more wide beam lower dose and plenty of fractions approach would be more likely to hit the cells wherever they are.

As I like to point out I don't know anything other than what I read on the internet, and what I think I can deduce with common sense. However cancer does not always follow common sense logic.

 

Dave

User
Posted 24 May 2024 at 17:21

Originally Posted by: Online Community Member
As I like to point out I don't know anything other than what I read on the internet, and what I think I can deduce with common sense.

Afternoon Dave,

 An excellent combination. You know what you're talking about.

It says that the treatment is effective for low and intermediate disease and that they intend to trial it on high risk patients.

I would have loved to have had, an only five zap, no HT option, rather than surgery. I think it would have been the option I'd have taken.

It's too late for me, but having had surgery, I still fear recurrence, and wonder whether salvage treatment could also be reduced accordingly?

I think the mods have eradicated the news link. I'll try this one to the initial Beeb item, in Sept last year.

https://www-bbc-co-uk.cdn.ampproject.org/v/s/www.bbc.co.uk/news/health-66946336.amp?amp_gsa=1&amp_js_v=a9&usqp=mq331AQIUAKwASCAAgM%3D#amp_tf=From%20%251%24s&aoh=17165403388933&referrer=https%3A%2F%2Fwww.google.com

 

 

 

Edited by member 24 May 2024 at 21:19  | Reason: Add link

User
Posted 24 May 2024 at 21:39

Adrian,it sounds similar to the PACE trial. A relative was asked if he wanted to be considered for 20 sessions instead of 30plus sessions,that was about four years ago. I think the 5 SABR sessions may only be for organ confined disease. 

Thanks Chris 

User
Posted 25 May 2024 at 01:09

Originally Posted by: Online Community Member
I was treated in 2018 at the Christie using an Elekta VersaHD Linac. I read the product information leaflet, and it said it could do SABR, but on me they were just doing the normal low dose reasonably wide field RT.

Thanks Dave. Interesting insight into LINACs. It sounds as though the line between conventional EBRT and SABR might be disappearing with these recent machines. By the time I had my treatment, a couple of years after you [and in Australia] they'd moved to using high dose, narrow field using a LINAC [and active monitoring]. I suspect that the advances in computer control of these units have played as big a part in progress as have the LINACs themselves, which are the obvious thing we see.

Jules

 
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