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Proton Therapy for Prostate Cancer

The first patient treated at MD Anderson with proton therapy had prostate cancer and started treatment in 2006. Since then we have treated thousands of men who have prostate cancer with proton therapy.

About prostate cancer

Prostate cancer is the second leading cause of cancer death in men in the U.S., but there is good news. If detected early, prostate cancer has a five-year survival rate of nearly 99%.

Prostate cancer occurs when cells in the prostate (a gland in the male reproductive system found below the bladder in front of the rectum) grow and multiply uncontrollably, damaging surrounding tissue and interfering with the normal function of the prostate. The cancer cells can then spread to other parts of the body.

While surgery and radiation therapy may have similar outcomes for early-stage prostate cancer, radiation therapy is the primary option for locally advanced prostate cancer and can also be used for localized prostate cancer. For larger or more aggressive tumors, radiation therapy may be used in combination with hormone therapy. At MD Anderson, patients have the option to choose a newer and more precise form of radiation therapy called proton therapy.

My proton therapy treatment during the COVID-19 pandemic

After retiring from a 35-year career teaching and coaching at my dream job, I’d planned to spend time with my wife, Joanna, and enjoy my favorite activities -- hunting, fishing and training my three Labrador Retrievers. Two months later, I was diagnosed with prostate cancer.

My prostate cancer diagnosis

After my brother was diagnosed with prostate cancer in 2011, I started getting annual prostate cancer screenings. For years, my prostate-specific antigen (PSA) level was at a borderline level of 3.9, with no physical abnormalities.

But in July 2019, my PSA level jumped to 4.9. Since a PSA level of 4.0 or higher is a possible sign of prostate cancer, I had a prostate biopsy in October 2019. The pathology initially showed a Gleason 6 cancer. At that point, my urologist suggested I seek prostate cancer treatment.

My path to the MD Anderson Proton Therapy Center

I researched prostate cancer treatment options and reviewed the potential side effects for each one. I was interested in proton therapy because it often has fewer side effects.

Shortly after that, I met a cancer survivor in my hunting club who’d undergone proton therapy at MD Anderson. After hearing about his experience, I contacted MD Anderson and was scheduled for a consultation with Dr. Seungtaek Choi.

As soon as I walked into the Proton Therapy Center, everyone made me feel at home. Dr. Choi was incredible, too. He was very thorough, but he explained things in terms I could understand.

MD Anderson’s pathologists reviewed my biopsy again and found that it showed a Gleason 7 cancer. That meant the prostate cancer was more aggressive than we’d initially thought.

After talking with Dr. Choi, I decided to undergo proton therapy.

My prostate cancer treatment at the Proton Therapy Center

I started my 39 proton therapy treatments on Feb. 17, 2020. Because I live in Houston, I was able to commute for treatments every morning.

I met with Dr. Choi every Wednesday during my eight weeks of treatment. He and my care team told me from the beginning that I might have some side effects. So, when I noticed a dull ache and slow urine stream around week six, I knew to drink cranberry juice, which really helped.

I felt a bond with the other patients I met during my visits to the Proton Therapy Center. Before the COVID-19 pandemic, we gathered in the dressing rooms before treatment and told stories to help pass the time. Developing friendships with fellow prostate patients was the best part of my experience.

My proton therapy treatment during the COVID-19 pandemic

The last few weeks of my treatment were during the early stages of the COVID-19 pandemic. While a lot had changed, MD Anderson was prepared and had implemented a lot of precautions to protect patients and employees from the coronavirus. My treatments continued as usual, but I was screened for COVID-19 each time I entered the Proton Therapy Center. Everyone wore masks and practiced social distancing.

In order to ensure proper social distancing, only one patient was allowed in the dressing area at a time. I missed bonding with my fellow patients during that time, but we stayed in touch through texting and social media.

Throughout my treatment, I realized I wanted to give back to future patients. My radiation therapists suggested I volunteer by speaking to new prostate cancer patients and sharing my experience to ease their concerns. Once the COVID-19 pandemic improves, I plan on doing just that.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Benefits of proton therapy for prostate cancer

There are many benefits of proton therapy treatment for prostate cancer at the MD Anderson Proton Therapy Center including:

Precise, accurate delivery of even high radiation doses to kill cancerous cells in the prostate
Minimal impact to surrounding, healthy tissues and vital organs, such as the bladder and rectum
Less invasive – treatment is painless and requires no downtime
Provided in a comfortable, outpatient setting with free parking

Targeted Care

Proton therapy precisely targets even the most difficult to treat and reach tumors and allows higher doses of radiation to be delivered to the prostate with fewer side effects. Unlike treatment with conventional X-ray therapy (which may require 8 beam angles), treatment with proton therapy can be achieved using just two beams.

Pencil beam scanning proton therapy

Patients who come to MD Anderson's Proton Therapy Center may be treated with pencil beam scanning proton therapy, also called spot-scanning, which is an even more advanced type of proton therapy. Pencil beam proton therapy delivers a single, narrow proton beam (which may be less than a millimeter in diameter) that is magnetically swept across the tumor, depositing the radiation dose like a painter’s brush strokes, without the need to construct beam shaping devices.

Using rapidly fired pulses, the pencil beam hits each planned spot within the tumor with the prescribed amount of radiation, starting at the deepest layer and working in succession, layer by layer, until the whole tumor is covered. Typical tumors require between 1,000 to 2,000 separate spots arranged in approximately 20 to 30 layers for a single pencil beam treatment. Though highly effective, pencil beam proton therapy treatment takes only a few minutes to deliver.

Pencil beam scanning proton therapy:

Uses a proton beam which may be less than a millimeter wide to target prostate cancer with even greater precision
“Paints” the tumor with proton radiation, allowing even more accurate treatment of tumors that are oddly shaped or that have varying depth
Can be directed to a prescribed depth in tissue in the prostate, which minimizes dose to healthy surrounding tissues, such as the bladder and rectum
Optimizes the ability to treat a patient’s prostate tumor without compromising quality of life – during and after treatment
Results in quicker treatment times because no apertures or shaping devices are needed

The Proton Therapy Center pioneered pencil beam proton therapy treatment and currently is the only center in the United States and one of only three clinical centers in the world using this technology to treat patients. Talk to your radiation doctor to see if this is the right type of proton therapy for you.

What to expect during proton treatment

With proton therapy for prostate cancer, treatments typically take only 15 to 20 minutes each day and are delivered five days a week for approximately eight weeks. There is little to no recovery time after treatment, and the risk of immediate post-treatment impotency is minimized, especially in those with good sexual function prior to treatment. Most patients tolerate the treatments extremely well and are able to continue to work, exercise and remain sexually activity during their treatment course and immediately after treatment is complete.

For more on what to expect watch this video of former Proton Therapy Center patient Joe DePasqual. He discusses why he chose proton therapy, his favorite thing about MD Anderson, being proactive in his treatment process, and how he chose to spend his free time in Houston.

Proton Therapy Patient Stories

Cancer-free since 2011: Why I chose proton therapy

"With proton therapy radiation, doctors can control where it hits, unlike traditional radiation where it comes out through the other side of my body."

Read Dave's story