Proton therapy is precise and much less invasive form of radiation therapy against cancer. It is the method of choice for children and patients whose tumours are located near critical structures or lie at great depth. It is distinguished by high safety and, in most cases, allows to obtain a more pronounced clinical effect and achieve long-term remission.
Proton therapy is a modern, high-precision form of radiation therapy for the fight against oncological diseases. It combines high efficiency and a gentle effect on the human body. This technique has been used around the world for many decades. As technology advances and investment increases, proton therapy becomes more widely available and in demand for medical indications.
More than 150,000 patients worldwide have been treated with protons. The standard indications for the therapy today are chordoma and chondrosarcoma of the skull base and axial skeleton and, increasingly, solid tumours in children.
The patient more easily tolerates radiation therapy if it destroys the cancerous tissue more precisely. It is the main advantage of proton therapy. Immediately after penetrating the tissue, the particles release minimal energy. And at the moment of their complete stop, energy production increases sharply (a kind of small "explosion"), allowing the doctor to control the impact with an accuracy of a millimetre. At the point of reaching the maximum dose, the effect of the beam also stops abruptly, due to which the surrounding healthy tissues are practically not exposed.
Description of the proton therapy
First, every patient should have a personal consultation with a radio oncologist. He will explain the side effects, the expected results in your particular case, and the specific treatment plan. The first phase of treatment includes diagnostic scans (MRI or CT, preparation of a stabilising device, etc.).
The key to treatment success is its precise planning. Therefore, a team of physicists and clinical doctors prepares an individual radiation plan for each patient. The exposure plan determines, in particular, the directions and intensity of the proton beam that will illuminate the tumour. The process is complicated and usually takes a week to complete before treatment begins.
Therapy takes place on an outpatient basis. One visit lasts about 60 minutes, and irradiation is a matter of a few minutes. Before the procedure, specialists carefully check the patient's position and perform several partial checks, without which the irradiation cannot be started. After the treatment, the patient undergoes a medical check-up at least once weekly. The doctor then discusses the results with the patient and checks if any following additional treatment methods should be indicated.
Suitable candidates for radiotherapy with protons
Clinical studies identify the patient groups that benefit from treatment with protons. Such an advantage has already been demonstrated for some tumours below:
- Soft tissue and bone tumours: chordomas, chondrosarcomas;
- Many paediatric cancers, especially in the brain;
- Tumours of the salivary glands, especially adenoid cystic carcinomas;
- Neoplasms that are very close to sensitive, healthy organs (at the base of the skull or the spinal cord);
- Eye tumours (retinoblastomas).
Other indications for proton radiotherapy through clinical studies also show fabulous results:
- Brain tumours;
- Prostate carcinomas;
- Tumours in the previously irradiated region which need high-dose re-irradiation;
- Oesophagal tumours;
- Inoperable lung carcinomas;
- Inoperable liver cancer (hepatocellular carcinomas);
- Pancreatic carcinomas.
Therapy with protons is suitable for specific tumour types and treatment areas. The majority of protons are used when the aim is to cure a tumour. The doctor treating you decides whether treatment is an option. Generally, there is no standard guideline for radiotherapy with protons. Therefore, each malignant tumour can be considered for application. The primary strategy is to consider proton therapy as an alternative to traditional radiotherapy as a more advanced technique.
Primary benefits of proton beams over traditional radiotherapy
Proton therapy is an efficient, precise and gentle method of treating cancer with minimal side effects. A proton beam precisely aimed at the tumour significantly reduces the risk of complications. Thanks to this, the therapy gives a chance for a good quality of life after cancer treatment.
Therapy aims to maximise patients' chances of recovery while minimising the side effects associated with treatment. Unlike conventional radiation therapy, proton therapy is more advanced and based on the action of protons. Compared to classical radiation therapy, the most significant advantage is accuracy and the ability to protect healthy tissues.
It is a beneficial treatment for childhood cancer. Because the organism of children is more sensitive to X-rays, suffers more from their toxicity and is more affected by undesirable side effects.
The results of specific clinical studies have shown that proton therapy reduces the risk of growth disorders and developmental problems on the one hand and the risk of secondary tumours on the other. Common side effects of traditional radiotherapy are scarring and organ damage after the course. On the other hand, protons don't cause such outcomes.
