If your tumor is larger than 2 cm you may not be a good candidate for Proton Therapy. The only way to find out is to send your actual MRI results and ask for consideration. Send the written report and a copy of the MRI. At the Massachusetts General Hospital Proton Therapy Center there is a doctor who will accept your MRI results and study your case, with a team of doctors. If you are interested in this possibility, then send your MRI results to :
100 Blossom Street
Boston, Mass 02114
Attn: Dr. Jay Loeffler
Care of: Ms. Jen Fitzgerald 617-724-1548
We had also sent my husband's MRI to other proton Centers around the USA, so please don't think that we are in any way connected to MGH. We previously had absolutely no connections to MGH until we were lucky enough to find the Proton treatment there.
We are encouraged by superior results for my husband, so far. He completed proton therapy in August 213. Read about my husband by simply searching under the profile forum name of KeepSmiling. He is faring well. He is still deaf in his ear. He still gets occasional tinnitus. He is feeling fine. Now it is 2015 and he is well. Two weeks ago he finished a grueling bicycle ride in the difficult weather of Florida. He rode his bicycle with his crazy competitive pals in the 2015 Multiple Sclerosis Charity Fundraiser (160 Mile total - Ponte Vedra Florida to Daytona Florida and then back to Ponte Vedra Florida the next day) . They finished in the top 10% of 1,800 bicycle riders. My husband needed a neck massage afterwards and then was tired for a couple days but otherwise fine. Excuse the crude language-but that is really badass!
Here are some studies to ponder: (READ it all at the websites given )http://journals.lww.com/neurosurgery/Abstract/2003/09000/Proton_Beam_Radiosurgery_for_Vestibular.6.aspx
"...CONCLUSION: Proton beam stereotactic radiosurgery has been shown to be an effective means of tumor control. A high radiological response rate was observed. Excellent facial and trigeminal nerve function preservation rates were achieved. A reduced prescribed dose is associated with a significant decrease in facial neuropathy."http://www.tastro.org.tw/DB/Edu/580-5.pdf
"...Particle beams, such as proton and heavier ion beams, show an increase in energy deposition with penetration depth up to a sharp maximum at the end of their range to form the so-called Bragg peak. Almost no dose is deposited in the normal tissue beyond the Bragg peak. The particle range is deter- mined by the energy of the incoming particles (Fig 1). Favorable dose distributions with a steep dose fall-off at the field borders and, thus, more precise dose localization can be achieved with these beams compared with photon beams. As a consequence, it seems likely that dose escalation can be per- formed without aggravating toxicity in surround- ing normal tissues....Most of the proton therapy facilities have focused their clin- ical programs on pediatric tumors, skull base tumors, and head and neck tumors. In addition, some of the proton facilities in the United States have an extensive expertise in treating patients with localized prostate cancer and inoperable early-stage lung cancer. Given the availability of beam time, tumor entities such as paraspinal tumors and other tumors in difficult-to-treat regions are sometimes accepted....The reduction in integral dose to normal tissue achieved with proton RT is assumed to be most beneficial for the treatment of pediatric tumors because the risk for secondary malignancies is ex- pected to be reduced compared with photon RT....However, randomized clinical phase III trials compar- ing proton RT versus precision photon RT are not considered reason- able because it is unlikely that photon RT will achieve better outcomes or a reduction in toxicity.
Marginal misses are not expected to occur more often after proton RT as long as the clinical target volume concepts are not altered, safety margins included in the planning target volume are appropriate with respect to target movement, and patient alignment is checked and optimized before each irradiation....Most of the available data was retrospectively analyzed, and local control rates achieved with proton RT were comparable to rates achieved with modern photon RT modalities such as fractionated stereotactic RT. The observation times in almost all case series are too short to rule out late toxicity. Although the advantage of minimizing low-dose exposure to normal tissue seems likely to be important for the pediatric population, the issue of finding a mea- surable benefit in adult patients remains controversial.
It is always good to look at quantitative information aboutProton Therapy. Best of luck to you, whatever you consider !
Stay optimistic and keep smiling. Attitude helps.