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.