Treated 2002 • Posted 2008

Howard is a physicist. Here is his response to an individual who made an inquiry about proton therapy:

A reason to select a particular treatment approach for prostate cancer:

Primarily there are two approaches to overcoming prostate cancer where the cancer is still contained in the prostate capsule: 1) surgically remove the prostate capsule, sometimes referred to "the Gold Standard", and 2) destroy the cells in place. The former can provide successful results when performed by a skillful surgeon. The potential problems are that you may not get it all, may require several months to recover from the surgery, may result in incontinence, may result in impotence, or internal infection. These problems can result in major life changing events. The probability of one or more of these problems as a result of surgery is not trivial, and there are only a few surgeons in the U.S. who have a reasonably good record.

Destroying the cells in place is a matter of collateral damage to otherwise normal tissue. The use of ionizing radiation is a principle approach, with much experience gained by various practitioners. When used properly, cancer cells are destroyed and most of the normal cells recover. This has led to a procedure where about two "Grey" units of ionizing radiation are induced daily over a period of about 8 weeks, for a total of 80 Grey units. This has been found to leave most normal tissue intact, and the cancer cell population is reduced to such a low level that the bodies immune system completes the job. This procedure is done by use of X-rays and by protons. Both procedures have shown excellent effective results. Skillful use of x-rays, as with IMRT equipment reduces some or much of the damage to other normal organs in the body, however x-rays are most ionizing where they enter the body, and continues ionizing as it leaves the body. Some tissues, such as the colon, are susceptible to burning and great discomfort and bleeding for a long period of time. A well defined proton beam can confine the major part of its ionizing to a small controlled volume, such as the prostate, with minimal ionization upon entering the body, and none of it leaving the prostate area.

In practice, the proton beam treatment yields the superior cancer results with essentially negligible collateral effects, which minimizes follow-up treatment or hospitalization. Why would anyone choose any procedure other than the proton beam treatment? I am a retired physicist and I completed Proton beam treatment for my prostate cancer in December 2002 at Loma Linda at age 73. I had no physical effects, my PSA dropped to 0.1 in about a year and it has remained at that level ever since. Loma Linda has performed this procedure for prostate cancer since 1990, and they treat about 180 people every day, or about 1200 people treated per year. With 18 years experience and about 13000 patients, I suspect that if anyone referred to it as being experimental, he must not be taking it seriously, or he's a politician running for office.

Howard B. Glenn