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I am a 71 year old who has recently, (1 month ago), been diagnosed with a single finding of early stage, small core adenocarcinamo (Gleason.6)
Other than the cancerous growth in or on my prostate I'm in good health, work out, lift weights, jog, play a lot of golf and have a very active sex life. MY former urologist who left St. Louis for Northwestern university ( one of the founding fathers of the PSA project at Washington U.) has suggested prostatectomy, however I am more interested in quality of life issues than longevity, ( A combination of both would be nice)
I'm in the process of selecting a treatment option and the first radiation oncologist that I consulted with last week at St. Johns Pratt Cancer Center ,
recommended a form of radiation therapy called The Tomo Process, which uses 3D images from a combination of scannong technologies ( such as CT and MRI) and special software to establish the precise contours for each treatment volume(tumor) and any regions at risk.
I mentioned that a well respected urology expert associated with Prostate Commons , a respected medical website, had stated recently that "Fiducial Marker Seeds ( gold fiducial markers are the fixed standard of refrence for comparison or measurement every time the patient has their radiation treatment"
The R.O. stated that fiducial markers were indeed very helpful in allowing radiation to be directed precisely to the diseased areas of the prostate and that they had been used at St. Johns Pratt Cancer Center sucessfully until the Tomo process was initiated approx. four years ago.
However the Hi-Art (Tomo) treatment delivery machine combined with a CT scan just before each treatment verifies the position of the tumor and insures that radiation is directed right where it should be. There is continious 360 degree treatment delivery of modulated radiation therapy( IMRT) with a helical(spiral) delivery pattern. THe Photon radiation is produced by a linear accelerator (or LINAC for short), which travels in circles around the patient and moves in unison with adevise called a multi leaf collimator, or MLC. Meanwhile the couch is also moving --guiding the patient slowly through the center of the ring.
In other words it allows minimum radiation exposure to healthy tissue without having to utilize the much more invasive process of inserting gold markers.
My question for Dr Greenstein is the information given to me from this particular radiation therapist reliable and what does he thing of Tomo therapy as a treatment option for earl stage prostate cancer.
P.S. I have a consultation with a second radiation therapist at Barnes/ Washington University Cancer center next week. I believe that his bias has been in the direction of radiation seeding.
Any advice that will aid me in reaching a decision on treatment options would be greatly appreciated.
Martin
Mr. Flannery,
These are fantastic questions. Unfortunately, an answer does not exist for "what's best?" If I line up ten urologists and ask them the best way to manage your cancer, I will have 4 different answers. The same exists if I ask radiation oncologists the same question. The R.O. will make a recommendation based on their experience, their personal beliefs and their available technology. At the Steeplechase Cancer Center at Somerset Medical Center, the radiation oncologists like the marker seeds because they help locate the prostate every single treatment day. The R.O. you saw seems to be happy with his results without the seed markers. If he's happy, you trust him and they have good outcomes then I say go for it. I would get your second opinion and see what you think. I think that external beam radiation is excellent choice for a man in your situation. Good luck.
Dr. Greenstein
I am a 56 year old who have undergone tomo radiation with the aid of Fiducual Markers in Aug 2009. I feel my radiation therapy went well however I have experienced bladder and rectum spasm from the day the markers were placed (actually before the radiation treatment started). Immediately after placement of the markers I began to experience impaired bladder function. Bladder slowly improved but I continued to retain fluids, so much fluid that I had to have a catheter placed to remove the fluid. Upon the completion of radiation treatment I was released to go home having to self catheterize as needed. Bladder function have improved to a point that I no longer have to self catheter however I still have the bladder and rectum spasm. My question is, have you seen this in any other patients which underwent the Fiducial Marker Implants.
i am a prostate cancer person,stage 4,.I was told i should have the marker installed and i would like this at well but my issue is i haven't any monies to do so,my question is are there any agencies,out thats welling too help someone like myself to recieve these markers,.If so could you please help me,.thank you and by the way i havent any insurance,.thanks again,.
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