We really don't know what we're doing...

TooFastTim

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I've been in this science/business for nearly thirty years now. It is really is (and I **** thee not) right at the cutting edge of the medical and physical sciences. This business and science is consuming vast amounts of capital (from which I am, handsomely, benefitting).

The modality does work. It has an extraordinarily successful cure rate for those cases for which it is recommended.

Now, from my 30 years of experience, I realise: WE KNOW NOTHING. Barely a jot. We are merely scratching the surface. I keep poking and prodding at this knowledge only to realise that they (they being collective the they. AKA I and my peers) are ignorant.

For those of you old enough to remember Supertramp. Supertramp had an album: Crime of the Century: "Well lets rip off the mask and lets see. Well there's you and there's me". Well, here am I and We are exposed. We are naked.

This is not bullshit. This is real. The more I dig the more I realise how little we understand of the physics underlying the modality.

Would you continue or retreat to a monastery?

Oh, I am an ex-Saffie and got my grounding in the modality in SA.
 
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Zoomzoom

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Now, from my 30 years of experience, I realise: WE KNOW NOTHING. Barely a jot. We are merely scratching the surface. I keep poking and prodding at this knowledge only to realise that they (they being collective the they. AKA I and my peers) are ignorant.
I keep saying this but out there in the big wide world anything uttered by a guy in a white coat from a lab with letters after his name is taken as blinking gospel irrespective of how blatantly stupid it is.
 

TooFastTim

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I keep saying this but out there in the big wide world anything uttered by a guy in a white coat from a lab with letters after his name is taken as blinking gospel irrespective of how blatantly stupid it is.
You might be closer to truth than is comfortable. But we have a way of dealing with his type. Err, I might be that guy in a white coat...So, let it be.

But! There is no conspiracy. Just an (ignorant) desire to pursue that which results in the best outcome.
 
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Zoomzoom

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What part of what you do is it that you think no-one understands how it works? The entire basic premise that bombarding cancer cells with a proton beam destroys them?
 

TooFastTim

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Good...good my young Padawan you know what I do (and without much more thought you'll know who I am).

The radio-biological effectiveness of the energetic proton is proven without any doubt (they have an RBE of about 1.1. Cell species dependant). The problem is where do they stop? This is contentious. Do we assume the Bohr, Landau or Vavilov model? How do we assume the energy distribution of the output of the accelerator? And the influence of the beam lines? How do the previous effect where the protons stop? What is that cumulative uncertainty? Given this uncertainty how can we reduce the probability of secondary tumours?

The big question is: where do they stop? Can it be measured? Can it be quantified?
 
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TooFastTim

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When I began my journey into the mysteries of this modality and its intimate involvement with the intricacies of the physics of particle accelerators we didn't give a damn where they stopped as long as they stopped. Now I play a game of statistics and microns.
 

Zoomzoom

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You might be closer to truth than is comfortable. But we have a way of dealing with his types. Err, I might be that guy in a white coat...So, let it be.

But! There is no conspiracy. Just an (ignorant) desire to pursue that which results in the best outcome.
I was thinking more in terms of that kind of research where there is blatantly an agenda behind it, but it is being presented as unbiased/genuine/whatever for public consumption.


Good...good my young Padawan you know what I do (and without much more thought you'll know who I am).
Don't put a photo on with the name of the company LOL

The radio-biological effectiveness of the energetic proton is proven without any doubt (they have an RBE of about 1.1. Cell species dependant). The problem is where do they stop? This is contentious. Do we assume the Bohr, Landau or Vavilov model? How do we assume the energy distribution of the output of the accelerator? And the influence of the beam lines? How do the previous effect where the protons stop? What is that cumulative uncertainty? Given this uncertainty how can we reduce the probability of secondary tumours?

The big question is: where do they stop? Can it be measured? Can it be quantified?

LOL if you don't know, how am I supposed to know?
 

Zoomzoom

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When I began my journey into the mysteries of this modality and its intimate involvement with the intricacies of the physics of particle accelerators we didn't give a damn where they stopped as long as they stopped. Now I play a game of statistics and microns.
Aha now we come to the real issue - PRECISION - the more precise the targeting the more effective it is with fewer side-effects, but how do you increase precision if you can't measure EXACTLY where everything is? Am I following you correctly? Would I be right in thinking this is at least partly a basic uncertainty principle problem?
 

TooFastTim

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I was thinking more in terms of that kind of research where there is blatantly an agenda behind it, but it is being presented as unbiased/genuine/whatever for public consumption.
I have lived through time when this modality was the Anti-Christ. It was demonised. But the results have come to bear.

Don't put a photo on with the name of the company LOL
I didn't. You took the time to look up the company. Thanks for taking that time.

LOL if you don't know, how am I supposed to know?
Well, that's the original question I pondered. We "dunno fokal"? It's that question I hope to help to answer.
 

TooFastTim

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Aha now we come to the real issue - PRECISION - the more precise the targeting the more effective it is with fewer side-effects, but how do you increase precision if you can't measure EXACTLY where everything is? Am I following you correctly? Would I be right in thinking this is at least partly a basic uncertainty principle problem?
Not at this level. At the biological or cellular level. The uncertainty is more mechanical. Statistical uncertainty sure. But not quantum-mechanical uncertainty. But even at this, relatively, high level, we don't understand.
 

Zoomzoom

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I have lived through time when this modality was the Anti-Christ. It was demonised. But the results have come to bear.
Not so long ago either - looking at 2017 report from Canada stating that the clinical effectiveness is based on low-quality studies and offers in little in the way of increased effectiveness over traditional radiation therapy.
 

TooFastTim

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Not so long ago either - looking at 2017 report from Canada stating that the clinical effectiveness is based on low-quality studies and offers in little in the way of increased effectiveness over traditional radiation therapy.
Ja ja..Prostate stuff?

Pinged you.
 
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TooFastTim

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The prostrate stuff is out there at the mo'. But, by conventional radiotherapy, it's a very unpleasant experience.
 

TooFastTim

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No ethics debate on whether or not to implement the therapy in Canada.
Yeah, that's a complex one. The cost is obscene. And that comes from somebody who was part of the team that gave South Africa proton therapy. So we have to try to reduce the cost. But how? Do you want part 2 of my existentialist dilemma?
 

Zoomzoom

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From what I have read proton therapy has far fewer side-effects than conventional radiation therapy - which is a far less precise - for want of a better analogy proton therapy is akin to a rifle with a laser sight, while radiation therapy is more like a shotgun.


Do you want part 2 of my existentialist dilemma?
Let's have at it. I've apparently got nothing better to do at 4am. LOL
 
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