With only 46 active proton centers in the U.S. (https://www.proton-therapy.org/map/), much has to do with access.

Also, with recent studies (COMPPARE and and PARTIQoL) showing similar tumor control rates and patient-reported quality of life outcomes, insurance companies sometimes have an impact on that decision (given the cost of proton over photon).

Ultimately, it was proton’s Bragg-Peak characteristics that persuaded me (and the fact that Medicare fully covered it, and that there was a top proton center just a 40-minute drive from my home helped my decision immensely).

During April-May 2021, I had 28 fractions of proton radiation (2.5 Grays each session), with SpaceOAR Vue, and 6 months of Eligard (for a localized Gleason 4+3=7, Grade 3).

Short-term —> I only had 1 day of adverse side-effects during my 28 sessions of proton beam radiation treatments (during April-May 2021). On the 3rd day of treatment, I had urinary issues. My RO told me that with some men there’s an inflammatory response to the radiation, and if that inflammation is near the urethra can cause the issues that I was experiencing. He recommended that I take 2 Tamsulosin/day for the remainder of the treatments. Everything cleared up by the next day; I haven’t had any issues since.

Long-term —> My “recovery” from radiation treatments since then has been uneventful.

My experience? —> It was a walk in a park.

Dr. Rossi provides good information about proton in his portion of this 2023 Mid-Year PCRI presentation: https://www.youtube.com/live/WTqPnSRYtW4
—> Starting at timestamp 3:38:45.