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Effects of radiation on healthy cells
I thought that any healthy cells next to the prostate would die and never come back. According to Mayo's website in Florida it says "Radiation therapy damages cells by destroying their genetic material. Genetic material controls how cells grow and divide. Healthy cells may be damaged along with cancer cells during radiation therapy. But healthy cells can repair themselves more easily than cancer cells." The key word here is "can" and not "will". However, it is still comforting to know that such cells may regenerate themselves.
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I think it is why proton versus photon radiation is important to know about. There is less damage of radiation coming in and no radiation damage going out versus photon. What every you can do and/or treatment to reduce damage to healthy tissues and organs to me is just commont sense.
Phoenix and Rochester offer proton radiation treatment for prostrate cancer but Jacksonville does not. Jacksonville is building a new cancer institute which will have proton radiation. Hopefully it will have the same proton radiation treatments available for prostrate cancer that Rochester and Phoenix offer.
Part of the problem with proton is it uses wider margins than the MRIdian. It does not have a built in mri so one uses fused images instead of real time. It also does not have automatic shutoff with its operation.
There is no trial that has been done comparing the two machines so as a patient, you are left with radiation in little or no out versus the aforementioned. I did see a theoretical study that concluded that if the proton therapy had a built in MRI, as the MRIdian does, that the proton therapy would be better. We as patients need more practical comparisons of these machines to help with the decision making process. It’s not enough to say the outcomes are the same and toxicity minimal. For those cancer centers that have both machines, other than the labor issue of one machine vs another, it would be interesting to find out why they bought one machine vs another.
Regarding proton delivery: In my research a few months ago I came across the Calypso system that allows for "gating capability" during radiation treatments. The full name is Calypso® 4D Localization System - GPS for the Body® and is described on the Varian site https://www.varian.com/why-varian/improving-accuracy-radiotherapy-using-calypso-system. One doctor states "we can reduce our treatment margins to a threshold of 2 mm." Then to cut off the radiation, "Calypso tracks whenever the target motion exceeds our threshold, the treatment beam is automatically stopped, and we realign the target with minimal impact on workflow." Calypso "monitors the tumor in real-time and is like a continuously running movie because it gives us a live, continuous view of tumor position." One possible problem is "Implanted Beacon transponders may migrate such that they pass from the patient’s body or move to a different location within the body and may include, pain, bleeding and infection." To be able to see the prostate in real time, they must be using an Ultrasound probe in the rectum rather than a real time MRI ?? Note: the Varian article was dated August 16, 2017 which makes one wonder if this is old technology. More info> https://www.upstate.edu/cancer/cancer-care/treatment-options/radonc-patientcare/treatment_options/external/calypso.php Please give me your opinion of MRIdian versus proton SBRT+Calypso approaches. Seems like MRIdian would surround the tumor much better with a 2mm margin rather than using 3 straight or curved lines to connect the 3 transponders.