Proton or Photon

[Garfield-_1234]

Hi all, my wife and I are trying to determine the best choice for my prostate cancer. The biopsy/pet scan showed advanced prostate cancer with spreading to the right seminal vessel and involvement of one lymph node. We have had our first consult, locally, with a radiation (x-ray/photon) Dr. who suggested immediate hormone therapy and has set me up for radiation/x-ray treatments on 10 Oct. We have also contacted Loma Linda U concerning proton therapy and have initiated their process, but no consultation yet. The local radiation Dr. has 4 yrs as an intern and 5 yrs practicing.

Our question to the community is which therapy do you consider most viable for my case: photon or proton? and reasons why.

Thank you

[Scout4answers]

Above my pay grade to tell you if Proton is better than Photon but I could not find any evidence. Having an experienced doctor doing the procedure is most important in my opinion. I chose photon (IMRT) by a guy who had done 1200 PCa procedures. He was a master at shaping the scope of the radiation. See my profile for more details.

[Tall_Allen]

There has never been a prospective randomized comparison, but it doesn't seem to make a difference.

prostatecancer.news/2016/08...

prostatecancer.news/2016/08...

If you decide on proton, get it at Scripps, not Loma Linda. Scripps has more advanced equipment.

[wilcoxsaw in reply to Tall_Allen]

You probably meant California Proton which used to be affiliated with Scripps but is now with UC San Diego Health.

[hfl20]

A couple of years ago, after much reading and research I opted for IMPT, which is the pencil beam proton. I started 2 years of hormone therapy about 5 months prior to the 8 weeks of proton therapy both for scheduling purposes and to shrink my large prostate. The simulation and planning process is extremely complex and I opted to go with the very long term experience of MD Anderson and travel to Houston for my treatment (as do folks from all around the world). I selected Dr. Steven Frank as my radiation oncologist and he directed the planning process in my case. No matter which radiation therapy you select, the experience and skill of the radiation therapy team (including physicists and technicians) will likely have a lot to do with your long term results.

One video that influenced my decision to decide on proton therapy was this one:

youtube.com/watch?v=DFKAFXD...(Not working as expected?)

Here's another one that shows the complexity, the need for experienced folks, and a sampling of the planning process:

youtube.com/watch?v=uzPMp4R...(Not working as expected?)

IF the above link does not work search for "Christine Chung Proton Therapy" and/or treatment planning in practice

[wilcoxsaw]

I would suggest a consult with Dr Rossi at California Proton in San Diego. He is the most experienced proton doctor in the world having treated more men for prostate cancer with protons than any other MD.

[louschu]

Equally effective at killing cancer. Proton should have lower side effects but the doctor and equipment matters. Using the PSMA matters. Either way you should be on hormones. My preference is Orgovyx.

[Healer73]

I totally agree with everything said about Proton radiation. I was Dx at 73 in 2019. I did not want Photon X- ray due to the whole body side effects. Proton radiation has no whole body side effects. As of today (9-1-2024), I have had no side effects from the radiation. I received my treatment from Mayo Clinic in Phoenix. Good luck and remember that there is No Perfect answer.

[PC-22 in reply to Healer73]

Good Evening,

I am scheduled to start Proton Therapy at Mayo in Phoenix next week. Your information is encouraging to me. My RO is Dr. Laughlin. Is this the same doctor that treated you?

[Roadtrek]

I had Proton treatment at California Proton in San Diego . Dr Rossi has done more treatments then any other doctor. He used to head up the Loma Linda proton department. Gleason 9 treated in 2019 and still ticking.

[VictoryPC]

Proton is the go to. Has side effects later on but a nobrainer.

[Omalley]

Used Loma Linda Proton in 2009, Dr Rossi was still there and my doctor. I think the Proton is best but in my case I only got 25 Protons then they went to3 D conformal to get a larger area. If I had it to do again I would have refused the 3D. I asked Dr. Rossi why he didn't use IMRT for the other radiation, he said he didn't have it but if he did he would have used it. I think that bordered on malpractice to use a treatment he knew wasn't the best. I have had bladder problems and blocked urethers as a result. Had them reworked at UCSD and I'm better now. To be perfectly honest I can't complain too much I'm still here fifteen years later but my recommendation would be Proton

[Phillipsman1]

It worked for me.

I am 2 1/2 years so far so good.