proton or photon

[Infamous9597]

My 25 sessions of IMRT for the whole pelvic are set to begin next Wednesday, but I just received notification that my insurance has approved proton therapy. If the commute and time commitment are similar for both treatments, which one should I choose? I'm aware of the recent trial suggesting no significant difference between proton and photon therapies, but I want to make the best choice, especially since I'm still young (51).

[Tall_Allen]

It doesn't matter. Choose on the basis of convenience.

[Derf4223]

With IMRT you need to arrive with and endure a full bladder for about 10 minutes. Proton treatments take longer -- I've read ~20 minutes. That is going to be uncomfortable to the point of bladder pain. The last few sessions will be the worst. Your ability to hold back urination will worsen as sessions accrue.

[Infamous9597 in reply to Derf4223]

Thank you. I will make sure to ask for the details of the proton treatments

[Jpburns]

You really should go with your doctor’s advice, vs what sounds newer or cooler. When I met with my RO, I asked about proton vs photon, and he said he thought photons were the best answer for my particular diagnosis.

[j-o-h-n]

Note: There are many prior posts regarding proton or photon treatment(s). If you wish, do a search on H.U. History file and review them. Whatever you choose, I hope it works!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

[khaiden]

I went through 25 sessions of proton radiation at age 54. Hardly any side effects. The most difficult part was to show up with empty rectum and full bladder.

I was high risk and went through 18 months of Eligard and HDR on top of proton. 2.5 years later everything is fine.

According to physics, the protons should be better than photons, but studies have not found a big difference.

I agree with Tall Allen.

[Infamous9597 in reply to khaiden]

did you treat the whole pelvis with proton?

[khaiden]

I am not 100 % sure, if it was whole pelvis, but the prostate gland, seminal vesicles and the lymph nodes were targeted.

[Infamous9597 in reply to khaiden]

Thank you. Could you share how long you have to keep your bladder full on the table for each proton session?

[khaiden in reply to Infamous9597]

The full bladder was not much of a hassle. The empty rectum was far more difficult. Since my bowel movements are very irregular, I stopped eating before the sessions and ate later. To keep the bladder full, I drank water before the treatment. Sometimes, I drank too much and I had to let go before getting on the table, because my bladder was too full.

One time, there were delays. My bladder was really full. I told them, I cannot hold it anymore. They gave me a bottle to pee in and everything was fine. If I had gone to the bathroom, they would have to do another CT scan to get me aligned correctly.

All in all, this was not much of a hassle. You go through it and get it done.

Nothing like surgery with all kinds of issues afterwards as I have heard from friends. I did not lose a single day of work, I never wore a pad and my sex life is slowly coming back, after ADT is wearing off. I have no complaints about my treatment with ADT, 25 sessions of proton radiation and HDR