Proton Therapy and Frequently Asked Questions
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therapy is a form of radiation therapy that destroys cancer cells
by preventing them from dividing and growingthe same as with
standard X-ray radiation. Proton therapy uses protonspositively
charged atomic particlesinstead of the photons used in standard
X-ray radiation therapy.
can be precisely controlled to release much of their energy directly
in the tumor, reducing damage to nearby healthy tissue.1 As a result,
patients can often receive higher doses and have far fewer side
effects from treatment.1
does proton therapy work?
can be manipulated to release their energy at precise depths so
they can target tumors near the skin surface or deep inside the
body, depositing much of their energy exactly at the tumor site.
The peak of this proton-radiation dose (called the Bragg Peak) is
set so it releases the radiation when it hits the tumor; immediately
after that point, the dose falls to almost zero. Less radiation
reaches the healthy tissue in front of the tumor, and almost none
reaches the healthy tissue behind the tumor, resulting in less damage
to healthy tissue.1 Patients often experience fewer of the short-
and long-term side effects that typically accompany standard X-ray
radiation.1-7 In addition, because more energy can be deposited
directly in the tumor, a higher dose can often be delivered, leading
to more effective treatment.1
do proton beams destroy cancer cells?
protons reach the nucleus (or center) of cancer cells, they transfer
energy to the cells' electrons causing a series of interactions,
or ionizing events, that damage the DNA of the cancer cells. The
damaged cells are permanently injured, can no longer divide, and
proton therapy experimental?
proton therapy is not experimental. Proton therapy was approved
in 1988 by the U.S. Food and Drug Administration to treat patients.
It has been used to treat patients since its first medical application
in mid-1950s and Medicare and Medicaid began covering the procedure
in 2000. To date, almost 70,000 people worldwide have received proton
therapy at centers in Europe, Asia, and the United States.
is the history of proton therapy?
1946, physicist Robert Wilson first proposed that protons could
be used to deliver an increased dose of radiation to a tumor while
simultaneously decreasing the exposure of surrounding healthy tissue
1950, the first research trials were being conducted on patients
in Europe. Results were promising, but the inability of imaging
technology to accurately "see" or locate many tumors and
the inability to direct protons to sites deep within the body meant
that only a few patients were appropriate candidates for the treatment.
in imaging, including computed tomography (CT), magnetic resonance
imaging (MRI), and positron emission tomography (PET), now allow
physicians to "see" deep inside the body and precisely
define the location, size, and shape of tumors. This capability,
coupled with improvements in proton technology, brought about today's
growing interest in proton therapy as an important treatment option
first hospital-based proton-treatment center in the United States
was built in 1990 at Loma Linda University Medical Center in California.
As of March 2012, ten facilities are operating in the United States:
CDH Proton Center, A ProCure Center, in suburban Chicago; ProCure
Proton Therapy Center, Oklahoma City, Oklahoma; ProCure Proton Therapy
Center in New Jersey/Metro New York; Francis H. Burr Proton Therapy
Center at Massachusetts General Hospital; the Midwest Proton Radiotherapy
Institute at Indiana University in Bloomington; the Proton Therapy
Center at the M.D. Anderson Cancer Treatment Center in Houston,
Texas; The Roberts Proton Therapy Center at the University of Pennsylvania
in Philadelphia; the Florida Proton Therapy Institute at the University
of Florida Shands Medical Center in Jacksonville; Loma Linda University
Medical Center in California; and Hampton University Proton Therapy
Institute in Virginia. In addition, there is a specialty proton
center that treats only cancers of the eye at the University of
ProCure proton therapy centers are in development and will be opening
was proton therapy first used for medical purposes?
therapy was first used to treat patients in Berkeley, California,
in 1955 in a research setting. While proton therapy was promising,
it wasn't until advances were made in imaging technology, such as
CT, MRI, and PET scans, that doctors could accurately "see"
the location, size, and shape of cancer tumors. Accurately locating
tumors made it possible to leverage the precision of protons. The
first U.S. center opened at Loma Linda University Medical Center
many patients have received proton therapy?
the first hospital-based proton-treatment center opened in California
in 1990, nearly 35,000 people have received proton therapy in the
United States, and almost 70,000 people worldwide. Experts conservatively
estimate that about 250,000 cancer patients in the United States
could benefit from proton therapy.
kinds of studies have been/are being done to prove the effectiveness
of proton therapy?
effectiveness of proton therapy has been studied by researchers
around the world. A growing number of studies report on the effectiveness
of proton therapy and its benefits compared to alternative treatments.
