Could Proton Beam Therapy be Future Prostate Cancer Treatment?
Introduction
Having had an unsatisfactory experience personally when I was diagnosed with prostate cancer 4 years ago; I have taken a close interest in updates about the diseases detection and treatment. There is a lot of material available and regular new material being published, and to say the least; there is no easy way for a man, already under stress, to make a well informed decision based on clear, well explained options.
Whilst, like me, most men will heed the advice of their medical practitioner or specialist, I personally believe that in many cases this may be biased; either by their practitioners personal preference or for financial reasons.
According to The Centre for Disease Control and Prevention (CDC), prostate cancer is the most common form of cancer amongst men, followed by lung cancer and colorectal cancer.
An Interesting New Case Study
A recent article in “everydayhealth.com” caught my attention. Steve Scott, a former three-time U.S. Olympian and member of the USA Track and Field Hall of Fame wrote about his quest for the best treatment for his prostate cancer, which was diagnosed in the U.S. summer of 2014.
In the article Steve says “I plotted out my treatment goals, researched my medical options, consulted with expert physicians, and selected the path I felt would give me the best opportunity for success, on my terms.”
Having looked at the most common treatments available i.e. a prostatectomy (surgery to remove the prostate gland) and radiation therapy, Steve was unhappy with both these options which, according to the American Cancer Society, are chosen by over 90% of men with prostate cancer who opt for treatment rather than a period of observation known as “watchful waiting”
Steve says “The probable side effects of these two treatment options were unacceptable to me. I also was not comfortable with the “watchful waiting” approach. I was shocked and depressed about my options.”
It was then that Steve heard about another lesser known option called “Proton Beam Therapy”, which has a long and proven track record in the successful treatment of other forms of cancer, mainly for tumours surrounded by sensitive structures such as the eye, brain, and spinal cord, where conventional radiation therapy could cause unacceptable damage to surrounding tissue and organs; but it has only recently been used to treat prostate cancer.
After further research Steve chose this alternative form of treatment, saying “After consulting with various medical specialists and exploring the fullest range of treatment possibilities, I chose to undergo proton therapy at the Scripps Proton Therapy Center in San Diego.”
Steve has now completed the proton beam therapy and is very pleased with the outcome at this early stage, saying “According to my radiation oncologist my treatments were delivered successfully. The goal was to eradicate my tumour, resulting in a cure. And that’s the path that I am now on. My prognosis is excellent, and I’ll continue with regular follow-up visits for monitoring. I’m very confident in my treatment choice, and very confident that everything is going to turn out great.
And importantly, I have experienced absolutely no side effects from my treatments. I’ve maintained the intimacy I value so much with my wife.”
So what is Proton Beam Therapy, and is it a Better Option?
There are currently at least 40 Proton Beam Therapy centres worldwide, with 14 in the USA and 10 more under construction. In Australia the first centre will open in 2018 and the UK plans to have 2 centres in London and Manchester, also by 2018. There are 5 in Japan, and another 3 in Korea and China and the rest are in mainland Europe with at least 5 in Germany.
A recent article in medscape.com reported that “Proton-beam therapy is not new, but its use for medicinal purposes has greatly increased during the past decade. Much of the controversy related to this treatment arose because of cost.
According to a 2009 report by the Institute for Clinical and Economic Review (ICER) on management options for low-risk prostate cancer, the cost to construct and equip a facility to provide proton-beam therapy ranges from $25 million to $150 million. In comparison, acquisition costs for IMRT systems (i.e. conventional radiotherapy technology) range from $1.8 million to $5.4 million.
In his article “Is proton beam therapy for prostate cancer worth the cost?” Durado Brooks, MD, MPH – Director, Prostate and Colorectal Cancers, American Cancer Society, provides the following definition:
“Proton therapy is a new way to deliver radiation to tumours using tiny sub-atomic particles (protons) instead of the photons used in conventional radiation treatment. Proton therapy uses new technology to accelerate atoms to 93,000 miles per second, separating the protons from the atom. While moving at this high-speed, the particles are “fired” at the patient’s tumour. These charged particles deliver a very high dose of radiation to the cancer but release very little radiation to the normal tissue in their path. In theory, this approach minimizes damage to healthy organs and structures surrounding the cancer.”
