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#80684 09-18-2008 05:43 PM
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My mother-in-law found an article in Parade (the insert found in Sunday papers) regarding proton therapy used in cancer treatment. Does anyone know anything about this?


age 35 at DX,EBV-, HPV+,stage 4a oropharyngeal BOT rt side 1 node+/15 nodes - rt side of neck, non-smoker/drinker, induction therapy to begin 9/18/08 cisplatin,5FU,taxotere 2X, radiation to follow for 7 wks, radiation completed 1/21/09
terryandtroy #80687 09-18-2008 06:11 PM
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Type proton into the search box in the upper right of each page -- a number of posts pop up.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
terryandtroy #80688 09-18-2008 06:11 PM
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I do know that MD Anderson has been doing some research in this area and I found this

http://www.mdanderson.org/care_centers/radiationonco/ptc/

Head and Neck is listed, but not linked.

Kevin



18 YEAR SURVIVOR
SCC Tongue (T3N0M0) diag 06/2006.
No evidence of disease 2010
Another PET 12-2014 pre-HBO, still N.E.D.


�Remember to look up at the stars and not down at your feet. It matters that you don't just give up.�
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This is very nice.... in principle. It solves the problem with the exit radiation. The protons only penetrate to a certain (selectable) depth. Therefore there is much less tissue damage.
On the other hand there are just VERY few places (6?) where they do this (as opposed to IMRT). I am not aware if there are results for sizeable cohort (Brian?). I tried to look into this and my GP and myself contacted the FL center.... no response.

Timeliness of the treatment and accessibility are major concerns and may negate potential advantages of proton therapy!

M






Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
Markus #80702 09-18-2008 08:42 PM
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Loma Linda and a couple other places are doing it on a limited basis. But it is not the mainstream choice right now. Remember that targeting is really great in brain etc. but in areas where the tumor is more diverse, invasion into surrounding tissues more likely, too targeted a beam does not do the task. Gary is the one we need to email about this, he's the radiation guru.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
Markus #80703 09-18-2008 08:44 PM
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It also sounds as though it would only be suitable for tumors determined to be 'non-surgical.' My tumor, for example, was removed surgically and radiation was used to kill off any remaining cancer cells, that may or may not have been there. The proton therapy would be used to target just the tumor itself and not larger fields.

Very cool stuff though!


Stage IV SCC lt lateral tongue, surgery 5/19/08 (partial gloss/upper neck dissection left side/radial free flap reconstruction) IMRT w/weekly Cisplatin & Erbitux 6/30/08, PEG 1 6/12/08 - out 7/14 (in abdominal wall, not stomach), PEG 2 7/23/08 - out 11/20/08, Tx done 8/18/08
Second SCC tumor, Stage 1, rt mobile tongue, removed 10/18/2016, right neck dissection 12/9/2016
Third SCC tumor, diagnosed, 4/19/2108, rt submandibular mass, HPV-, IMRT w/ weekly Cisplatin, 5/9 - 6/25/2018, PEG 3 5/31/2018
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There was an article about IMPT (Intensity Modulated Proton Therapy) in the Journal of Oncology about a year and a half ago. It mentioned MD Anderson as one of the places that uses it, in fact has an entire building donated to it's use. The article described it's advantages over say IMRT in that it is like a smart bomb. It can be programmed to seek out a specific tumor and actually conform to its internal shape and "explode" inside killing the tumor but sparing surrounding tissues. The article was a BIT more technical than my summary. It's uses are obviously suited for hard to reach tumors as in the brain or other sensitive areas but as Brain says it would not be suited for an area as great as most of us have to have radiated. I kept that magazine around in my office forever and now I can't find it!!


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
davidcpa #80729 09-19-2008 10:53 AM
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LVH Muhlenberg Hospital in Bethlehem, Pa will be building a section for proton therapy...very expensive. And from what I understand the machines weigh a lot...a whole lot. Much more then the IMRT. The next closest center that is doing this is in Boston, Ma....from where I'm located. Not many exist.


7-16-08 age 37@Dx, T3N0M0 SCC 4.778cm tumor, left side of oral tongue, non smoker, casual drinker, I am the 4th in my family to have H&N cancer
8-13-08 left neck dissection and 40% of tongue removed, submandibular salivary gland & 14 nodes clean, no chemo, IMRTx35
11-4-08 Recovering & feeling better
Ray1971 #80731 09-19-2008 11:52 AM
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I was down at St. Jude this morning and asked one of the Physicist that we work with on a regular basis about this. His take is that it is an up and coming technology and they are very excited about it due to the fact that it does not do damage to the surrounding tissue. He added this is especially important in pediatric cases because the little one are still growing.

When they got their machine, they built the building back around it. It was too big and heavy to do anything else. Didn't get a chance to go see (it was on the other side of the campus) but have an open invitation to do so.

Very cool !

Kevin


18 YEAR SURVIVOR
SCC Tongue (T3N0M0) diag 06/2006.
No evidence of disease 2010
Another PET 12-2014 pre-HBO, still N.E.D.


�Remember to look up at the stars and not down at your feet. It matters that you don't just give up.�
Stephen Hawking
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To be even more exotic, there is the emerging possibility that antiprotons are even more effective! (how is that for science fiction). Antimatter to the rescue!

Perhaps the lower collateral damage would allow dose escalation and shorter duration of therapy.

Realistically however, IMRT (and variations) will be the Rad Tx of choice for many years to come and this is also available in smaller towns

M




Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
Markus #80928 09-22-2008 04:19 PM
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I presume that you are all talking about PBT (AKA Proton Beam Therapy). There are around 1/2 dozen treatment centers operational in the US today. It costs a LOT of money to set one up. MDACC spent 200M on theirs (contrast with 9M for an IMRT machine). Loma Linda, by the way, commonly uses IMRT with it to acheive clean margins as PBT is so accurate. So you might get ionizing radiation even if you elect to go with PBT. It is showing great promise and has much higher patient throughput. One PBT generator can service multiple treatment rooms/gantries.
More information: http://health.usnews.com/articles/health/cancer/2008/04/16/the-promise-of-proton-beam-therapy.html

And:

http://www.proton-therapy.org/index.html

It is hard to gain access to however with only 6,000 treatments spots avaiable. Don't look for it to come to a hospital near you anytime soon however.

One other factoid - practically all OC cancer treatments have their roots in prostate cancer treatment.



Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
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