The amount of research being conducted on proton therapy is rapidly
increasing as more centers open and more patient experiences become
Read the Clinical Literature »
proton therapy be used in combination with other cancer treatments?
many cases, yes. Proton therapy can be used in combination with
chemotherapy, as a follow-up treatment to surgery, and in combination
with standard X-ray radiation treatment. ProCure has joined with
several medical centers to provide patients with additional cancer
are the potential side effects of proton therapy?
should not feel pain or discomfort during treatment sessions. There
may be side effects during or after treatment, but they are generally
minor, less frequent, and less severe than the side effects that
can result from standard X-ray radiation therapy, primarily because
less healthy tissue is exposed to radiation in proton therapy. Depending
on the site of your tumor, side effects may include skin irritation
in the direct path of the proton radiation, tiredness, and hair
loss in the area being treated. Your doctor will discuss with you
the specific side effects that you may experience based on your
there continuous research on proton therapy?
the medical community continues to conduct research studies on proton
therapy. Major institutions like MD Anderson Cancer Center and Massachusetts
General Hospital have many ongoing clinical trials to help find
improvements in treating cancer with proton therapy. As dedicated
providers of proton therapy, ProCure centers are currently participating
in two clinical trials. One is a Phase III randomized trial comparing
the effects of standard radiation dose and a higher daily dose of
proton radiation in patients with low-risk prostate cancer, the
other is an evaluation tracking project that collects and analyzes
information from patients who have been treated with proton therapy.
For more information on these trials, please click here. If you
are interested in participating in either trial, please speak with
a doctor or a nurse at a ProCure center.
What are some of the common tumor sites treated with proton therapy?
types of cancer are more appropriate for proton therapy than others.
While research continues to support using protons in more types
of tumors, they are primarily used to treat:
Head and neck tumors
near the spine
Gastrointestinal (GI) cancers
Melanoma (cancer) of the eye
therapy is particularly appropriate for treating tumors in children,
who typically experience more serious short- and long-term side
effects from radiation treatments than adults.
Learn more about tumor sites that can benefit from proton therapy»
proton therapy be used for all types of cancers in all patients?
therapy is not appropriate for all types of cancers or all patients.
Proton therapy is most effective in treating solid tumors that are
well-defined and localizedthose that have not spread to other
areas of the body. If the tumor has spread (metastasized), proton
therapy may still be an option, depending on the extent of the metastasis
and other factors. Only a healthcare provider can determine the
best approach for a patient's unique condition.
Why is proton
therapy an option for only certain types of cancer?
of the limited number of proton treatment facilities worldwide,
physicians have focused on using proton therapy primarily for tumors
near critical organs, such as the heart and bladder, or structures,
such as the spine. The types of tumors treated will continue to
expand as research continues and doctors develop treatment plans
for more types of tumors.
proton therapy be used to treat children with cancer?
in fact proton therapy is particularly effective for children who
need radiation therapy. Clinical studies indicate that proton therapy
reduces the likelihood of growth and developmental problems and
of secondary tumors which can occur years later.3,5,8 Because a
child's body is small and still growing, the damage to nearby healthy
tissue and organs from standard X-ray radiation can be harmful.
This damage can cause growth abnormalities, reductions in IQ, and
other complications.9 New tumors can also develop later in the child's
life. A growing body of research is confirming the advantages of
using proton therapy for children.