The procedure does not involve invasive intervention and does not cause complications. Therefore, patients can immediately return to everyday life without needing postoperative rehabilitation.
Risks associated with the protons
Proton therapy can cause side effects if the cancer cells die or the proton beam's energy damages healthy tissue near the tumour. However, the procedure affects fewer normal cells and has fewer side effects than traditional radiation therapy. Nevertheless, proton therapy releases some of its energy into healthy organs.
The side effects depend on the dose and which body part is being treated. For example, after the proton therapy, patients may feel fatigued and have hair loss, redness and pain around the treated area of the body. Usually, such complications are well managed by doctors with symptomatic post-procedure treatment.
How to recover after proton beam treatment?
As a rule, patients tolerate the course of treatment well. They often return to their daily activities without experiencing severe side effects. But, of course, you should remember that acute side effects of therapy can be caused by other factors - for example, medications.
Patients visit centres on an outpatient basis during the course, and the whole treatment program takes 5-7 days. In general, the method of proton therapy makes it possible to reduce the risk of long-term complications and recurrence of tumours after a course of treatment. Doctors prescribe simple symptomatic treatment after the radiation and are advised to have a follow-up scan to check the results. During 2-4 days following the irradiation, patients have a rest but generally can proceed with their daily activity.
Many patients are curious about hair loss and sports after proton beams. The majority of cases are not leading to hair loss. However, the answer depends on the treatment area and the dose. If the tumour is big enough to cause systemic effects, patients might experience general fatigue and lose hair. Radiation oncologists recommend returning to sports after 7-10 days.
What type of cancer can be treated with proton beams?
Proton therapy allows doctors to eliminate cancer in the early stages, metastases and small tumours: lung and prostate cancer, sarcomas, eye melanoma, tumours of the head and neck, and neoplasms of the respiratory and reproductive systems. The therapy is safe not only for adults but for children.
What is the success rate of proton treatment?
Three years after a course of proton therapy, 46% of patients were cancer-free. Furthermore, 56% of people who received proton therapy were alive after five years. Nevertheless, it is individual for everyone because it depends on the state of the body, the possibilities of immunity and the presence of metastases and complications.
Who is a good candidate for radiotherapy with protons?
Patients with solid tumours near sensitive organs, such as brain, breast, and lung cancers, are excellent candidates for proton therapy. Whereas for recurrent, paediatric and eye cancer, proton radiation is considered the standard of care.
Is proton treatment a painful procedure?
Proton therapy is a non-invasive and often painless treatment in which patients feel no physical sensation from the proton beam, hear very little noise, and experience minimal discomfort. Unlike the old technology, each treatment session takes about 30 minutes, and the actual treatment time only takes 1-3 minutes.
What are the benefits of proton therapy?
- Laser precision. The doctor controls proton beams to deliver radiation directly to the tumour.
- The flexibility of the radiation dose. The therapy allows doctors to change the radiation dose intensity at any point in the tumour, which is impossible with other technologies.
- The technology expands treatment options to treat more extensive and irregularly shaped tumours.
- Reduced radiation toxicity leads to a lower incidence of secondary tumours than standard X-rays.
- Minimal side effects.
- Fast treatment time.
What are the best clinics for Proton therapy?
Who are the best doctors for Proton therapy?
Prof. Dr. Raimon Miralbell Izard from Teknon Medical Centre Barcelona
Dr. Jiri Kubes, Ph.D. from Proton Therapy Centre Prague
Prof. Dr. med. Daniel Zips from University Hospital Charite Berlin
Prof. Dr. med. Jurgen Debus from University Hospital Heidelberg
Prof. Dr. med. Rita Engenhart-Cabillic from University Hospital Marburg
The cost of proton beams therapy
There are few clinical centres of proton therapy in the world, so the device itself is currently considered one of the most expensive. Therefore, the price quote is approximately four times higher compared to standard radiotherapy.
The final price of proton oncology therapy depends on many factors:
- Size and location of the tumour;
- Nature and stage of the malignant formation;
- Additional examinations before and after the procedure (CT, MRI, PET-CT, laboratory tests);
- The number of sessions and radiation dose.
Therefore, the exact cost is determined after a comprehensive patient examination and can be estimated based on the medical records and latest scans. The approximate price can be 50,000 $ - 105,000 $.