Proton vs Photon therapy

RobCarroll · November 2023

Results of my biopsy show out of 12 location I have two with 4+3 Gleason and I with 3+4. I am 76 years old and in good shape otherwise.

Have talked with Proton Therapy center in Knoxville and would prefer this treatment but my Humana Advantage plan will probably not cover the cost. Now setting up an appt with Photon radiation treatment doctor.

I'm trying to find out how much worse the side effects are using the second method without and with hormone treatment. Would like to hear from survivors of both treatments.

Thanks

Clevelandguy · November 2023

Hi,

Photon radiation is a strong radiation beam that goes completely through your body. Proton radiation has a fixed beam length which hits the tumor and does not go past it. There should be less damage beyond and before the tumor with Proton technology. But the choice is up to you and your doctor team and sorry to say your insurance company, I have includes a link for you to study. Hopefully your insurance company will cover the Proton technology. Both technologies have good tract records as far as killing cancer cells.

https://www.oncolink.org/cancer-treatment/radiation/introduction-to-radiation-therapy/radiation-therapy-which-type-is-right-for-me

Dave 3+4

RobCarroll · November 2023

Thanks, very good information. My plan is to use Proton if the insurance covers it. However the Proton folks thinks it very likely the insurance company will not cover it. Then I have to decide

https://csn.cancer.org/discussion/comment/1710221#Comment_1710221

whether or not the outcome from Proton in terms of lesser side effects is worth paying for it myself. I know the side effects using Photon will be much worse but I don't have a good feel for how much worse. I understand the success rate of cure is about the same for both therapys

Anyone out there who can describe the severity of the side effects of the Photon therapy?

Old Salt · November 2023

To my knowledge, there have been few peer-reviewed studies that actually demonstrate that proton therapy is preferable over photon therapy for prostate cancer. Here is a link to a recent paper that tries to compare the two methodologies:

Proton versus photon radiation therapy: A clinical review - PMC (nih.gov)

Note in particular section 3.1.

Based on published evidence such as the study cited above, I advise you to also talk to a radiation oncologist who specializes in photon therapy. I bet that (s)he will discount a lot of the information regarding side effects that you have been given by the proton therapy specialist. Moreover, the (very expensive) proton facility has to be paid for. Hence, proton therapy practitioners may not be neutral with their 'guidance'.

I will not discount side effects; they do occur with photon therapies, but they are typically manageable (I should know after 3 SBRT and 21 IMRT sessions). These days a product called SpaceOAR is often used to minimize side effects to the rectal area.

Of course, what is most important is that the group that will perform the therapy is highly experienced.

centralPA · November 2023

The proton beam dumps its energy at a finite distance in, but as per @Old Salt paper, controlling that precise distance is tricky. I expect some sloppiness results in normal tissue getting dosed more than desired.

I was thinking I would want proton beam if the day came for me to treat, but the science just hasn’t backed it up.

bdhilton · November 2023

Robc...I'd look into a cyberknife treatment. I've had surgery, salvage radiation and the last go around was with cyberknife treatment at UCSF. I'd also go to a recognized teaching hospital for prostate cancer too. I've been dealing with this beast since I was 53 in 2009.

Good luck in your journey