@manojsmishra
There is a difference between photon and proton. You are right the new photon radiation treatments have improved drastically over the years to control the beam more prescisely.
However the difference is that photon radiation continues through body. Proton radiation does not. Proton radiation can be stopped at a precise point and not have the radiation continue. Thus using the margins set by R/O the proton beam stops at that precise location and does not continue through body.
Thus the benefit is not in treatment outcomes (both are equal) but the prospects of reducing damage done by photon radiation continuing through body. This is the benefit identified by proton centers. It is why I mentioned proton is used a lot in children, eye cancers, throat , etc. Mayo Jacksoville does referrals to UFHPTI for specific cancers especially in children where they are really trying to reduce the amount of radiation to other organs and tissues.
Mayo Jacksonville does not have proton radiation. They are building a new cancer facility and it will have proton radiation.
My information on proton and photon comes from WEB MD, Mayo, Cleveland Clinic, american cancer society, my PCP at Mayo Jacksonville, my R/O at Mayo Jacksonville and my R/O at UFHPTI.
UFHPTI will send you a booklet regarding proton radiation and all the research it that has been done on photon and proton. The booklet is outstanding in clarifying differences and the specifics of what UFHPTI does as a treatment facility. UFHPTI got a 25 million dollar federal grant to do on going research in radiation treatments with photon and proton. I volunteered to be in their research program.
Mayo R/O and UFHPTI stated same as your R/O the cancer success and outcome of treatments by photon or proton is equal. Thus that is why they say no additional benefit. The benefit is that proton does not pass through body thus affecting the organs, tissues, beyond prostrate. With many advances in photon radiation techniques there is more and more success in photon reduction in damage to surrounding organs and tissues. So the photon radiation is drastically improving.
My R/O as UFHPTI when I first got my second opinion said he wanted to emphasize two things. One, that they are state salaried employees and do not receive any benefit from adding tests. He will only order what he thinks I need to succeed in treatment Second, the only difference in the NEW photon radiation treatments and proton radiation is the benefit that the proton radiation stops at the precise location the R/O has set and does not continue through body like photon. The outcomes of cancer treatment success are the same.
I had what they call pencil beam proton radiation with the markers and Space/Or. My PCP when I told him I was going with proton (He advised me to get two separate opinons) that he believes my decision was good based on my specific case. My PCP stated the patient must decide and choose what they feel is best for them after consultations and research.
Good Luck!!!!
I suspect a (marginal) benefit of photon over proton would be that if the cancer has spread a bit more than detected, the radiation spreads a bit more too, and might just attack it anyway.
For most people, though, I agree that proton would be more desirable if available, especially for cancer that's in a very early stage and clearly isolated in one or two spots in the prostate. Radiation cystitis (bladder damage) and proctitis (rectal damage) — even when extremely mild, like mine — are annoying, though you learn to live with them.
Still, even if it had been available, I probably wouldn't have gone for proton in my case, because my cancer had already spread non-locally to my spine, so there was a non-trivial chance there might be some hanging around near the prostate as well that didn't show up in the scans. They told me that even though it's fairly precise, the SBRT (CyberKnife) photon radiation I received continues working and spreading for quite a few weeks after treatments end.