This is a really outstanding site Les.  An excellent addition to
the PCa patient's information resources.

Thank you very much.

   Alan

Hello Lee,
If you'd like comments from a radiation therapist, you could post (or crosspost)
it to news:sci.med.diseases.cancer
Steph's our (alt.support.cancer) radiation therapy and oncology consultant.
He was trained in UK, as I recall, specifically at Christie.
He refined his technique is his ongoing career in Canada.
I *think* he would be interested, but it's always hard to say since I cannot
speak for another.
So his reaction could be saying nothing, a one-liner comment, an indepth
discussion of details on your webpage, comparison's between Canada and what you
show on your webpage (for UK) or anywhere in between.
I'll leave that decision to you. If you want to add sci.med.diseases.cancer to
your list to view responses, and it's highlighted in the first line (above),
just click on it, and download messages, then post.
J

Hi Les...Nice site, very well designed and thought out with lots of
useful information.  I especially enjoyed the section on
hypofractionation.  I hadn't heard of that, but as you point out, it
seems awfully important.

A few points for your consideration:
1) Age seems like an important factor in selecting XBRT (BTW, in your
PCa story you didn't mention your age).  Secondary cancers at 10 years
are a real occurrence, but small on an absolute scale, a few percent.
The question on the table is, what will happen in years 10-20?  A good
paper on this subject is: Cancer, Volume 88, Issue 2 , Pages 398 - 406,
Published Online: 20 Nov 2000; Second malignancies in prostate
carcinoma patients after radiotherapy compared with surgery; David J.
Brenner, D.Sc. 1 *, Rochelle E. Curtis, M.A. 2, Eric J. Hall, D.Sc. 1,
Elaine Ron, Ph.D. 2.  I favor this paper because of their use of RRP
patients, rather than the general population, as the control group.
Another, more recent, paper on this subject is: Int J Radiat Oncol Biol
Phys. 2003 May 1;56(1):83-8; Radiation-induced second cancers: the
impact of 3D-CRT and IMRT; Hall EJ, Wuu CS.  This paper provides some
provocative reasons why IMRT may lead to more secondary cancers than
3D-CRT.
2) Again along the lines of patient age, XBRT does not destroy the
entire prostate, some healthy cells and perhaps some unhealthy cells,
remain.  For a young man, this could have consequences.  For whatever
reasons the cancer occurred in the first place (probably at least in
part due to DNA mutations), there remains fertile ground for the cancer
to reoccur, if the man has many years left in front of him.
3) One typo, in the text in part 10 (your story) you mention twice that
your second biopsy involved 14 cores, but the legend in the
accompanying graph says 12.

Again Les, I think it is an excellent site.  Anyone who takes the time
to help others and move our understanding forward deserves special
thanks!..Best wishes and good health, Ron

Hello Les Bradbury,
   I was scheduled for ebrt.....in 1999. I was 49.
I was given Lupron shots to decrease the size of the prostate.
I went on to find out, that RP was better than radiation.
I am 6 years now, out of treatment, and do get  erections,
I do not have any problems with urine.
Viagra helps with a tiny dose in the "man dept"
So, If I chose the route of EBRT, what would I be saying now, versus what I
chose?  RRP
Just a question.
I understand EBRT causes bladder inflamation, and also colon problems.
I also understand that erectile function diminishes, rather that improves.
Anyway, just wondering....John Loomis  RP 1999
So far les than 0.01 PSA
Hey, great discussion.  Wish you the best.
John Loomis    cancer survivor...hum...

Nice job.

At some point you might want to consider adding a section on salvage EBRT in
response to biochemical failure (rising PSA) following prostatectomy.

I hope you post the web address with some frequency so those who are new to
all this know where to find it.

JP

Thanks for the various comments and I have already amended the site to take
some of them into account.

I should stress that I am not advocating EBRT over other therapies but it is
simply that surgery and EBRT remain the mainstays of prostate cancer
treatment particularly in the UK and I felt that a website devoted solely to
EBRT would therefore be useful.

The problem with all these therapies is that our individual response to them
is very variable. John Loomis mentioned his experience with RP and obviously
there are lots of success stories like this and, in fact, the long term
success rate for RP is better than EBRT. The whole question of side effects
is very difficult because I think that the man's general state of health
prior to treatment probably has a big impact on how the side effects
develop. Now that I have stopped taking the Casodex, I really have very few
side effects. I still get erections and orgasms although the ejaculate is
very small and I think comes mainly from the Cowper glands. I too use a
little Viagra as a booster. As John mentions, EBRT tends to produce side
effect later but I hope these don't develop. Most of the trouble from EBRT
side-effects seems to have occurred before 3-D conformal became widespread .
My own consultant said that he had not had any examples of rectal bleeding
since introducing 3-D conformal a few years ago.

I will look up the papers that Ron mentioned and I have corrected the typo -
thanks. His comments about the fact that there is prostate remaining after
EBRT are pertinent.

I will, as suggested, mention this website from time to time so that
newcomers know about it. It will also be updated as things progress.

Les Bradbury