MK,
to get this thread back on topic, I just read your post and need to give you a heads up. Irregardless of what what radiation she receives - it is no walk in the park. The treatment itself is pretty brutal and the full effects will be felt for some weeks after the end of treatment. There can be many small but potentially dangerous issues from infections, aspiration, pneumonia, nausea, weight loss, thrush, mucositus, zerostomia, etc. It is estimated a month of recovery for every week of radiation.

You will need some help convincing your mother to stay the course. You may want to find a therapist now for her to talk to. Also make sure that her doctors know her feelings about this and if she needs meds for pain, anxiety and/or depression that they take care of it. Elderly people can be very quirky about pain medications. She will need a full care time caregiver to manage nutrition and meds.

I was as healthy as an ox going into this in my mid 50's and it beat the crap out of me.

The main advantage from IMRT is in the QOL issues later. Even with IMRT it was still a good 18 months before I had any significant salivary function return.

I too am curious why they changed horses in mid stream about XRT vs IMRT? I would really be grilling them about that.

There really isn't, nor should there be, a debate of IMRT vs XRT. Ionizing radiation has been used with great success since the 70's when it replaced the standard at the time, Cobalt 60, which had been in use since the late 1800's. There has always been a search for better and more accurate treatment and tissue sparing. Cobalt 60 caused horrific and many times permanent skin damage (especially when it reached its half-life and the treatment time period had to be extended). XRT was a huge leap up from this. 3D conformal then IMRT is merely a small technological improvement (we think - at least the preliminary data is encouraging) and its closely related successor, tomo-IMRT. To paraphrase what Gail said, only time and science will be able to determine the true, long term efficacy, of IMRT. As the XRT people are weighing in here - it has obviously saved many lives. I think that we are all saying the same thing - get the treatment that will save your life based on the best advice from knowledgeable doctors and hopefully being your own advocate and being at peace with your decision. On the forum we can only share our personal experience, strength and hope (especially since none of us are doctors). We could just as easily debate Apples vs. PC's and have the same degree of controversy and passion I am sure.

PBT is yet another relatively new player on the scene with only a handful of institutions providing it worldwide at this time. PBT, or proton beam therapy, is a fascinating approach as it uses a "charged particle" concept so that doesn't develop it's total potential until it is actually painting the exact target. There is no entry point damage. It does require a MAJOR capital investment. Whereas a (9 ton)LINAC can be bought for a few Mil, a PBT system, multiple treatment suites and the 35 ton gantries required for each suite, including a dedicated building is why this costs around 200M to install.