How does proton compare to other radiation monotherapies?

Anecdotally, never met any Proton alumni that regret their decision, though for most part same can be said of SBRT.

Nomar Lupron 4 Me said...
Anecdotally, never met any Proton alumni that regret their decision, though for most part same can be said of SBRT.

No doubt! Enthusiastic, even. The vertically integrated marketing machine in that segment is very well-fed...the best in the industry. They get the entire staff aligned to pump-up the fresh customers. Stronger marketing, even, than Spamadi.

PBT was a high-cost solution looking for a problem just as the PSA-era started cranking out more and more favorable-risk prostate cancer patients. Perfect storm...now we have too many facilities and the PC gravy train of favorable-risk men is drying up as AS is ramping up.

Well, aren't photons and protons the same? The names sure sound alike...

I can only say that it was a good experience for me. I completed treatment 16 months ago and no side effects at this stage, although I'm mindful that with radiation of any type SE's may occur later.

I didn't expect any better chances of a cure with proton therapy than with any other treatment that I could have chosen. Preservation of sexually potency was very important for me and thankfully I still have it. I had no fatigue during or after treatment. I exercised a lot every day and my doctor thought that probably helped, though I never heard any of my fellow patients complain of fatigue. Most of us had some minor urination burning during treatment.

InTheShop said...
I am waiting for Star Trek transporter technology. Then they scan your body and beam the PC cells in to a solar trajectory and fry them suckers.

That's actually an excellent strategy for favorable-risk PC cases, which is the largest segment of cases!

The important part is the "what"...waiting until treatment is really needed.

The "how" is in the details TBD later...maybe the transporter technology, or maybe improved surgery, or maybe something else.

Kris,

No one is saying proton is bad, it's just no better than other less expensive alternatives.

You obviously have good insurance with low co-pays, but what about the rest of us who subsidize your expensive treatment by paying higher premiums? Insurance pooling means we're all in this together. Many insurance companies are denying proton coverage for this reason.

Ideally, due to the Bragg Peak, protons could be more precisely delivered, but that's not what happens in actual practice. Protons are charged particles, so they are difficult to collimate over longer distances, like deep into the pelvis. They also diffract from the edges of the collimator. They form secondary charged particles that deflect in various directions. And they use a "spread-out Bragg peak" to treat the deep tissue. The result of all this is that it is no better than other popular and less expensive types of radiation treatment, as you can see in the chart. It is not as good as some in preserving erectile function. This is based on UFPTI data.

I am hopeful that with pencil beam scanning they can reduce toxicity, that hypofractionation can reduce treatment time and cost, and the newer "mini" models can reduce cost still further.

- Allen