Proton beam therapy for prostate cancer:
I have studied the subject matter thoroughly. As a
scientist, I have access to the primary medical
literature, and I have carefully scrutinized over
100 publications on the subject. I have also had
discussions with over 20 men who had so-called
conventional treatments (radical prostatectomy,
various forms of external beam radiation, and two
forms of brachytherapy), in addition to 30 men who
had proton therapy. My conclusions are that,
indeed, as argued by several contributors to this
compilation, all forms of treatment are equally
successful. The difference lies in the side
effects, particularly posttreatment.

My particular concerns with respect to treatment
are the minimization of the chances for urinary
(i.e. incontinence) and sexual (i.e. erectile
dysfunction) complications. My research shows that
proton radiation offers a much better chance of
avoiding such complications than conventional
treatment. Some adverse medical literature
notwithstanding, there are numerous reports in
primary publications, most significant among them
those by doctors/researchers without a vested
interest in any of the forms of therapy, which
point to the superior aspects of proton radiation
in these respects. These papers show that it has
become a standard alternative to other methods,
that quality of life issues have become paramount
for men afflicted with prostate cancer, and that
the choice of treatment should be left to the
patient.

The statement that there are no rigorous studies
the compare modern conventional IMRT with proton
radiation therapy is correct. What is incorrect,
indeed disingenuous, is to construe this as an
argument against proton radiation as a treatment
choice. There are no studies that show that
conventional treatment is better or even equal to
protons. However, there is unequivocal science.
Nobody can argue with the existence of the Bragg
peak and therefore the corresponding reduction in
exposure of nontarget tissue.

I therefore would have to vehemently disagree with
the proposal to stop Medicare reimbursements for
proton therapy in the treatment of prostate
cancer.