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"Proton therapy can successfully cure up to 99% of prostate cancer patients." MUDr. Jiří Kubeš Ph.D., Senior Physician
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The Highest Chance Of Being Cured

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The Highest Chance Of Being Cured

Prostate Cancer Treatment

Proton radiotherapy for prostate cancer is a precise and gentle treatment method with minimal side effects. Thanks to proton therapy we can successfully cure up to 99% of low-risk prostate cancer patients.

Since opening in 2012, we have treated over 2,500 patients with prostate cancer. Based on long-term monitoring of said patients, the Proton Therapy Center can boldly boast excellent results and achievements of proton radiotherapy. Ongoing evaluation processes of our results show that from 2012 until now, we have managed to cure 98-99% of low-risk prostate carcinoma patients, of which 99% of patients do not experience any difficulties with incontinence.

The aim of modern cancer treatment is to provide patients with the maximum chance of cure while minimizing treatment-related side effects. This can be achieved with proton therapy.

Proton Therapy Reduces The Risk Of Impotence And Incontinence
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Your Chance Of Retaining Potency Is Higher With Protons

 

surgery-photon-proton.png (25 KB) 

Thanks to the precision of the proton beam, the risk of impotence (erectile dysfunction) is substantially reduced compared to conventional treatment methods. The precision of the procedure plays the most important role in maintaining the man’s potency. Intervention near the nerves, damage to which causes erectile dysfunction, represents the risk factor in surgery. In addition, protons can significantly reduce undesirable irradiation in the penis bulb (root) area, which is one of the causes of erectile dysfunction after radiotherapy.

 

Your Chance Of Preventing Incontinence Is Higher With Protons

 

incontinence.png (34 KB) 

Incontinence refers to the involuntary leakage of a small amount of urine, which causes a social and hygiene problem for patients. For an active man, permanently wearing incontinence aids represents a major problem. After proton therapy, the risk is minimised to a mere 1%. On the other hand, after surgery (complete prostate removal), up to 15% of patients suffer from spontaneous urinary leakage. In the case of conventional radiation therapy, up to 5% of patients suffer from this complication.

Proton Therapy Can Takes From 5 To 21 Business Days
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Proton Radiotherapy At PTC Is Done On An Outpatient Basis

Depending on the stage of the disease you have been diagnosed, treatment at PTC takes 5, 19, or 21 business days. Before initiating proton therapy, a tailored radiation plan needs to be prepared for each patient. The radiation plan is prepared by the physicians together with clinical physicists.

How To Choose The Optimal Treatment

If your physician discovers you suffer from prostate cancer, carefully consider the options you have. It is not true that you have to decide right away. Your overall chances of cure depend mainly on the stage at which the prostate carcinoma was diagnosed.

Part of the Proton Therapy Center is also the Department of Radiodiagnostics and Nuclear Medicine, where we can gladly arrange an examination for you.

Keep in mind that your decision will significantly affect your future life. Our physicians are prepared to answer all of your questions related to PROTON THERAPY; therefore, do not hesitate to contact us immediately.

 

The only thing YOU need to do is to come to US in time. WE are ready to help you.

Contact Us

You can send your medical documentation for assessment of the suitability of proton therapy by e-mail to pacient@ptc.cz. Alternatively, you can contact our treatment coordinators, who are prepared to answer all of your questions related to proton therapy. You can call them at +420 222 999 031.

 

DID YOU KNOW THAT...

Surgical treatment poses a considerably heightened risk of impotence. Relapse represents another frequent postoperative complication. Therefore, patients must undergo additional treatment after surgery – most often radiation – and thus risk the development of other adverse effects associated with the particular treatment method.

Besides surgery, another option available is active monitoring. Active monitoring is an alternative to the radical form of treatment, however, it is only available, to a certain, strictly defined group of patients whose carcinoma is a low-risk clearly bordered type of tumor. In these patients, it is assumed that the disease will not spread or will spread very slowly. The objective rests in delaying definitive radical treatment or avoiding it completely.

Radiation represents an effective solution in prostate cancer treatment. In the case of radiation therapy, your attending physician should properly inform you about the options available, and you should be given a choice of whether you would like to undergo photon or proton radiation therapy. While the principle behind the treatment and the tumor destruction method are almost identical, the adverse effects of each method differ dramatically and principally affect the quality of your further life.

