I'm happy to report that my proton radiation treatment has been "approved" by United Healthcare (UHC) under the following conditions:
- It must be administered as Stereotactic Body Radiation Therapy (SBRT) -- The key difference between SBRT and "normal" proton therapy is SBRT delivers radiation in higher dosages over a shorter number of cycles (5 cycles in this case). Both approaches, however, make use of safer proton radiation, which should reduce "radiation splash".
- It must be administered between January 1 and March 26, 2025 -- obviously this is the easy part!
Though I'm very happy with the approval, I wish to add that Emory indicated that there is no cost difference between SBRT with Protons vs SBRT with X-Rays. Cost would only go up if proton treatment was administered the "normal" way: lower dosages over a greater number of cycles (e.g., 15 cycles). This may help explain the quick approval by UHC.
The one concern I have about SBRT is that the higher dosage with each cycle means that delivery must be very precise, otherwise any errors or misalignments are magnified. This is of particular importance when it comes to my right kidney, which abuts the tumor.
That concern aside, I'm also happy to report that I will be undergoing simulation scanning this Thursday (January 16). This is when they use CT and MRI scans to carefully map the area being treated. They will then create some sort of "cast" (likely of my midsection) that they will later use to help get me aligned properly during treatments. And in addition to the cast, they will put marks on my body to further assist with alignment during treatment.
Next, the radiation doctors use the scans in order to produce a radiation plan. It can take up to 2 weeks after the simulation scanning for this plan to be complete. The plan will consist of the precise dose, location of radiation, beam angles, etc. Treatment cannot start until this plan is completed.
The one concern I have about SBRT is that the higher dosage with each cycle means that delivery must be very precise, otherwise any errors or misalignments are magnified. This is of particular importance when it comes to my right kidney, which abuts the tumor.
That concern aside, I'm also happy to report that I will be undergoing simulation scanning this Thursday (January 16). This is when they use CT and MRI scans to carefully map the area being treated. They will then create some sort of "cast" (likely of my midsection) that they will later use to help get me aligned properly during treatments. And in addition to the cast, they will put marks on my body to further assist with alignment during treatment.
Next, the radiation doctors use the scans in order to produce a radiation plan. It can take up to 2 weeks after the simulation scanning for this plan to be complete. The plan will consist of the precise dose, location of radiation, beam angles, etc. Treatment cannot start until this plan is completed.
Once treatment starts (probably 2-3 weeks post simulation), I'll get blasted with high dose radiation for 5 consecutive days using pencil beam proton therapy. Here's a helpful illustration that shows how it works:
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| Pencil Beam Proton Therapy |
This phase of my cancer journey is moving actually much faster than expected, but that's fine with me. Probably the less time I have to contemplate the "what-ifs", the better!
