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Thank you for your kind words, David. I know that you are not alone in appreciating the input from all the Yana men (and a few of their women).
The practise of using higher but fewer radiation doses is termed Hypofractionated Radiation if you want to search around for some references. Using the Site Search Engine and that phrase will bring you some links as will IMRT. The best known of the current hypofractionated radiation therapies has a registered trademark and is marketed as CyberKnife
Many of the claims made for hypofractionated radiation seem not to be supported by good independent studies and evidence of its claimed superiority. On the other hand, as one of the sites I found said, it does have the potential of creating a much better throughput for the radiologists since they can treat about five or six times the number of patients in the same time span.
Two years ago when I was initally diagnosed with low risk GS6 cancer I was talking to Dr Lee at Duke. At that time they were starting a trial where they would reduce the normal nine week treatment (45 treatments) to a two weeks (I believe it was only 7 treatments), but at a much higher dose. At that time I opted for AS so I didn't join the trial. You might contact Dr Lee at Duke to see if they are still offering the short IMRT protocol.
Recently I finished proton treatment at UFPTI where they were giving guys with low risk PCa the chance to try 29 treatments over 6 wks at a slightly higher dose instead of the normal 39 treatments over 8wks. I heard early "scuttlebutt" (Navy speak for rumors) that the shorter treatment seemed to be yielding similar results as the longer one in early findings.
As Terry alluded to: "Medicine is a business, and the purpose of business is to make money." The shorter the treatment cycle, the more patients can be treated, and the more money can be made. Also I think the heath care industry can see the handwriting on the wall that the cost of Medicare and other health services must be reduced in the future.
Oddly enough, during my stay at UFPTI, I talked to a lot of fellow patients, and most opted to stay with the 8wk plan especially if they were retired. The ones that opted for the 6wk plan seemed to be those guys still working or who could not be away from home for the additional time.
Joe (and all): I was offered a similar treatment here in my town - only with a new study that is only 5 total treatments. I have chosen not to do this because it is a trial and in meeting with a surgeon, I had my "A-HA' moment. I had been looking for a less intrusive way to handle my condition but a few other factors have opened my eyes. I have bilateral kidneys and both reside very securely by my hips and not up further where most people have them. When I met with the rad-onc last Thursday he said I would probably be okay but he could not guarantee that they would not recieve some "scattered" radiation. That concerned me although perhaps it shouldn't (I am diabetic - controlled by diet and exercise). The next day I went to see the surgeon at the same hospital. He was unlike most any other surgeon I have encountered. He took his time, laid out all options including radiation. A couple things really caught my attention. When he took a look at the CAT SCAN I had done, he got really curious and probably spent about 15 minutes just showing us frame by frame the entire scan. He was really interested in the kidneys but said that should not be a problem with Da Vinci from his perspective. Second - and most important - he said it is younger guys like me that make the good results on ED and long term incontinence go up. The younger patients by and large (with him anyway) have had very few SE and it is the older patients that bring the numbers down. He also mentioned that it would not be fun and he did not sugar coat anything - going so far as to describe the catheter (which I actually fear the most) but assuring me it hurts more going in but that I would be deeply asleep at that point. He has done over 2000 PC removals and around 400 on Da Vinci. He also had a sense of humor (which is very important to me). We sat down and went through a Sloan Kettering program which basically graded me 98% cancer free in 10 years. And it was around 90% in 20 years (equal to general population). Radiation could not give me that assurance b/c it has not been around that long. So now I am researching surgery - the one thing I really did not want to do! Anyway I look at it, it's going to be a pissy month or so (pun intended)- whatever month I choose. The next step is up to me. Sigh.
