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I think this has been a good exchange about the relative benefits of photon and proton radiation bearing in mind the lack of definitive studies.
I see that the Dattoli site was mentioned. I believe that some of the material on that site is misleading and if SOME is misleading, then it might be an idea to be somewaht wary of other information.
In particular I was interested in a statement made to a young man who consulted the good doctor. He was told in writing that prostate cancer in young men was more aggressive (he had a diagnosis what was Low Risk in terms of current definitions). This intrigued me because it is a subject I am personally interested in, having being diagnosed as a 'young man'. So I mailed the organisation and asked if I could be directed to the data or studies supporting this statement. The response I got was from the Marketing Department saying that the statement was based on their observed experience.
In another section of the site, the various options were listed and mainly dismissed. In this section references were given to studies that it is implied support the statements made. Very few do that.
I took this matter up in a discussion with a vehement PCa activist, suggesting that it might be in the interestes of men to campaign against the posting of informaiton that might be misleading. His response was that in a commercial world such statements were acceptable; the importnat point being that all men diagnosed with PCa be treated.
John, since I'm a "graduate" of the MD Anderson PBT treatment protocol, I feel I must respectfully challenge some of the misinformation that your post on the subject contains. First, MDA's PBT regimen treats the full range of localized PCa without the need for any photon boosts at the higher risk levels. Most men with a Gleason score >= 4+3 are also on Lupron to help knock down their tumor. PBT generates dosage levels to the target area at least equal to IMRT, if not slightly greater (according to my MDA doc).
Second, and perhaps because of your first erroneous point, you suggest that cancer control with PBT might not be as good as it is with IMRT. This is simply baseless. I will grant that the precision of PBT requires excellent dosimietry and treatment planning by your radiation oncologist (i.e., to ensure proper coverage of the gland, with a small 4-5mm margin), but once that is accomplished, the outcomes are at least equal. For an outstanding overview of PBT in the Journal of Oncology (June 2011), please see --
http://floridaproton.org/pdf/1106ONCHoppe.pdf
In particular, take a look at the stunning comparative illustrations on the bottom of p.645 and then tell me whether you'd prefer your pelvis baked "medium" (proton) or "extra well done" (photon). The answer is fairly obvious to most of us. This graphically depicts why the so-called "integral dose" of radiation to the body is substantially lower with PBT, while at the same time not compromising the dose reaching the all-important target area (your prostate).
Now, not surprisingly, with less total dosage being absorbed by the body and pelvic region, there do tend to be side effect advantages, which are beginning to be documented. Here's a persuasive link in that regard, although I will concede more research must continue to be done --
The sexual function scores are particularly gratifying for many of us who wish to continue activity in that area. I'm several months post-PBT at this point and am running at "full steam" in that department so far (i.e., no change from prior to treatment).
