Ask yourself one simple question, forgetting about how many sessions are involved - long term it is irrelevant:
Do I want to be part of a clinical trial that shows that HDR + Proton therapy showed NO better results than a therapy which showed a proven 90% 10 yr success rate?
Or even further, a trial that had side effects either worse or more long lasting than the proven treatment?
I personally would not be part of a clinical trial if I did not have to be - ie: dead in 6 months if I didn’t try…
But you may want to do it in the name of science and that’s also a personal choice.
But you don’t have that kind of gun to your head so why take the chance?
A good friend just had HDR + SBRT (5sessions) at Sloan (with gel spacer). Three months out he is still having bowel SE’s; less with time, but still there. It’s not the proton vs photon question, but the very high doses of radiation administered both internally and externally. Protons can burn too!
Spreading the radiation out over 20-25 sessions is much gentler on the body; in fact some RO’s still do 36-39…the amounts of radiation are equal in most cases.
I consented to 25 sessions IMRT vs 39 for my salvage therapy to the bed/nodes after reading the clinical research showing that incidence of SE’s for both groups were the same after 6 months.
And of course, there WERE brave souls in that trial who exposed themselves to risk and allowed me to reap the benefit, no question. Would I have done it? Probably, only because of the travel time, inconvenience, bowel prep and all that. But HDR was never in the equation in my case (also Gleason 4+3 unfavorable) since my prostate had already been removed; and even though I feel HDR is an excellent treatment modality in some aggressive cases, it IS a huge wallop to the area and SE’s do seem to be linked to it much more frequently than with IMRT. Just my cowardly thoughts…Best,
Phil