@charlesprestridge Dr. Cooperberg actually said: "God forbid we would do proton therapy for prostate cancer which should basically never...."

But he clarified this a sentence or two later: "Jason actually ran honest to god RCT of proton versus photon which showed very little difference."

This is what all the experts I've heard who are not enthusiastic about protons say, i.e. the literature so far shows very little difference in outcomes in patients treated with photons or protons.

So the complaint is, the docs see all this money going into building facilities to administer proton therapy, and they see other needs that could have been addressed with that money.

Cooperberg blames the situation on the fact that "We are one of only two countries on the planet that allows direct to consumer advertising in healthcare. It's a travesty. It drives up costs. It drives confusion. It is an absolute mess."

I've seen this in Seattle, the big city nearest where I live. The NCI designated cancer center there invested more than $100 million in a proton facility years ago. It is proven to be better for pediatric cancers among others. But to keep the machine busy, they flood the regional sportscasts with ads touting protons for prostate cancer. When you see a doc there about your prostate cancer they are definitely unenthusiastic about it. Its not that protons are not a good therapy for many cancers, including prostate.

Meanwhile, the RO I see there at my latest appointment replied to my question as to why they don't have an MRI-Linac machine by saying the center won't allocate the $5 million for it.