Proton Beam Therapy Procedure: Cancer Treatment | Getwellgo

Proton Beam Therapy

Proton Beam Therapy is a form of radiation therapy that employs charged proton beams as opposed to the conventional X-rays in the treatment of cancer. It is known as external beam radiotherapy that has minimal side effects on other parts of the body and often recommended in cases where cancer cells are located close to vital organs.

Proton Therapy Side Effects

Proton therapy is less toxic to normal tissues as compared to conventional radiation therapy but several side effects are still possible based on the location and size of the tumor, total dose delivered to the tumor and general health condition of the patient.

Common Side Effects (General):

These can happen in any sort of proton treatment either for cancer or for other conditions:

• Fatigue (most common)
• Skin reactions at the treatment site such as redness, peeling, and soreness.
• Hair loss in the treated area
• Pain or discomfort felt by patients near the tumor site.
• Swelling or inflammation in nearby tissues

Proton Therapy vs Radiation

Proton therapy is a technique in which protons which are positively charged particles are used to treat the tumor. This is because the radiation is localized at the tumor area but the exit dose is low, thus suitable for tumors close to some vital organs like the brain, eyes or spinal cord. This results in the reduction of the side effects, particularly when it is used in children and the tumor is in sensitive areas. However, proton therapy is much more costly and facilities for it are not as numerous, with the number of centers in the world. It also has a longer planning and setting up time before the actual experiment can be initiated. 

While alternative methods like traditional radiation therapy use photons (X-rays) that travel through the body, getting in, irradiating the tumor, getting out with the potential possibility of further damaging healthy cells in their path. It is more damaging to nearby tissues and has more dangerous side effects; however, this approach is rather efficient for most types of cancer. Conventional radiation is however more available, easy to begin, and can be paid by insurance thus making it the standard cure.

Proton Therapy for Prostate Cancer

Benefits of Proton Therapy for Prostate Cancer:

Conformal Radiation: Protons can be focused on the prostate with less damage to other parts of the body such as the bladder and rectum.

Lower Risk of Side Effects:

• Less bowel irritation and rectal bleeding
• Less frequency of pressure, urgency or botheration of passing urine
• May have a reduced risk in sexual dysfunction but it is not fully exempted
• Non-invasive and painless: Outpatient procedure with no recovery time.

Proton Therapy for Breast Cancer

Benefits of Proton Therapy for Breast Cancer:

• Cardiac Shield: Compared to conventional radiation therapy, charges of proton therapy are also beneficial in cutting down the radiation impact on the heart especially when the subject has left-side breast cancer because this reduces potential long term cardiac ill effects.
• Less Damage to Normal Tissue: Protons do not penetrate as far as X-rays and therefore there are reduced doses to lungs, ribs, skin etc.
• Beneficial during the Treatment: Suitable for the treatment of chest wall, reconstructive breast or localized lymph nodes such as internal mammary nodes.

Proton Therapy for Brain Tumors

Benefits of Proton Therapy for Brain Tumors:

• High Precision: Protons deposit their energy mostly at a particular point of the tumor tissue (Bragg Peak); there is little energy delivered to the surrounding non-targeted brain matter.
• Lower Some Chemistry side effects: Minimizes or avoids irradiation to areas involved in memory, thought, and hormonal regulation.
• Especially suitable for children: It does not cause significant adverse impact on the growth of the brain or have adverse effects related to development and learning capacities of the human body.
• Lower Risk of Secondary Tumors: Especially important for children and young adults.

Proton Therapy for Lung Cancer

Lung tumours can be treated with proton therapy if the tumour is close to crucial structures inside the body such as the heart or the esophagus or if the patient’s lungs have limited function. Its main strength is in the targeted delivery of the dosage to the tumor mass minimally affecting sound tissues.

Proton Therapy for Pediatric Cancer

Why Proton Therapy Is Ideal for Children

• Reduces the probability of injury of healthy proliferating tissues, bones, brain and organs.
• Lessens the chances of developmental focal delay, growth disorders and disorder in learning or memory among the students.
• Reduces the ability of developing second primary cancers at some other period in life due to the minimal exposure of the healthy tissue to radiation.
• Required for tumor types that invade important regions within the patient’s body such as the head, spine, eye or heart for example.

Proton Therapy for Head and Neck Cancer

Less danger to essential body parts: minimizes impact on the salivary glands, spinal cord, eyes, hearing apparatus and jaw.

Fewer side effects than the traditional radiation:

• Less dry mouth 
• Reduced difficulty swallowing
• Lower risk of tooth and gum damage
• Less nausea, fatigue, and skin irritation
• May enable delivery of higher tumour ablation dose and minimal damage to the surrounding healthy tissues.

