PCRI’s Executive Director, Mark Scholz, MD, talks about proton therapy as a treatment for men with the Teal stage of prostate cancer. He compares it with other forms of radiation and describes the appropriate situations for its use.

0:24 Teal prostate cancer, also known as intermediaterisk prostate cancer has treatments that range from active surveillance to a single treatment, to a combination of 3 treatments. Proton therapy is often given on its own as a monotherapy. But it can be used as a part of a combination therapy protocol as well. Proton therapy is typically for men with Basic Teal or "intermediate intermediaterisk" prostate cancer.

1:09 Proton therapy is similar in many ways to IMRT (intensitymodulated radiation therapy). Proton therapy is typically advertised as exposing less of the body to radiation since the protons emitted by the machine stop inside the prostate and do not travel through the body like xrays from standard IMRT. Side effects are no worse than IMRT, cure rates are similar, but there are no studies that show that the side effects are better with proton therapy than with IMRT. From a clinical standpoint. One can think of the two as equivalent, although proton therapy centers are rarer, and the treatment is more expensive.

2:28 Proton therapy technology. Modern proton therapy is called IMPT or intensitymodulated proton therapy. There are older forms of proton therapy called conformal proton therapy that does not use computer guidance like modern proton therapy. There are still centers that use the older technology; this should be avoided.

3:35 Beam radiation (IMRT and IMPT) doesn’t deliver as much radiation as seed implant radiation does and thus the cure rates are lower. But cure rates are high for pretty much all forms of treatment for basic teal, and beam radiation can be less invasive than a radioactive seed implant.

4:42 IMRT and IMPT historically have required daily visits to the doctor, Monday Friday for up to 9 consecutive weeks. Modern studies show that it is safe to give equivalent radiation over a 5 week period and this is becoming a new standard.

5:20 IMRT is a perfectly good form of treatment. It is feasible as long as there is a quality center near you since you will be making daily visits. As with all treatments, the procedure takes skill and you must find competent and experienced medical professionals for best results.

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