Connect
← Return to Proton, Photon, or Cryotherapy?
Discussion
Proton, Photon, or Cryotherapy?
Prostate Cancer | Last Active: Jul 14 6:18pm | Replies (28)Comment receiving replies
@brianjarvis
Good information. It is why proton is not as widely available as photon.
I think but not sure that Medicare at one time was not approving proton but changed and is now covered. Mine treatments were covered by Medicare.
I was not aware that there were only 46 active proton centers in U.S. That really explains that most radiation offered to patients is photon.
I think those reading these posts can see that medical experts are not saying that proton carries a higher success rate of treatment of prostate cancer than photon. Per my PCP, R/O at Mayo, R/O as UFHPTI all said the same. The biggest difference told to me by all my medical specialist is that proton does not proceed past the target area and out through body.
Studies are going on and on about this and just how much advantage this gives long term for radiation damage and secondary cancers caused by radiation treatments. I know my Mayo R/O said to me when trying to seel Photon SBRT was, "Oh the secondary cancers caused by radiation you would not have to deal with them for 10 years." I said to myself wow. And that is when I made up my mind to do as much a possible to prevent any further damage than necessary to other organs and tissues.
My PCP (Mayo) and I sat for an hour consultation going over all the two opinions I got and we both decided what was best for me was the low dose, 30 rounds of proton radiation at UFHPTI.
Each person though needs to do same thing. Do what is best for them both mentally and physically and not what another did as may not be the best for you as an individual.
Replies to "@brianjarvis Good information. It is why proton is not as widely available as photon. I think..."
Connect
Medicare paid 80% of the cost of my proton radiation treatments (my supplement plan covered the 20% that Medicare didn’t).
Technically, Proton with its Bragg-Peak characteristic (“…proton does not proceed past the target area and out through body.”), should provide fewer QOL side-effects than standard IMRT/photon. (That is ultimately why I chose Proton.)
There are two clinical trials looking into this; COMPPARE and PARTIQoL.
> The PARTIQoL trial’s interim results indicate that both therapies achieved similar tumor control rates and patient-reported quality of life outcomes. Specifically, there was no significant difference in progression-free survival or patient-reported outcomes like urinary, bowel, and sexual function. (These results are interesting. If proton performs better than photon for brain, liver, and other cancer tumors, are the rad oncs not doing the complicated calculations correctly for prostate, or are other factors at play? Hopefully, the laws of physics still apply to prostate cancer……?)
> The COMPPARE trial is another large-scale study also comparing proton therapy and IMRT, but with a different focus on patient-reported outcomes. The COMPPARE trial is still ongoing.
See the attached Bragg-Peak characteristics graphic.
As for secondary cancers, those occur when radiation overshoots the prostate and hits otherwise healthy organs and tissues. So, the better the radiation accurately and precisely hits only the prostate, the lower the risk of secondary cancers. (I did use SpaceOAR Vue, just in case…..). . Just as important, not only the accurate/precise radiation, but also the dosimetrist (who calculates the correct biological effective dose), the physicist (who designs and shapes the beam, ensuring the tumor is targeted while minimizing exposure to surrounding healthy tissue), the radiation technicians (who are truly hands-on the radiation system), and of course the radiation oncologist (who I liken to a team manager). If they all do their jobs right, we come out with no side/after-effects!
With my proton treatments, they gave me three options:
> 20 sessions at 3.0 Grays per session,
> 28 sessions at 2.5 Grays per session, or
> 39 sessions at 2.0 Grays per session.
(As is typical for me, I picked Door #2.)
Finally, with all the research that I did, I overlooked one thing —> I was caught by surprise on the last day as I was leaving the proton radiation treatment facility. The entire radiation team was gathered around with a Certificate of (proton radiation treatment) Completion that they had all signed, as well as a bell for me to ring. Somehow, In all my studying up on various treatments, I missed that protocol for completion of radiation treatment. Still, that day was as much for them (as a team) as it was for me, so I completed that final task just before I left.