Tuesday, January 29, 2013

Proton Pipedream Up In Smoke

By virtue of a series of mini-miracles, I returned to UFPTI to thoroughly explore the possibility of treating my recurrent cancer with another round of proton therapy. Prior to our meeting Dr Gud E. Nuff ordered a Pet-scan and a a triple contrast MRI. To kick off our "face-to-face" Dr Gud E. Nuff conducted an especially thorough DRE. Our dialog evolved along the following lines (liberally paraphrased):

Dr:  "The Pet-scan, the MRI and my DRE all proved negative. Based on your rising PSA you probably have cancer somewhere in your system, but in my judgement it is no longer active in your prostate gland."

Pt:  "How do you explain  the findings of Mayo Clinic? You may recall Mayo Clinic identified a 1.1 cm nodule of recurrent cancer in the upper left quadrant of my prostate by way of the Choline scan. Mayo Clinic confirmed this finding the same day with an endorectal MRI."

Dr:  "After radiation the prostate gland reacts to technological interventions in unpredictable ways. Based on our test results and my DRE, I am convinced your prostate gland is cancer free. Accordingly you are not a candidate for proton therapy."

Pt:  "Please indulge me; let us assume Mayo Clinic's results are accurate."

Dr:  "Even if your recurrence were restricted to your prostate, you would not be a candidate for retreatment with protons. During your initial treatment your surrounding organs  were bombarded with the maximum prudent amount of radiation. Further radiation could potentially do more harm than good. You would be at risk for causing irreversible damage to your colon. More particularly your colon could be damaged to the extent that you would need a colonostomy. You wouldn't want to wear an external bag for the rest of your life, would you?

Pt:  The latter question did not require a great deal of soul-searching on my part. I responded rather simply, and I suspect, rather predictably, "No" I said, "I would not."

From the get-go I realized my unscientific proposal may be nothing more than a pipedream. Nevertheless I launched my return trip with a fair degree of optimism. One of the mini-miracles preceding my journey put me in contact with the only man on earth (presumably) who successfully underwent proton therapy (at UFPTI no less) following failed IMRT. His very existence stoked my hope.Not only did his existence lend credibility to my grand plan, in addition. this fine gentleman contacted key UFPTI staff in my behalf. Shortly thereafter I received an invitation to return to UFPTI  for the above described evaluation.Unfortunately neither his existence  nor his influence could overshadow Dr Gud E. Nuff's findings and logic.
In the final analysis I pursued my (pipe)dream, that I would have evermore regretted  had I not done so.
 The search goes on.

Friday, January 4, 2013

Protons for Treatment of Recurrent PCa?

 Earlier in my ongoing adventure I proposed the following "Clinical Trial of One" to Dr Gud E Nuff:
 1. Begin with a shot or two of lupron to starve, weaken and shrink the 1.1 cm cancerous nodule identified by Mayo Clinic
2.Kill what remains with proton radiation at whatever volume it takes as determined by UFPTI
3.Reduce the liklihood of a recurrence by adopting a life long regimen of finasteride.

To date UFPTI has not responded substantively to this proposal. An unexpected turn of events has provided me an opportunity to thoroughly explore this option. Although it may take awhile to play out, and I have no way of predicting the outcome, this interim report seems warrented.
Stay tuned.