Do You Know The Answers?
  • What treatment has my attending physician recommended?
  • Has the physician informed me about the risks and complications associated with currently used treatments?
  • Has the physician informed me about proton therapy?
  • Has the physician informed me about the risks and complications associated with an operation or standard radiation methods?
  • Do I have a sufficient amount of information today?
  • Do I know how to decide?
  • Do I know how to prevent complications and lower the risk of impotence and/or incontinence in my specific case?
  • Has my physician informed me how proton therapy works in my condition?
  • How is proton therapy able to destroy the tumor with millimetre precision while not causing any harm to healthy organs?
  • Why does proton therapy bring the best results?

 

Below You Will Find The Answers To Your Questions

Think about the options you have. You don’t have to decide immediately. The treatment you choose has a fundamental influence on the quality of life not only during but also after treatment. Side effects may vary considerably for different treatments for prostate cancer.

How Proton Therapy Works
How Proton Therapy Works
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What Is Proton Therapy?

Proton therapy is an effective, accurate and gentle cancer treatment method with minimal side effects. Thanks to the precise targeting of the proton beam directly to the tumor, the occurrence of side effects is significantly reduced. This gives proton therapy patients a chance to enjoy a quality life even after cancer treatment without an increased risk of late toxicity, which can appear several years after irradiation (10, 15 or even 20 years).

Proton Therapy Provides A High Chance Of Being Cured
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Modern, Effective And Safe Oncological Treatment

The goal of modern oncological treatment is to ensure the maximum chance of recovery for patients while minimising adverse effects related to the treatment. Currently, this can be achieved by proton therapy. Unlike conventional radiotherapy, which uses photons for tumor cell irradiation and destruction, proton therapy is more advanced and uses protons. These particles give proton therapy its many advantages. The biggest advantage, compared to conventional radiotherapy, is its accuracy and its ability to protect healthy tissues.

The commonly used photon beam goes through the body and emits a significant portion of its energy in the regions in front of and behind the tumor.

Protons have a certain physical property called the Bragg peak, which means they emit significantly lower amounts of energy on their way to the tumor, thus minimising their impact on healthy tissues behind the tumor.

How We Treat You
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Few patients are aware of the complexity of the technology hidden below the Proton Therapy Center, which ultimately allows us to treat cancer gently. Protons, the positively charged elementary nuclei of the hydrogen atom, are accelerated in the cyclotron to approximately half the speed of light. This provides them with energy to destroy tumours up to 30 centimetres deepThen the protons are directed via a strong magnetic field into a very narrow beam and transferred to the tumour with high precision. As protons impact tumour tissue, they release energy, ionise, and damage the DNA of the affected cell. When the protons damage the tumour repeatedly, the cancer cells stop dividing or immediately die.

 

How We Can Irradiate Tumors With Millimeter Accuracy

Pencil Beam Scanning (PBS) marks the exact distribution of the proton beam dose and is currently the absolute peak in proton therapy technology. PBS irradiates the target area with millimeter accuracy with minimal damage to surrounding healthy tissues and organs. With this irradiation method, the thin (pencil) beam is directed to the appropriate point of the target volume by means of a magnetic field. Highly precise control of this magnetic field achieves gradual irradiation of the entire tumor site.

To illustrate how PBS works, imagine the task of colouring in a circle on a piece of paper with a pencil. As you fill in the circle, you will focus on making sure that you do not cross the borders. PBS also focuses on staying within the borders of the area being treated. That is why side effects with proton therapy are minimal.

Why Choose Proton Therapy?

Our physicians’ experience, our technology, excellent results, and professional attitude give patients the maximum chance of being cured.

  • Based on the latest published data, the 5-year survival rate without PSA relapse is 97–99% for low-risk prostate carcinoma, 85–95% for moderate-risk prostate carcinoma, and 75–85% for high-risk prostate carcinoma. Such results are usually achieved using neither photon techniques nor surgical procedures.
  • Proton radiotherapy has minimal toxicity (side effects). Recently published studies describe severe toxicity of treatment in less than 1% of a large population of patients. When compared with published data on photon radiotherapy and surgeries, such toxicity is minimal and significantly lower than that in other methods.
  • Unlike surgical therapy, proton therapy does not lead to the development of impotence, thus significantly enhancing patients’ quality of life.
  • In the case of high-risk prostate carcinoma, proton radiotherapy allows for irradiation of the pelvic lymph nodes with high probability of subclinical affection. This clinical situation best reflects the dosimetric and clinical benefits of proton radiotherapy as it causes no harm to organs in the abdominal cavity, in particular intestinal villi.
  • Proton radiotherapy is a fully outpatient therapy. For low- and moderate-risk prostate carcinoma, it is possible to use stereotactic radiation lasting 10 days.

