What's the difference between proton vs traditional radiation?

Not a lot. Both better than surgery in most cases imo.

I also had mridian 5 treatments at Dana Farber/Brigham & Women's Cancer Center in Boston. The margin of error is 2mm and the machine stops if your body internally moves off the target. Helps prevent healthy tissue involvement. Minimal side effects that quickly go away. This is SBRT radiation.

cfo: I completed photon with mridian from viewray (viewray.com). 5 treatments completed mid February. The only photon machine that has a built in MRI into the linac machine so treatment is with real time imaging not images that are fused in as primary. Margins used are 2 mm vs 4-5 for other radiation machines. Better protection of healthy tissue. Automatic shut off if your internals move and radiation reaches the edge of the margins.

Photon IMRT excellent option.
I had IMRT radiation for BCR after prostatectomy (both at Johns Hopkins), hour 15 min away.
37 radiation sessions involved a lot of attention to bowel/bladder prep. The travel made it a bit more challenging.

Dear cfo,
Here's some good information on option for photon radiation. https://www.cancer.org/cancer/types/prostate-cancer/treating/radiation-therapy.html#:~:text=The%20main%20types%20of%20radiation%20therapy%20used%20for,into%20the%20body%29%20External%20beam%20radiation%20therapy%20%28EBRT%29
It lists the following types:

1. Extenal Beam Radiation Therapy (ERBT) the oldest form with least effectiveness
2. Three Dimensional Conformal Radiation Therapy (3D-CRT) Radiatio beams are shaped from several directions to reduce tissue damage.
3. Intensity Modulation Radiation Therapy (IMRT) It's an advanced form of 3D-CRT and it says it's the most common form of radiation for prostrate cancer.
4. Stereotactic body radiation therapy.(SBRT) It's an advance image guided technique that takes only a few days with high doses. It's also called the cyberknife.
5. MRI-Guided Radiation Therapy. It uses several of the other forms but also uses MRI that can change the beam stream, if the prostrate shifts in some way. It will always hit the target.
When I was looking at photon beam therapy, IMRT was the only option for me near me. Since then the options are much larger. I guess the form near you will be dependent on cost.

Best to you. this is a tough decision like all of use. Any will work. Just try to cause least damage.

What is "The most advanced form of photon"? Any specific name from anyone? I am Gleason 9 (5+4) however only 4.17 PSA currently. I have option going with Photon locally or Proton 3 hours away from home. Really like the local radiology oncologist. I had heard this too, I just need more definitve information. Thanks!!

PSMA PET Scan didn't show any cancer but psa's over the last year .20, .24, .24, biochemical recurrence. Radiation Oncologist suggests 40 IMRT, I'm guessing to the pelvis. Worried about side effects (bladder, bowels); What kind of radiation? Glad your husband did well. Nice to hear something positive. This is all new to me. Thanks for answering.

He did very well. It was exhausting of course as the cancer center is an hour away. I am grateful the doctors made the choices they did for him. The side effects were minimal, and his PSA plummeted in the first month and his most recent scan showed nothing but a giant prostrate.
I hope this shows that no one solution is the right one for everybody.
What is the doctor recommending?

Hi, how did your husband do with radiation?

@mamarina thank you. I have a zoom with Dr. Fagundes in a few days.