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Proton therapy is effective in treating many types of cancerous and non-cancerous tumors.
Early prostate cancer often shows no signs, and the vast majority of prostate cancer cases diagnosed today are the result of PSA screening. In patients who do not undergo screening, prostate cancer can progress and eventually lead to symptoms that include:
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Much research has been done to study how various factors affect the risk of developing prostate cancer, and researchers continue to learn more each day. Currently, the following risk factors have been identified as possible contributors:
Prostate cancer is one of the most diagnosed cancers (one in six U.S. men will be diagnosed in their lifetime), and it is also one of the most treatable and curable. Unlike other forms of cancer, prostate cancer usually has no symptoms. By the time symptoms do appear, it may have spread and is harder to treat, much less cure. That’s why early detection is so important. Two common tests used to screen men are the prostate-specific antigen (PSA) test, which measures the amount of PSA in a man’s blood, and the digital rectal exam (DRE), which is a routine exam during which your doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for any hard, lumpy, or abnormal areas. The American Cancer Society recommends that men make informed decisions about having prostate cancer screening tests based on available information, discussion with their doctor, and their own views on the benefits and side effects of prostate cancer screening and treatment. If the results of either one of these tests are abnormal, your physician will recommend additional testing to determine if cancer exists. Often, testing will include imaging exams, such as an MRI, CT scan, ultrasound, and a biopsy. If cancer is diagnosed, your physician will use information from the pathologist and the TNM staging system to determine the stage of your disease. The TNM system considers: T: the size and extent of the tumorN: whether and how far the cancer has spread to the lymph nodesM: whether the cancer has metastasized (spread) to other organs in the bodyYour physician will use the stage of your disease and other information about your age and health to determine the best treatment plan for you.
PSA Test & Gleason Score:
A PSA test is a simple blood test that detects elevated levels of prostate-specific antigen (PSA), which may indicate the presence of prostate cancer. Treating prostate cancer is easier and more effective when diagnosed early, and the PSA test is the best method for early detection.
Because early prostate cancer may not have symptoms, a PSA test is the best method of early detection. Naturally, your age, family history, and overall health are considerations regarding whether to get a PSA test. While not all men should have their PSAs checked, men ages 55-69 with a higher risk of prostate cancer do benefit from PSA testing. Speak with your doctor to see if a PSA test is appropriate for you.
Based on guidelines developed by the American Urological Association (AUA), PSA testing is recommended for men aged 55-69.1 Men with higher risk factors, such as African American race or a family history of prostate cancer, will also benefit from a PSA test.1 Talk to your doctor about the pros and cons of PSA testing before making a decision. For the complete guidelines on PSA testing, visit the AUA Web site.
The AUA recommends testing intervals of 2 years vs annual testing. This decision, made with your doctor, gives you the majority of the benefits while reducing over-diagnosis and false positives.1
While it is true that routine PSA screening for healthy men aged 55-69 can reduce the chance of dying from prostate cancer by 20% or more,2 your decision should be based on your individual situation.
Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA testing as well.
The higher your PSA level, the more likely it is that you have prostate cancer. However, sometimes the PSA level may be elevated for reasons other than cancer and no action is necessary. A biopsy may be the next step, depending on your individual case and your doctor’s recommendation. If you have an elevated PSA level, the next step is to talk with your doctor.
While biopsies may occasionally result in complications, such as infection, they are often used in conjunction with PSA testing to accurately diagnose a cancer that may be “silent” (symptom-free). Ask your doctor for more information.
A Gleason score represents the results from a prostate biopsy. A biopsy removes small samples of prostate tissue so that they can be examined under a microscope for evidence of cancer. A pathologist will usually assign the biopsy results a Gleason score after examination.
A low Gleason score means the cancer tissue is similar to normal prostate tissue and the tumor is less likely to spread; a high Gleason score means the cancer tissue is very different from normal and the tumor is more likely to spread.3
For additional information, please see the references below and consult your doctor. If you’ve already been diagnosed with prostate cancer, please contact us by calling the numbers at the top of the page or clicking on the Request for Information button and filling out the form. We’re ready to help.
Proton therapy significantly reduces the radiation exposure to healthy tissue. Proton therapy’s ability to precisely target prostate cancer means surrounding tissue and organs receive much less radiation than with traditional radiation. In fact, a comparison study shows a 35% - 59% reduction in radiation exposure to the bladder and the rectum.*
See for yourself: These images show the different amounts and locations of radiation during treatment with proton therapy vs X-rays/IMRT.
By minimizing excess radiation to non-targeted areas, such as the rectum,3 the likelihood of gastrointestinal side effects is reduced, according to recent studies.4 Less radiation to surrounding tissues means low risk of long-term side effects, such as incontinence and impotence.3 Men who received proton therapy for prostate cancer reported little to no side effects.4
In a study of prostate cancer patients receiving proton therapy, patients reported no difference in urinary and bowel function before and after treatment.5Contact one of our centers or use the Live Chat button to speak to one of our experts.
Types of Prostate Cancer
ProCure treats non-metastatic prostate cancer in all risk groups. ProCure also treats residual prostate cancer after surgery.
Proton therapy is an advanced form of radiation that destroys cancer cells by preventing them from dividing and growing. Proton therapy uses protonspositively charged atomic particlesinstead of the photons used in standard X-ray radiation therapy. With proton therapy, doctors can precisely target the tumor while minimizing damage to the surrounding, healthy tissue. Unlike standard X-ray radiation, protons deposit much of their radiation directly in the tumor and then stop.
