If you watch the 2023 PCRI Video and see Dr. Carl Rossi talking about radiation you find some interesting things. For one he’s been doing Proton radiation treatments since 1994 when they built a building for the machine in San Diego. The first patient was the person that invented it, He lived to over 100. He has done Proton radiation on over 13,000 prostate cancer patients.

That video link is in the @brianjarvis message a few messages above this one.

Proton therapy definitely causes less secondary cancers than other radiation therapies. They prefer to use it in children to avoid secondary cancer risk over their lifetime. Proton therapy machines have been extremely expensive to build or treat patients, which is why it is so much more expensive and less used. They have finally been able to get a proton machine built in one and two rooms, which will greatly reduce the expense. Eventually, it seems proton, will probably be equal in priced to other techniques and will be used much more often.

Some information about secondary cancer risk

Stanford Edu
In a study of about 145,000 men with prostate cancer, the team found that the rate of developing a later cancer is 0.5% higher for those who received radiation treatment than for those who did not. Among men who received radiation, 3% developed another cancer, while among those who were treated without radiation, 2.5% developed another cancer.

Here is a link to the full study from Stanford

Prostate radiation only slightly increases the risk of developing another cancer, Stanford researchers find
https://med.stanford.edu/news/all-news/2022/070/prostate-radiation-slightly-increases-the-risk-of-developing-ano.html
The question with proton therapy is how long will you live? For somebody in their 60s desiring to live Another 20-40 years, it’s nice not to worry about secondary cancers. For somebody who is 75 the risk of a secondary cancer is very low so the lesser expensive therapies make more sense, or do they.

While we’re talking about it, here’s some info about the secondary Cancer risk of different types of radiation.

Studies suggest that SBRT may be associated with a lower risk of developing a second malignancy compared to other radiation modalities like conventionally fractionated intensity-modulated radiotherapy (CF-IMRT) and brachytherapy (BT), according to ScienceDirect.com. Another study found that SBRT's probability of causing secondary cancers was similar to that of radical prostatectomy (surgery), according to ScienceDirect.com.

I had salvage radiation at 67 and 10 years later no secondary cancers.

And lastly, here is a map of where the proton centers are located, it doesn’t show the exact location. Mayo in Scottsdale has one apparently. Surprising how most of them are on the eastern side of the USA.