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Jim Marshall (not a doctor) said ... If your first treatment for prostate cancer is radiotherapy, getting to each session, five days a week for several weeks can be a problem. These researchers asked whether this would affect your results. Their answer - it does not make a difference in the first four years. Four years because that is the length of time they studied their patients. Longer time results will have to wait more years. ... end Jim J Med Imaging Radiat Oncol. 2018 Feb;62(1):116-121. doi: 10.1111/1754-9485.12675. Epub 2017 Oct 13. Effects of interruptions of external beam radiation therapy on outcomes in patients with prostate cancer. Dong Y1, Zaorsky NG1,2, Li T3, Churilla TM1, Viterbo R4, Sobczak ML1, Smaldone MC4, Chen DY4, Uzzo RG4, Hallman MA1, Horwitz EM1. Author information Abstract INTRODUCTION: To evaluate if interruptions of external beam radiation therapy impact outcomes in men with localized prostate cancer (PCa). METHODS: We included men with localized PCa treated with three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) of escalated dose (≥74 Gy in 1.8 or 2 Gy fractions) between 1992 and 2013 at an NCI-designated cancer centre. Men receiving androgen deprivation therapy were excluded. The non-treatment day ratio (NTDR) was defined as the number of non-treatment days divided by the total elapsed days of therapy. NTDR was analysed for each National Comprehensive Cancer Network (NCCN) risk group. RESULTS: There were 1728 men included (839 low-risk, 776 intermediate-risk and 113 high-risk), with a median follow up of 53.5 months (range 12-185.8). The median NTDR was 31% (range 23-71%), translating to approximately 2 breaks (each break represents a missed treatment that will be made up) for 8 weeks of RT with 5 treatments per week. The 75 percentile of NTDR was 33%, translating to approximately 4 breaks, which was used as the cutoff for analysis. There were no significant differences in freedom from biochemical failure, freedom from distant metastasis, cancer specific survival, or overall survival for men with NTDR ≥33% compared to NTDR<33% for each risk group. Multivariable analyses including NTDR, age, race, Gleason score, T stage, and PSA were performed using the proportional hazards regression procedure. NTDR≥33% was not significantly associated with increased hazard ratio for outcomes in each risk group compared to NTDR<33%. CONCLUSION: Unintentional treatment breaks during dose escalated external beam radiation therapy for PCa did not cause a significant difference in outcomes, although duration of follow up limits the strength of this conclusion. © 2017 The Royal Australian and New Zealand College of Radiologists. KEYWORDS: outcomes; prostate cancer; quality; radiation therapy; treatment interruption PMID: 29030906 This extract can be found on http://PubMed.com, and is in the public domain. On PubMed.com there will be a link to the full paper (often USD$30+, sometimes free). Any highlighting (except the title) is not by the author, but by Jim Marshall. Jim is not a doctor.
Xofigo (radium 223) has changed the treatment of prostate cancer metastatic to bone. Xofigo is chemically similar to calcium, so tissues that uptake calcium uptake radium as well. That means principally bone, especially in highly metabolically active sites like bone metastases. Lutetium-177 (Lu-177) is a radioactive substance which scientists have attached to an antibody found on the surface of at least 95 percent of prostate cancer cells and called prostate surface membrane antigen (PSMA). Unlike Xofigo, which only attaches to bone metastases, Lu-177-anti-PSMA attaches to any metastasis — bone, lymph node or visceral. It can potentially treat systemic micrometastases as well. Click on the link to read an interesting article in the New Prostate Cancer Infolink.
In short Jim had 4 years of continuous hormone therapy: 8 months before radiation; 4 months during radiation; and 3 years after the end of radiation. Hormone therapy is also called ADT (androgen deprivation therapy). After 3 years of undetectable PSA, Jim took a break from hormone therapy. This break lasted 2 years, but the PSA started rising again, so Jim is now on hormone therapy again. In detail Click on this sentence to see Jim's full story. If you know how to post on the website, why not post your own story? Or Click on this sentence to be helped to write your own story.
Geoff Buttfield posted a topic in The loungeFound an interesting video by A/Prof Henry Woo of the Sydney Adventist Hospital addressing a local support group on the latest scanning and treatment techniques (recorded October 14), highlighting the great leaps forward in disease imaging occurring at the moment. Aggressive Treatment of Aggressive Prostate Cancer ~ A/Prof Henry WooPublished on Oct 19, 2014 A peek into the cutting edge of treatment for advanced or aggressive Prostate Cancer, with information on the next wave of diagnostic scans about to break. Here is the link- //www.youtube.com/watch?v=g-5NXyKo-t8