A patient at Loma Linda University Medical Center in California receives a proton treatment.

That's because many had been prompted by a close personal friend or business associate to follow in his footsteps. The footsteps led to a prostate cancer treatment that has been around for decades but remains little known.

It's the proton beam, and last week's support group that gathered in a Hilton Hotel conference room either had direct experience with the treatment or were thinking about it.

"I was told by the urology department where I went for tests in Houston that it was a 'gimmick,'" John Watson, 66, said.

"And then I saw where they're planning a $100 million proton facility of their own by 2003."

Watson's Prostate Specific Antigen (PSA increases often precede later diagnosis of cancer) dropped in 10 months from 7.4 to 0.8 following the two-month-long proton treatment at Loma Linda University Medical Center in Loma Linda, Calif. The story was repeated, with variations, but all ended with similar results: PSAs dropping from as high as 14, down to as low as .1.

Lynn Martell, vice president for advancement with Loma Linda University Adventist Health Sciences Center, organized the alumni meeting and said of the center's 7,000 cancer patients treated to date, 62 percent have been prostate patients.

The center began as a sanitarium in 1905, and after adding educational and medical services over the years, became the world's first proton treatment facility in 1990.

"We are using proton treatment now on eye, liver, lung - a wide variety of cancers, but it is especially effective for prostate cancer because of its narrow beam, that can surround an irregularly shaped target like the prostate gland," Martell said.

The difference between standard radiation treatment and proton therapy is in a physician's ability to conform the proton irradiation pattern to the cancer, he said.

While conventional radiation techniques will control many cancers, healthy tissues may receive a similar dose and be damaged. But Martell said the proton therapy reduces damage to healthy areas and vital organs, with fewer side effects.

Dr. Henry O. Williams, urologist with Mamie McFaddin Ward Cancer Treatment Center in Beaumont, said he has no first-hand knowledge of the results of proton treatment but it is "becoming more and more an acceptable form of treatment for prostate cancer. I have not seen any data that it's better, however."

Martell said the U.S. Food and Drug Administration has now put its stamp of approval on proton beam treatment, it's been Medicare approved, and consequently, more insurance companies are accepting it.

"More than 200,000 are diagnosed with prostate cancer every year in the United States, and we treat 600 to 700," Martell said.

The non-invasive, precise form of radiation treatment is a surprisingly well-kept secret, according to testimonials of former patients, who say if they had not heard about it by word of mouth they probably never would have.

According to the National Association for Proton Therapy, there are as many as 20 facilities now using some proton treatment.

"There are none in Texas, but M.D. Anderson is planning one," said Leonard Arzt, executive director of the association. "But that's years away, because they have to come up with the funding. Massachusetts General has just opened with limited treatment, and the one in Canada is research-oriented, and not hospital-based for treatment."

Most proton patients at the Wednesday meeting were older male prostate patients, but they aren't the only ones proton treatments have benefited. Brian and Lori Alter attended to share their story of a son who was diagnosed at age 12 with a rare brain tumor.

"The odds were one in 50 million that he would get such a tumor," said his father. "It is usually found only in adult males."

Lori Alter described the family's harrowing experience in seeking treatment.

"We took him first to Texas Children's Hospital in Houston and after examinations and tests they came back to us and said, 'Take him home and hug him.' Then we took him to M.D. Anderson in Houston and they basically said the same thing."

From their own personal determination, the couple ended up in Little Rock, Ark., where their son Daniel underwent an 18-hour surgery that successfully removed 70 percent of the chordoma, followed by two more shorter surgical procedures. His by-then remaining horseshoe-size tumor, Lori said, was inoperable.

"The doctor there told us then that proton beam treatment could help, and that's what we did. They had pretty much mentioned that from the beginning, recognizing it was going to be so difficult to reach."

Now 17, Daniel is a junior at West Brook High School and co-captain of the debate team.

"He has had his lifetime amount (of radiation) to his brainstem," his mother said. "If it (residual tumor) grows away from the stem, he could have more proton treatment."

She said doctors had described the tumor like a beehive. "When the bees are dead, the hive remains. But in the four years since treatment, the tumor has not changed."

Williams, who treats many prostate cancer patients with seed implantation, said that the equipment for proton treatment is "highly sophisticated and one reason there are not many facilities nationwide. I think it will probably find its niche. There will be some diseases where it is clearly the treatment of choice . . . it can deposit a lot of ionization to a localized area, so it has certain specialized uses."
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