He also makes the following points:
“Proton therapy has been proven beneficial for tumours surrounded by sensitive structures such as the eye, brain, and spinal cord where the potential for radiation damage is very high. In contrast, most studies of proton therapy for prostate cancer suggest that this new approach may be just as good as standard photon radiation treatment at controlling the growth and spread of the cancer, but there is no evidence that proton treatment does a better job of curing the cancer.
And in spite of the theory that protons cause less damage to normal tissue, there is at present no convincing evidence that urinary (bladder problems), gastrointestinal (rectal leakage or bleeding), or sexual (erectile dysfunction), complication rates are lower following proton therapy. A few studies suggest that rates of some side effects might even be higher.”
I have carried out further research from a number of highly credible sources – see links at the end, below this article – and there seems to be a wide range of views about the effectiveness of proton beam therapy for the treatment of prostate cancer, and it’s relative effectiveness compared to the two most common options mentioned above.
I have summarised some key points below; but if this is an issue that has relevance for you personally, or a family member or friend, please use the research and the links I have included below to do your own research, and then consult your own medical practitioner and discuss with them before making any decision to proceed.
According to the American Cancer Society website when comparing the most common current treatments for prostate cancer i.e. a prostatectomy, and radiation therapy “There is at present no reliable evidence that one of these treatments is “better” than the other for the long-term management of prostate cancer.
So the decision between surgery and radiation therapy often comes down to how men think and feel about the potential short-term and long-term side effects and complications of these treatments”
In a news article in October 2012, Scripps- the treatment center where Steve had his treatment, announced that a new study presented at the American Society for Radiation Oncology conference in October 2012 had found that “proton beam therapy preserves quality of life, specifically urinary and bowel function, in men treated with this highly targeted form of radiation treatment for prostate cancer.”
Web MD says “In proton beam therapy, beams of protons are targeted directly to tumours, thereby sparing healthy tissue, which theoretically should cause fewer side effects. Indeed, its benefit in treating eye and paediatric brain tumours is well documented. But for prostate cancer, the answer is far less clear.”
Conclusion and Summary
According to The Centre for Disease Control and Prevention (CDC), prostate cancer is the most common form of cancer amongst men, followed by lung cancer and colorectal cancer.
Steve Scott has had the Proton Beam Therapy and is very pleased with the outcome at this early stage, and appears not to have any significant side effects.
Proton Beam Therapy has been proven to be very effective for tumours surrounded by sensitive structures such as the eye, brain, and spinal cord where the potential for radiation damage is very high. But at this stage its effectiveness for the treatment of prostate cancer has not been proven.
There are currently at least 40 Proton Beam Therapy centres worldwide, with 14 in the USA and 10 more under construction; it is not new, but its use for medicinal purposes has greatly increased during the past decade
When comparing the current most common treatments for prostate cancer i.e. a prostatectomy, and radiation therapy, there is at present no reliable evidence that one of these treatments is “better” than the other for the long-term management of prostate cancer.
My personal opinion with no medical qualifications, based only on what I have read; it is clear that further research is required to confirm whether Proton Beam Therapy is a more effective treatment for prostate cancer than the two forms of treatments that 90% of cancer patients currently choose.
Based on its proven effectiveness for other forms of cancer where damage to surrounding healthy tissue is an issue, I believe that the outcome of new research will be positive – which would be very good news indeed for future generations of men.
In conclusion: please consult your own medical practitioner and discuss with them before making any decision to proceed with any form of treatment.
You can view the article written by Steve Scott here
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Other Resources used for research or cited in this article:
American Cancer Society – Durado Brooks Article:
Choosing the best prostate treatment cancer for you
Is proton beam therapy for prostate cancer worth the cost?
Centre for Disease Control and Prevention (CDC)
National Association for Proton Therapy
Scripps proton Treatment Center