Usually, treatments are given five days a week for nine weeks, depending on the stage of your prostate cancer and other health factors. Shorter courses of treatment, ranging from one week to five weeks, are available for select groups of patients. In most cases, you can go about your normal routine before and after your session.
Yes. Proton therapy can be used with many other kinds of cancer treatment, including hormone therapy, brachytherapy, and/or as a follow-up to surgery.
Most patients do not feel pain or discomfort during treatment. The majority of the time patients spend in the treatment room involves setting up for treatment.Your radiation therapists will have everything ready for you before the treatment begins. You will be moved into position before each treatment using an FDA-approved robotic positioning system. You will be asked to lie still on a treatment bed while your therapists make adjustments. After you are in position, the proton beam is delivered and is on for about one minute. You will not feel or see the proton beam. You may hear some clicking from the equipment around you, but generally, after a few treatment sessions, the sounds go unnoticed. During the actual treatment, your therapists will leave the room and monitor your treatment from a control room just outside the treatment room. Although they are not in the same room as you, they can see and hear you through a video monitor. They remain close by and you can easily talk to them if you need anything.There is no need to stay overnight in a hospital or remain at the Center after your treatment. In most cases, you can go about your normal routine before and after your session.
Benefits, Efficacy and Side Effects
Proton therapy and X-ray radiation therapy both treat prostate cancer by killing cancer cells when they attempt to divide and multiply. However, there is an important difference. Because X-ray radiation releases its maximum dose of radiation quickly after penetrating the skin and continues to release radiation as it passes through your body beyond the tumor, it exposes more tissue to unwanted radiation, potentially causing more damage to healthy tissue and organs than proton therapy. Proton therapy delivers much of the radiation exactly at the tumor site and then stops. There is essentially no radiation exposure beyond the tumor site once the radiation has reached and covered the treatment area. This allows proton radiation to target the tumor while reducing damage to surrounding healthy tissue.1For prostate cancer, this means less radiation is delivered to the bladder and rectum. In a study conducted at the University of Florida Proton Therapy Institute, proton therapy delivered on average 35 percent less radiation to the bladder and 59 percent less radiation to the rectum compared with standard radiation therapy. 2
Yes. According to a study from the University of Florida Health Proton Therapy Institute, 99 percent of men with early and intermediate prostate cancer and 76 percent of men with advanced prostate cancer are cancer free five years after proton therapy.4 These results compare favorably to outcomes achieved with surgery or other types of radiation.In a Massachusetts General Hospital Phase III study of 393 patients with early, intermediate, and advanced stages of prostate cancer (all risk groups), 91.3 percent of patients were cancer free at five years when treated with high doses of proton therapy.4,5
Proton therapy offers high cancer control rates.5 In one study, 91.3 percent of men in all risk groups were cancer free (no rise in prostate-specific antigen (PSA)) at five years post-treatment.4 High cancer free rates were also maintained for patients in the low risk group in follow-up at 10 years. For example, 92.9 percent of men in the low-risk disease were cancer free 10 years after receiving proton therapy treatment.5
Proton therapy shares a high cure rate with other cancer treatments, including brachytherapy and IMRT. The difference is that standard X-ray therapies such as IMRT deliver more radiation to normal tissues surrounding the prostate.6 With proton therapy, radiation to critical structures, including the rectum and bladder, is dramatically reduced, resulting in low rates of rectal and genitourinary side effects.4,8,9,10 A national trial led by investigators at the Harvard Cancer Center is ongoing to determine if the reduction in exposure to the healthy tissues can improve the long-term quality of life for patients after proton therapy treatment.
Most patients do not experience side effects during proton therapy treatment. If side effects occur, such as mild fatigue and more frequent urination, they are generally minor and manageable. In terms of long-term side effects, because proton therapy is very precise, it is unlikely to cause urinary or bowel problems. Additionally, proton therapy has a low risk of debilitating side effects like incontinence and impotence, which are often associated with treatment options like surgery.
Most men with prostate cancer are good candidates for proton therapy. If you and your doctor are interested in proton therapy as a treatment option, we can schedule a consultation for you to speak with a radiation oncologist at a ProCure Center. During the consultation, the radiation oncologist will work with you to determine if you are likely to benefit from proton therapy. The radiation oncologists at ProCure use all forms of radiation to treat prostate cancer, so they will provide you with an unbiased treatment recommendation that is best for you.
Proton therapy is covered by Medicare and many private insurance providers. Each ProCure Center has a financial counselor who is dedicated to guiding you through the insurance process. Please contact us if you have questions about coverage.
Pencil Beam Scanning
Unlike conventional radiation treatments in which the beam penetrates all the way through the target tumor into the normal tissues behind the cancer, proton beams deliver their dose to the tumor without any dose reaching the deeper tissues. Pencil beam scanning couples this unique property of the proton beam with an electronically guided scanning system that delicately and precisely moves a beam of pencil point sharpness back and forth across each layer of the tumor’s thickness. This “paints” the tumor with radiation in three dimensions and eliminates dose to the normal tissues on the other side of the cancer. The ultra precision of pencil beam scanning makes it an ideal treatment, especially for irregularly shaped tumors that are located next to critical tissues and organs, such as tumors of the prostate.
Currently there are several trials being conducted for prostate cancer at ProCure.