Proton Therapy for Liver Cancer

• Decreases harm to the healthy liver cells and thus decrease the chances of having liver failure.
• Enables the delivery of higher radiation doses to the tumor alone, thereby improving the local tumour control.
• It is more suitable for those patients with less viable liver function as compared to other traditional procedures for treatment.
• This is because radiation loaded on the spare ribs does not heat up the tissue and organs such as the stomach, intestines or kidneys as it does in the pelvis bone.

Proton Therapy for Spinal Tumors

• Conformal radiation: In proton therapy, the radiation is directed at the tumor while the spinal cord and other surrounding tissues receive little or negligible doses of the radiation.
• Sparing of spinal cord: Averts chance of neurological impairments for which normal radiation therapies are infamous.
• Reduction of side effects: Since proton beam preserves the health tissue around the tumor, it is likely to produce fewer side effects such as muscle weakness, numbness or even lack of coordination.
• Especially important for tumors in the spinal cord, spinal canal as well as vertebrae: Suitable for metastatic/invasive tumors that are difficult to reach.

Proton Therapy Treatment Process

Initial Consultation and Evaluation

• Medical history review: A number of questions are asked and answered with the intention of making a conclusive decision on whether the patient is qualified to undergo proton therapy.
• Neural exam: A neural examination is carried out to determine the size of the tumor and whether is located on the right or left side of the body.
• Imaging tests: For accurate localization of the tumor you will be subjected to some imaging tests including CT, MRI or PET scans. They will aid in determining the specific proton therapy treatment after taking these images.

Treatment Planning (Simulation)

• This is the process where you take images of your body and produce a 3D image of the tumor as well as the tissue around it. It uses imaging of various or even a computerized tomographic image of which is usually taken when you are in the position you will be during gunnery.
• Location specifics: Depending on the place of the tumor, specific treatment program will be suggested by your doctors. This includes:
• Positioning device: There may be an equipment like a mold or a head and body mask to keep one in the same positions used in each of the sessions depending on one’s type of cancer, for instance a head mask when it’s a brain cancer or a chest or abdomen mold if it is chest or abdominal tumor respectively.
• Identifying the skin treatment area: It is possible that some ink or adhesive marking (tattoo or sticker) will be applied to the skin in order to achieve better accuracy.

Treatment Plan Review and Adjustment

• A radiation oncologist, a medical physicist would go through the images and then coordinate the most appropriate proton beam orientation and the beam intensity in order not to harm healthy tissues surrounding a tumor.
• This planning might take couple of days to lay out the best plan, though it is essential to be accurate.

Treatment Sessions

• Treatments every day: Proton treatments are typically given 5 days per week (Monday to Friday) for a specific number of sessions, usually spread out over several weeks (usually 4–8 weeks).
• Duration of treatment: Each treatment takes approximately 15 to 30 minutes, but the actual radiation delivery only takes a few minutes. The remaining time is to position you and to set up the equipment.
• Positioning: You will be placed in a special treatment room, usually with a proton beam delivery machine known as a cyclotron or synchrotron that aims the proton beams directly at the tumor.
• Treatment delivery: Throughout the session, you will need to remain as still as possible while the machine delivers protons to the tumor. You will not feel the protons as they are delivered.

Post-Treatment Care

• Follow-up visits: Your physician will order frequent follow-up visits to assess how the tumor is progressing under treatment and to address any side effects.
• Management of side effects: Proton therapy has good tolerance, but your medical staff will take care of any side effects (such as tiredness, slight skin reaction, or short-term pain).
• Regular follow-up: Imaging tests (such as CT or MRI) can be done again after treatment to assess how the tumor has responded and to monitor for recurrence.

End of Treatment
After you have finished the scheduled course of proton therapy, your oncologist will tell you what to do next and whether any additional treatments (like chemotherapy or immunotherapy) are required.

It might take some time for the tumor to decrease or even be completely cured, and certain side effects can last a while after the last treatment.

Proton Therapy Success Rate

Proton therapy survival rates tend to be comparable to conventional radiation. 5-year survival rates for early-stage cancers (e.g., prostate cancer, lung cancer, head and neck cancers) tend to be 80-95%.

Factors Affecting Proton Therapy Cost

The cost of proton therapy can vary significantly depending on several factors. Below are the key factors that influence the overall cost of proton therapy:

• Treatment Location
• Type of Cancer and Treatment Plan
• Number of Treatment Sessions
• Technology and Equipment
• Insurance Coverage
• Patient-Specific Factors
• Treatment Duration

Top Hospitals for Proton Beam Therapy

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• Apollo Hospital, Delhi

Best Surgeons Proton Therapy

• Dr. S. Jayalakshmi
• Dr. Tejinder Kataria
• Dr. Anil Kumar Anand
• Dr. Charu Garg
• Dr. Manu Bhadauria