TREATMENT OF PROSTATE CANCER

Aspects of Cell and Molecular Biology in the Treatment of Prostate Cancer



Aspects of Cell and Molecular Biology in the Treatment of Prostate Cancer

Hypothesis & Aims of the Study

Prostate cancer is one of the most common cancers of older men, with a median age of onset of 72 years. It is the sixth most common cancer in the world and represents the third most common cause of cancer death in American men. However, because its age of onset is usually so late in life and because a variety of treatment options exist for both localized and advanced disease, many men with prostate cancer ultimately end up dying of other causes. In fact, many believe that if all men lived long enough, they would ultimately develop prostate cancer.

In this study it is hypothesized that Proton therapy can significantly provide an effective means of treating prostate cancer. After the initial success of this treatment, similar endeavors were undertaken at the Massachusetts General Hospital by a neurosurgeon by the name of Dr. Ray Kjellberg in the 1960s. Dr. Kjellberg began treating small intracranial targets with radiosurgical techniques at the Harvard cyclotron laboratory. Together with the physics group at the Harvard cyclotron laboratory, Dr. Kjellberg was able to develop instrumentation, methodology, and techniques for radiosurgical beam delivery, using protons. The treatments by Kjellberg have evolved into an active proton therapy program at the Massachusetts General Hospital, now known as the Northeast Proton Therapy Center, which is still active today.

In the 1960s and 1970s, while work continued at Harvard and Berkeley cyclotron facilities, further research in proton therapy was undertaken at several different physics research facilities around the world, most notably in Russia. Most of the work in Russia was done at the Joint Institute Nuclear Research and the Moscow Institute for Theoretical and Experimental Physics and in St. Petersburg. Soon after, treatment with proton beams was also begun at the National Institute for Radiobiological Sciences in Chiba, Japan, which is where a spot-scanning system for proton therapy was first developed. (Nicole, 2003, 61)

Rationale

Prostate Cancer is the most common noncutaneous skin cancer afflicting men in the United States. Traditional treatment modalities for prostate cancer include external beam radiotherapy, prostate brachytherapy, or radical prostatectomy. All of these treatment modalities have been shown to be excellent methods for achieving high survival rates and biochemical disease control. With all of the current advances in prostate cancer treatment, a man diagnosed with prostate cancer today will most likely die with—rather than of — prostate cancer. However, unwanted side effects from traditional radiation treatment can severely decrease a patient's quality of life. For example, following prostate irradiation patients may become impotent or develop multiple urinary or rectal problems given the close proximity of the prostate to the bladder and rectum. For this reason, proton therapy provides a possible alternative for delivering an effective dose to the prostate while also avoiding any radiation-induced damage to the surrounding bladder and rectum. Recent data from studies done at Loma Linda ...