Learn more »
proton therapy be used to treat recurrent cancers?
many cases, yes. Proton therapy can be used to treat recurrent cancers
that standard X-ray radiation therapy cannot. Patients should discuss
proton therapy with a board-certified radiation oncologist to determine
if it can be beneficial. Proton therapy can also be an option if
youve already had a course of standard X-ray radiation and
are unable to receive more.
Back to top »
protons and standard X-ray radiation
How is proton therapy different from standard
beams deposit much of their energy directly in the tumor, reducing
damage to healthy tissue and allowing patients to receive higher,
more effective doses.1 Less damage to healthy tissue and organs
can result in fewer side effects than are sometimes experienced
with standard X-ray radiation therapy, thus improving patients'
quality of life and long-term health.1-7 X-ray radiation can be
harder to control and deposits more radiation in healthy tissue
as it enters and leaves the body.
X-rays as effective as protons in destroying tumors?
and protons can be equally effective in destroying cancer tumors.
The difference is that X-ray treatments damage more healthy tissue
in the process. X-rays release much of their energy shortly after
penetrating the skin, damaging healthy tissue and organs on their
way to the tumor and, again, as they leave the body. Protons can
be precisely directed to release much of their energy when they
reach the tumor. Because there is much less exposure to healthy
tissue with protons, a higher dose often can be delivered, leading
to more effective treatment.1
is proton therapy often considered a better treatment option compared
to standard X-ray radiation therapy?
proton beams deposit more of their energy directly in the tumor,
less radiation reaches the healthy tissue in front of the tumor,
and almost none reaches the healthy tissue behind the tumor.1 Patients
often experience fewer short- and long-term side effects than typically
accompany standard X-ray radiation therapy. In addition, because
more radiation can be deposited directly in the tumor, a higher
dose can often be delivered, leading to more effective treatment.1
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ASSOCIATION FOR PROTON THERAPY
STORY OF FOUR YEAR OLD ALEX BARNES Alex was treated with
Proton therapy in the USA and whilst he is a young boy based in
the UK his mother and father have created a informatative and supportive
website which will guide people through the process of going for
treatment abroad. Great news to share that as of 2013 young Alex
is still cancer free after his successful treatment in 2008. www.alexbarnesproton.com
JF. What can we expect from dose escalation using proton beams?
Clin Oncol. 2003;15(1):S10-S15.
M, Lomax A, Schneider U. Intensity modulated photon and proton
therapy for the treatment of head and neck tumors. Radiother Oncol.
R, Lomax A, Cella L, Scheider U. Potential reduction of the incidence
of radiation-induced second cancers by using proton beams in the
treatment of pediatric tumors. Int J Radiat Oncol Biol Phys. 2002;54(3):824-829.
CS, Keating N, Yock T, Tarbell N. Comparative analysis of second
malignancy risk in patients treated with proton therapy versus
conventional photon therapy. Int J Radiat Oncol Biol Phys. 2008;72(1):S8.
CT, Bilton SD, Famiglietti RM, et al. Treatment planning with
protons for pediatric retinoblastoma, medulloblastoma, and pelvic
sarcoma: how do protons compare with other conformal techniques?
Int J Radiat Oncol Biol Phys. 2005;63(2):362-372.
R, Sejpal S, Wei X, et al. Reduction of bone marrow suppression
for patients with stage III NSCLC treated by proton and chemotherapy
compared with IMRT and chemotherapy. Particle Therapy Cooperative
Group 47. 2008;O10:14.
H, Murakami M, Kagawa K, et al. Acute morbidity of proton therapy
for prostate cancer: the Hyogo Ion Beam Medical Center experience.
Int J Radiat Oncol Biol Phys. 2007;69(2):434-443.
D, Sklar C, Donahue B, et al. Thyroid dysdunction as a late effect
in survivors of pediatric medulloblastoma/primitive neuroectodermal
tumors. Cancer 1997;80(4):798-804.
TE, Hua C, Shukla H, Ying Xiaofei, Nill S, Oelfke U. Protons versus
radiotherapy for common pediatric brain tumors: comparison of
models of dose characteristics and their relationship to cognitive
function. Pediatr Blood Cancer. 2008;51:110-117
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