Use of a high-tech radiation cancer treatment called proton beam therapy (PBT) has increased overall in the United States, but Black patients are getting it less often than white patients, two studies show.
What is proton beam therapy?
Traditional radiation treatment is photon-based, but PBT uses protons to deliver high-energy beams more precisely to tumors and reduce damage to surrounding healthy tissue.
PBT can be better than traditional radiation therapy for tumors with complex anatomy, tumors surrounded by sensitive tissues, and childhood cancers, but PBT can be twice as expensive, according to the American Cancer Society.
To treat a patient, doctors and physicists work together to focus the proton beam on the exact size and shape of the tumor, according to Johns Hopkins Medicine.
Increasing use in the U.S.
To assess the use of PBT in the United States, researchers analyzed data on nearly six million patients in the National Cancer Database. They found that the overall use of PBT for newly diagnosed cancers rose from 0.4% in 2004 to 1.2% in 2018.
Private coverage was the most common type of insurance among patients treated with PBT for recommended cancers, while Medicare was the most common insurance among patients treated with PBT for cancers for which the treatment’s efficacy is still under investigation.
RELATED: Why Black Men Should Consider Immunotherapy for Prostate Cancer
Disparities in PBT use
The study also found that Black patients were less likely to be treated with PBT than white patients (0.3% vs. 0.5%), especially for cancers for which PBT is recommended over traditional radiation therapy.
In fact, this racial disparity widened as the number of facilities offering PBT increased, and the disparity did not disappear after the researchers accounted for socioeconomic status or type of health insurance.
“We found that PBT use increased nationally between 2004 and 2018 for all eligible cancers, especially for cancers for which PBT is the recommended radiation treatment,” says Leticia Nogueira, senior principal scientist of health services research at the American Cancer Society.
“Especially concerning, however, was our findings also showed racial disparities increased as availability of PBT increased in the U.S.”
Celebrity spotlight: Montell Jordan’s prostate cancer fight
Grammy-nominated singer Montell Jordan recently revealed that his prostate cancer has returned and that he will undergo proton therapy, a form of targeted radiation, along with hormone therapy.
The 56-year-old R&B artist—best known for his 1995 hit “This Is How We Do It”—shared on NBC’s Today Show that follow-up scans detected cancer in his lymph nodes less than a year after surgery to remove his prostate.
Jordan will receive proton therapy five days a week for nearly two months. He described the treatment as “a seven-and-a-half-week interruption of life to make sure I have a longer life.”
Recurrence is not unusual
Dr. Kosj Yamoah, chair of the Radiation Oncology Department at Moffitt Cancer Center, noted that Jordan’s recurrence is not uncommon. The cancer spreading to his lymph nodes may indicate it was already outside the prostate before surgery.
“Recent tumor genomics studies suggest that about 20% of men of African origin who present with what looks like stage 1 or stage 2 disease may actually have aggressive biology,” Yamoah explains. “It’s not uncommon that after surgery the cancer may recur much sooner than expected.”
New imaging tools, such as prostate-specific membrane antigen (PSMA) PET scans, may help doctors identify such cases earlier.
RELATED: Why Are Black Cancer Patients Frailer Than Their Peers?
What are the benefits of proton therapy?
Although both regular radiation and proton therapy damage the DNA of cancer cells, proton therapy offers greater precision. Because less healthy tissue is affected, side effects are often milder.
Damage to delicate structures such as the brain, heart, oral cavity, esophagus, and spinal cord may also be reduced, Johns Hopkins Medicine notes.
Expanding access to PBT
Moffitt Cancer Center is scheduled to open Tampa Bay’s first proton therapy unit at its Speros campus in 2026. Experts say Jordan’s announcement underscores the importance of expanding access.
“Proton therapy by all means is an effective modality for treating prostate cancer,” Yamoah says. “Where you have lymph nodes close to sensitive structures like the small bowel or bladder, protons are very sharp in their margins. That precision can reduce side effects while still treating cancer.”
Black men face higher risks
Jordan is also working with ZERO Prostate Cancer to raise awareness about early detection—particularly among Black men, who face higher risks and worse outcomes.
“Black men are diagnosed with prostate cancer almost 10 years younger than the average, and in some cases with more advanced disease,” Yamoah says. “That makes early detection, comprehensive staging procedures, and access to advanced treatments like proton therapy especially important.”
RELATED: Blitz the Barriers: Prostate Cancer’s Night of Stars & Stories
Is PBT right for you?
Proton therapy isn’t considered appropriate for every type of cancer. It is typically used for cancers in sensitive areas, where surrounding healthy cells could be harmed by traditional radiation.
If you are considering this treatment, discuss it with your doctor. Because proton therapy can be expensive, check with your insurance provider about coverage. Many proton therapy centers also have financial counselors to help patients navigate costs.