 

prostate-comparison.png (92 KB)


The diagram shows the distribution of the radiation dose in the body using photon and proton therapy.
It is evident that the proton beam irradiates only the target volume (prostate area), i.e. the radiation is directed almost exclusively to the tissue that is affected. On the contrary, photon radiation, because of its physical properties, significantly affects the surrounding healthy structures in the abdominal cavity.

Important Facts For Your Decision

Our physicians’ experience, our technology, excellent results, and professional attitude give patients the maximum chance of being cured.

Based on worldwide experience and long-term results in treated patients, it is clear that patients after proton treatment have a higher quality of life compared to other treatment options.

Erectile Dysfunction - Impotence
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Erectile Dysfunction - Impotence

Thanks to the precision of the proton beam, the risk of impotence (erectile dysfunction) is substantially reduced compared to conventional treatment methods. The precision of the procedure plays the most important role in maintaining the man’s potency. Intervention near the nerves, damage to which causes erectile dysfunction, represents the risk factor in surgery. In addition, protons can significantly reduce undesirable irradiation in the penis bulb (root) area, which is one of the causes of erectile dysfunction after radiotherapy.

Based on the experience of our experts and the long-term results, it is clear that proton-treated prostate cancer patients have a higher quality of life than those who have undergone surgery. After surgery, up to 75% of men experience a complete loss of erection (erectile dysfunction). From the psychological aspect, this enormously high risk represents a major complication for every man and has a tremendous impact on his future life.

Disease Relapse
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Disease Relapse

Naturally, the patient’s biggest concern is whether the disease can relapse. The disease usually relapses in 10% of cases after surgery and in 5% of cases after conventional radiation therapy. After decades of experience in proton centers in the USA and Japan, the disease relapses in approximately only 1% of cases after proton therapy (applies to low-risk prostate cancer).

Incontinence
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Incontinence

Incontinence refers to the involuntary leakage of a small amount of urine, which causes a social and hygiene problem for patients. For an active man, permanently wearing incontinence aids represents a major problem. After proton therapy, the risk is minimised to a mere 1%. On the other hand, after surgery (complete prostate removal), up to 15% of patients suffer from spontaneous urinary leakage. In the case of conventional radiation therapy, up to 5% of patients suffer from this complication.

The Difference Between Surgery And Radiotherapy

There are several ways to treat prostate cancer.

Decide which treatment is best for you.

Some of these options are surgery (radical prostatectomy) and radiotherapy. In case of radiotherapy, today it is also possible to choose between photon and proton radiotherapy. Alternatively, it is also possible to monitor the patient and postpone treatment until the disease progresses.

 

PROTON THERAPY

Probability of being cured for various disease stages:

 

riskgroup-prostate.png (47 KB)

 

Below, we have compared for you the side effects of the most common treatments - surgery and photon irradiation.

 

Surgery (Radical Prostatectomy)

Surgery is a serious and extensive invasive surgical intervention

performed under general anaesthesia so the patient must always be hospitalised. During surgery, the prostate together with the prostate theca and seminal vesicles are removed, and a new connection is created between the urethra and the bladder. That is why a tube (catheter) is subsequently inserted through the urethra into the bladder and remains there for a period of two to six weeks. Although surgical procedures evolve (and robotic surgery is a good example of this), long-term results show that the risks persist.

  • Early risks and complications after surgery include pain, haemorrhage, infection.
  • Late risks and complications are erectile dysfunction (inability to keep a firm erection) and incontinence (urine leakage).
  • Erectile dysfunction after radical prostatectomy is quite frequent and ranges from 30% to 100%.
  • Up to 15% of patients have to use some sort of incontinence aid after surgery.
  • One of the common consequences of surgery is, for example, the inability to ejaculate semen due to incision of the ejaculatory ducts.
  • Nearly every third man who has undergone surgery must also undergo postoperative radiation therapy.


kazdy-treti.png (5 KB)

 
In such cases, there are thus not only the risks of complications caused by surgery but also the risks of adverse effects and complications associated with radiation therapy. The main reason is usually the fact that the patient has not been thoroughly diagnosed prior to the operation; therefore, the disease stage and the corresponding therapeutic procedure have not been determined accordingly.

(Retrieved from the Czech Urological Society website)

 

Photon Radiotherapy

This treatment method uses photons for tumor irradiation; however, their physical properties do not allow them to stop directly in the tumor and transfer the maximum of their energy into the tumor. Hence, on their way to the tumor, the photons transfer part of their energy elsewhere. The photons do not stop in the tumor, but continue passing through the body. Photon radiation is associated with undesirable complications.

