Proton Therapy

What is proton therapy?
Proton therapy is a type of external beam radiation therapy that uses high-energy (charged) proton particles instead of x-ray beams. The potential advantage of protons is a more precise radiation beam, but that advantage is somewhat lost in practice due to scattering of the beam within the body.  The radiation dose that can be safely given is as high or slightly higher than modern IMRT (Intensity Modulated Radiation Therapy), but lower than with brachytherapy.
Who is eligible for proton therapy?
You may be eligible for proton therapy treatment if:
1) You have a cancer which has not spread outside the prostate gland
2) You are prepared to travel outside Canada and pay for the treatment ($50,000 or higher.)
What are the advantages and disadvantages of proton therapy treatment?
Deciding if proton therapy treatment is right for you is a decision you should make after knowing the advantages and disadvantages and discussing them with your doctor.
Advantages of proton therapy Disadvantages of proton therapy
Similar cancer control rates as brachytherapy, but without the need for temporary or permanent seed insertion under anesthetic Not available in Canada
Non- invasive and minimal pain Costly
Similar side effects to IMRT Given 5 days a week over several weeks.
What are the possible complications of proton therapy treatment?
As with any procedure, there are possible complications and side effects of proton therapy. As well, each person responds differently to varying forms of treatment.  The specific side effects of proton therapy are typically to the rectum and the bladder, which shows as urinary and rectal irritation. The rectum and bladder are affected as they are located so close to the prostate gland. Longer term damage to these areas can also occur.  The risks are very similar to that of IMRT.
Is proton therapy available in Canada?
Proton therapy was approved for use in Canada by Health Canada in January 2015. There is not yet enough evidence to recommend proton therapy as a routine treatment for prostate cancer. It is currently not available for prostate cancer treatment, but that situation may change. 
Because proton therapy is very expensive and has no significant advantages in cure rate for prostate cancer compared with other treatments, it is not covered by Canadian public health insurance – you would need to pay for the procedure yourself.
To learn more about the discussion of publicly funded proton therapy, here is an article by Cancer Research UK about the approach being taken in the United Kingdom.   

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