Proton Therapy, IMRT, and SBRT | Mark Scholz, MD | PCRI

Many patients have been asking about proton therapy for prostate cancer and how it compares to more popular forms of radiation like IMRT and SBRT. Medical oncologist Mark Scholz, MD argues that while the theory behind proton therapy seems appealing, in practice, its results seem to be about equivalent with those produced by IMRT and SBRT.
0:10 What is proton therapy and how does it work?
2:45 Which criteria determine if a man would qualify for focal radiation therapy?
3:36 What are the side effect profiles of proton therapy, IMRT, and SBRT?
4:20 There are sometimes delayed side effects with IMRT and SBRT. Is the same true for proton therapy?
5:38 Since proton therapy was developed before IMRT, is it outdated compared to IMRT and SBRT?
7:11 Do you know of any other centers doing proton therapy?
7:34 Do you have any tips for making sure that a radiation oncologist is experienced and proficient in delivering radiation therapy?
8:20 Can radiation cause secondary cancers several years later?
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PCRI's resident moderator, Mark Moyad, MD, MPH, sits down with urologist Steven Gange, MD, FACS, to discuss the use of Cialis to treat lower urinary tract symptoms, bladder control drugs, and the use of supplements to treat benign prostatic hyperplasia (BPH, or prostate enlargement).
Dr. Steven Gange graduated from the UCLA School of Medicine in 1986. After his Urology residency training at the University of Kentucky in 1991, he entered the US Army as an academic urologist, teaching, and training residents. He joined Western Urological Clinic (now Summit Urology Group) in Salt Lake City, UT, in 1996. With over 25 years of clinical and research experience, he has developed an expertise in Men’s Health Urology, emphasizing minimally invasive procedures. He continues to be active as a Clinical Researcher and as such was the first Urologist in North America to perform the NeoTract UroLift for BPH, and the first in the world to perform UroLift under local anesthesia.
0:06 Cialis (tadalafil) as a treatment for BPH - Cialis (tadalafil) has an indication for the treatment of both erectile dysfunction and benign prostatic hyperplasia. Some men using Cialis have noticed an improvement in urinary symptoms, but it is not well understood why. Cialis is used, as opposed to a drug like Viagra, simply because Cialis lasts longer. A downside is that Cialis is expensive and it is also less effective for BPH than the alpha-blockers and 5-alpha reductase inhibitors.
2:28 Overactive bladder drugs - It often happens that a patient who is treated for urinary obstruction from BPH will continue to experience urinary symptoms due to overactive bladder. As the bladder begins to lose function, it will sometimes become hyperactive. Overactive bladder drugs relax the bladder so that it squeezes left often. Dr. Gange is unsatisfied with the side effect profiles of every bladder control drug with the exception of Myrbetriq, a beta-3 agonist.
4:55 Prostate supplements - There are no supplements that have outperformed placebo for BPH; however, placebos have performed so well that both Dr. Moyad and Dr. Gange are open to patients cautiously using supplements if they are improving symptoms.
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To learn more about prostate cancer visit www.pcri.org
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