Myth #7: There are no studies or documentation that support the success or superiority of proton therapy for prostate cancer.
We often hear from recently diagnosed men that their urologist is pressuring them to have surgery. When they bring up the subject of proton, they are often told some of the stories we have already addressed in Myths 1 through 6, such as “Proton therapy is ‘experimental’ or ‘investigational,’” or “it’s no better than advanced forms of conventional radiation.” Another story they are often told is that there are no published studies, documentation, or articles on proton therapy for prostate cancer showing the benefits, or no statistics to back-up claims of proton’s superiority. This is not true.
Over the past 23 years there have been dozens of studies and articles on this subject. A partial list is below.
What do these studies, surveys, and articles tell us? They tell us that:
- Proton therapy is the most precise form of radiotherapy available today.
- Two to three times less radiation is deposited on healthy tissue with proton than with any form of photon (X-ray) radiation.
- Higher doses of radiation do a better job of killing cancer, and, contrary to experience with conventional x-ray radiation, when proton doses are increased there is no corresponding increase in collateral damage and side effects.
- Cure rates with proton therapy are at least as good as surgery or conventional radiation.
- Genitourinary and gastrointestinal complications are lower with proton therapy than with other treatment modalities.
- Sexual function is better preserved with proton therapy.
- Proton therapy is an excellent treatment choice for young men with prostate cancer.
Here is a sampling of some of the studies, articles, and surveys relating to proton therapy for prostate cancer:
The graph below titled, “Rectal Sparing,” shows considerably higher doses of radiation to the rectum with IMRT vs. proton.
The chart below titled, “Dose Escalation Trials Support the Use of Protons for Prostate Cancer,” shows better disease control with proton and significantly lower GI (gastrointestinal) toxicity.
Are More Studies Really Needed?
Dr. James Cox, a prominent researcher from MD Anderson commented on this subject in an article in the Journal of Clinical Oncology. In the article he pointed out the fact that there is considerable documented evidence that with protons, there is two to three times less radiation deposited on healthy tissue, and radiation delivered to normal tissue causes damage to this tissue, and the severity of damage increases with increasing dose.
He states that, “We doubt that many of us, while healthy, would agree to receive, for example, 25 Gy to a large fraction of our brain or abdomen in exchange for some thousands of dollars, with no known or credibly hypothesized medical benefit. If we would not, how can we ask our sick patients to do so? Once proton beam therapy has become clinically available, is not the burden of proof on conventional x-ray therapy? Should not its advocates have to demonstrate that the cost savings achieved by using x-rays are not accompanied by undesirable additional morbidity? Do the users of x-ray therapy have the evidence to support such a claim?”
Myth #7: BUSTED!
Any questions? Just ask.