Welcome, Ashley.

Only a handful of institutions offer Pencil Beam Proton Therapy or Intensity Modulated Proton Therapy, IMPT, which is an advanced form of protons, with MD Anderson, Mayo Clinic, that I know of off hand that offer it, out of small selection of centers, 20, that offer any proton therapy to begin with. Anyway, it's basically the same protons with pencil beam or not, but pencil pencil beam cuts down the set-up time, and changing of brass snubs, each location, and conforms to any tumor changes, and others.

My proton treatment, which was my 5th different radiation treatment, was only for several areas, took 30-45 minutes set-up time, a minute for the actual protons itself, which is silent btw, while IMRT took 17 minutes for 17 zaps, which you heard loud and clear, but IMRT can do just about what proton therapy does, and both are external beams. Without IMPT, it may take a while to treat several areas with regular proteins, and if already talking about 3 lymph nodes, and primary, that may factor in if it's the correct type of treatment initially.

The other thing is proton therapy is usually only approved fir certain head neck cancers like brain, base of skull, carotid artery or after prior radiation therapy failed, like IMRT, unless in a clinical trail, so chemo or targeted therapy may be required to participate. It's not cheap, although medicare paid for mine, others insurances as well, some maybe nit, but it's twice as expensive as IMRT. Mine was $7,157 a day, but even with that it can be costly if there are any daily co-pays. Some, if they still do, offer grants.

Protons are the most advanced forms of radiation, and there is there is no exit burn, unlike IMRT, due to the Bragg Peak, which usually results in hair loss in the nape of the neck in head and neck patients, as most of the radiation dosage is to the tumor itself, so the tumor, receives a more concentrated dose, and minimally to other nearby structures, and skin.

Here is the website for the National Association for Proton Therapy where you can find more information. There are a few discussions about protons if you look it up under the search function here, in addition too, the radiation and chemo therapy, in the treatment section page. I hope this helps.

http://www.proton-therapy.org/howit.htm