A man watches as a proton beam lights up a chart in the sky.

Proton Therapy: What’s the Catch? – Part 3

Bobby was diagnosed with prostate cancer in 2020. He talks about his path to getting diagnosed and undergoing proton therapy for treatment. Read Part 1 and Part 2.

Treatment outcome

And now, as of this writing, 4 months post-treatment – 44 proton treatments over 9 consecutive weeks – I have had no negative side effects or problems. I have had some urinary urgency, and some various burning sensations, but that’s it, and even that is almost gone. So far, I have experienced no incontinence and no ED.

At my 3-month follow up, my PSA was checked. My PSA had risen to 7.22 following the biopsy, and that is considered my treatment baseline.

Three months post-treatment, my PSA was 2.8, which already brings it back to 2017 levels. They were pleased with that decrease. The expectation now is that it will continue to decrease, though maybe not in a straight line, for up to the next two years.

The catch

Well, then, what is the catch? There is usually always a catch, but it really is not with the technology, but the availability of it, and also its cost.

The machine that accelerates the protons is called a cyclotron. Cyclotrons are huge and expensive, and are installed via crane. It can cost about $150-200 million dollars to establish a proton center. And though there are currently a few dozen centers across the country, they may not be easily accessible.

I was lucky – my insurance actually covered proton, but not all insurance companies do.

Further, I believe that Medicare is/was attempting to classify all radiation therapy as “the same” to justify paying one flat amount regardless of the type of radiation you get. That could put proton out of reach for many. But I think the current administration is very cancer aware, and as such, I hope that proton therapy has renewed focus.

How I view the benefits of proton therapy

Proton therapy has been a successful treatment for prostate cancer for years, and thousands of men have undergone the treatment.

I think that the extreme precision of proton therapy can make it well-suited for the treatment of cancers in sensitive areas, like the prostate, while potentially reducing the side effects that are so common with other treatments.

Though expensive, it is covered by some insurance companies already, and hopefully will be routinely covered by insurance companies going forward. I think it can be helpful for men to learn as much as possible about proton therapy before making a prostate cancer treatment commitment.

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