  • Around 5% of men who have undergone conventional radiation therapy suffer from long-term incontinence.
  • Four out of ten men commonly have erection problems.

ctyri-z-deseti.png (6 KB)

 
In addition to the tumor, photons also irradiate healthy tissues and organs located in the adjacent area. Photons continue moving even beyond the tumor and affect, for example, the rectum, intestines, or urinary bladder. Regular photon therapy takes up to 33-41 days and is often accompanied by diarrhoea, urinary difficulties, and fatigue.

How Proton Therapy Is Conducted

How Proton Therapy For Prostate Cancer Is Conducted

Depending on the stage of the disease you have been diagnosed, treatment at the Proton Therapy Center takes 5, 19, or 21 business days.

 

Initial Assessment

In order for our medical team to assess a patient for suitability, we require some medical information from you. Your treatment coordinator will inform you of exactly what information we require. Usually, we will also request to see scans, such as an MRI, CT or PET scan. This information can be requested from the hospital or clinic and is often given to the patient on a CD. We can provide you with login details to upload the CD to our secure server. Alternatively, you can mail it to us.

Any information you already have about your diagnosis and previous treatments is very helpful and it is a good idea to provide us with as much information as possible in your initial enquiry. Your case will then be reviewed by our medical team at the daily indication board meeting. Your treatment coordinator will get back to you with the outcome, or possibly a request for more information if the oncologists require it to make their final decision.

You do not need to travel to Prague for the assessment.

 

Treatment Planning

When you come to Prague for treatment, you will first have a consultation to discuss the side effects and outcomes of treatment in your specific case, as well as the concrete treatment plan. The doctor also explains what to expect during and after the treatment. Finally, all of your questions are answered.

The first stage of treatment involves the diagnostic scans here at the Proton Therapy Center (MRI and/or CT, preparation of the fixation device, etc.). Precise treatment planning is crucial for treatment success. Therefore, a team of clinical physicists and physicians prepares a radiation plan tailored to each patient according to which proton therapy will take place. The irradiation plan also determines from which directions and with what intensity the proton beam will irradiate the tumor. This process is very complex and it typically takes one week to finalise before treatment can commence.

 

Planování Léčby

 

The treatment is outpatient, and you come to the Proton Therapy Center for radiation and regular check-ups during treatment. One visit takes about 60 minutes while the radiation is a matter of a few minutes. Prior to each radiation session, we carefully check your position using X-ray scans and carry out certain other checks necessary to commence irradiating. At least once a week, you undergo check-ups with the physician who will go through the treatment progress with you and check your condition.

If you are suitable for 19 or 21 fractions, individual treatment doses are given each day, Monday to Friday. If you are suitable for 5 fractions, individual treatment doses are given every other day (Mon-Wed-Fri-Tue-Thu). Treatment cannot be interrupted except for serious health reasons.

 

About Prostate Cancer

The risk of prostate cancer increases with age. In the ages from 40 to 60, one in 39 men is at risk. Every year in the Czech Republic up to 7,000 men become ill and prostate cancer is the second most common malignant cancer in men.

Thanks to the PSA test, we are able to detect prostate cancer already in its early stage, at a time when it cannot be detected by any other method. The PSA test performed after the age of 40 allows us to actually predict the risk of developing prostate cancer in the future for the particular man. After the age of fifty, it should be a matter of course to see a urologist every year. Those who have a blood relative suffering from prostate cancer should be examined from around forty years of age.

If you have been diagnosed with cancer and you do not know how to proceed, need more information or hesitate to choose a treatment, contact our treatment coordinators.

They will gladly answer all your questions concerning proton therapy. Contact our treatment coordinators at pacient@ptc.cz or +420 222 999 031.

 

 Prevention Is The Key

If you experience pain or burning while urinating or the presence of blood in the urine or sperm, do not hesitate to visit a urologist.

The Proton Therapy Center's Urology Clinic

The comprehensive urological examination at the Proton Therapy Center includes:

A preventive examination for prostate cancer, which includes:

  • urological examination, including rectal examination;
  • ultrasound examination of the prostate;
  • blood work for PSA (prostate cancer tumor marker).

Targeted uro-oncological examination, which includes:

  • ultrasound examination of kidneys, bladder and urinary tract (to exclude the presence of a tumor, urinary stones, congestion or other illness);
  • testicular test;
  • urine collection for biochemical examination (to exclude the presence of a tumor or urinary tract infection).

Advice for patients:

The extent and length of the examination depends on many factors, including the anamnesis. If necessary, the examining physician may perform or recommend additional examinations. Part of the comprehensive urological examination is instructing the patient on preventive examinations.

For more information please contact us at pacient@ptc.cz or +420 222 999 031.