Proton Therapy: What It Is, Risks, Preparation, Procedure, Expectation, Cost, Recovery

Proton therapy, also called proton beam therapy is a type of cancer treatment. It is radiation therapy using high-energy beams to treat malignant tumors. In common radiation therapy, X-rays beams are used to attack noncancerous and cancerous tumors. It is a newer type of radiation therapy that uses positively charged proton particles to attack abnormal growth. The treatment is gaining popularity as it is ideal to treat tumors in children. The doctor can control the proton precisely to avoid damage to normal cells. So, it aids in preventing serious complications as well as reduce the chance of developing secondary tumors. Unlike normal radiation therapy, it causes fewer side effects.

Learn More About Proton Therapy

The proton beam therapy adapts to the patient’s tumor shape. The tumors that develop in a patient has different size, shape, and location. So, it is unique to the individual patient suffering from the problem. Radiation therapy using x-rays follows the same method to treat all the tumors. But, the proton beams attack the tumors from different directions and destroys it. The radiologist can use customized hardware to sculpt the beam as per the needs of the patient. So, the beam strikes the borders of the tumor as per its shape. It reduces the damage caused to the surrounding cells. Therefore, it lessens the complications associated with radiation therapy.

Proton therapy is the latest treatment option under research to see its effectiveness. So far the treatment has shown promising results in treating malignant and other tumors. It has shown promising results in treating the following:

• Prostate Cancer
• Head/Neck Cancer
• Lung tumors
• Brain Cancer
• The base of the skull tumor
• Spine tumor
• Pediatric cancer
• Melanoma of eye
• Gastrointestinal cancer

Studies have suggested the treatment option offering positive results to patients undergoing different kinds of cancer. It causes fewer side effects to traditional treatments like radiation therapy. The doctors have more control over the proton beams depositing their energy on the tumors. But, it still remains unclear if the proton beam therapy can extend the lifespan of the patients. Unfortunately, the treatment is not available widely in all the hospitals offering cancer treatments.

Why It Is Done?

It is the therapy used to treat cancer and other types of noncancerous tumors. Your doctor recommends it as the only treatment. It also combined with other cancer treatments like chemotherapy or radiation therapy to get better results. The doctor decides on how to use the proton beam therapy based on your specific condition. So, the doctors use it for treating the following conditions:

• Cancer affecting children
• Brain tumors
• Esophageal cancer
• Breast cancer
• Eye melanoma
• Neck and head cancers
• Cancer in the lung
• Liver cancer
• Pituitary gland tumors
• Sarcoma
• Prostate cancer
• Tumors developing on the spine
• Tumors in the base of the skull

The clinical trials are gathering evidence of the effectiveness of the therapy for other types of cancer. Proton therapy is slowly gathering momentum in the medical community. But, it might take a couple of years to make it more accessible to patients.

Risks Associated With Proton Therapy

Proton therapy has the same side effects as radiation therapy. It occurs when the cancer cells die or when the proton beam damages the healthy tissues. Because your doctor can control the proton beam better, the highest concentration of energy only attacks the cancer cells. It affects the healthy tissue less compared to traditional radiation therapy. But, it does not mean the therapy is completely risk-free. It releases some energy into healthy tissue. So, you can suffer from side effects. The side effects experienced by the patients depend on the body part treated. It also relies on the dose of the therapy received by the patient. Therefore, the common risks associated with the therapy are:

Skin Problems

Skin problems can occur in people undergoing cancer therapy. The radiation therapy using proton beam can cause the following problems:

• Redness
• Dryness Of skin
• Skin Irritation
• Blister formation
• Peeling of skin

Other Side Effects

Depending on the location of the tumor, you can experience other side effects. These side effects occur early. So, you tend to experience it during the treatment or immediately following the treatment. The side effects include:

• Nausea
• Fatigue
• Vomiting
• Hair loss
• Eating or swallowing problems
• Urinary and bladder problems
• Digestion problems
• Headaches

Late Risk Factors

Some side effects may appear several months to years after the treatment. The adverse effects you suffer during the time may become permanent. So, you cannot reverse it. Depending on the area treated for cancer, the late side effects include:

• Lung changes
• Changes in the spinal cord
• Bowel changes
• Brain variations
• Infertility
• Lymphedema (swelling of a limb)

When a patient undergoes radiation therapy, including proton beam therapy, it increases the chances of developing other cancer. So, the individual undergoing the treatment can develop new cancer in the future.

How Do You Prepare For Proton Therapy?

Cancer is a deadly disease. But, with early detection and medical intervention, you can fight the disease. You can become cancer-free with early medical intervention. Your doctors can use effective methods like surgery, chemotherapy, and radiation treatment for removing the cancerous presence from your body. The doctor assesses your condition and utilizes the elements of each method to treat your condition effectively. Proton therapy is used as a part of the combined treatment plan. It is provided to ensure the patients have a better quality of life. But, before undergoing the treatment, you need to know everything associated with the method. You need to gather as much information as possible to enlighten yourself. You need to prepare yourself mentally before undergoing therapy. Before the procedure, you have to plan for the therapy. It involves the following:

Form A Team Of Doctors

Before beginning the therapy, a team is formed with a doctor to develop a proper treatment plan. The proton beam therapy is offered to the patient after careful assessment of the individual by a team of specialist doctors. The esteemed team consists of specialist doctors who are experts in the following fields:

• Internal medicine
• Surgery
• Radiation

Doctors from other fields also share their expertise in adopting a multidisciplinary perspective. So, you can ensure the best possible treatment to manage your condition. The treatment is adapted based on your requirements to alleviate the problem. Your medical team offers you guidance by taking you through the planning process. You can ask questions to your healthcare team to understand more about the therapy. The team develops the planning process to ensure the proton beam from the therapy reaches the cancerous tumor. So, all steps are followed to make sure the proton beam hits the precise spot in your body that requires the treatment. There is no universal method of treating cancer. So, your team of doctors develops the treatment plan based on your individual conditions.

Understand Your Condition

To offer the most suitable means of treatment, the team of doctors carefully perform the physical and mental condition. The doctor gives utmost importance to developing the right treatment plan based on the specific condition of the patient. So, they carefully examine the following:

• Age
• Symptoms
• Physical strength
• The ways of thinking about the different treatment

Based on the assessment, your health care team takes a decision.

Plan Protons Path

The next step in the preparation is detecting the ideal proton path. You need to undergo imaging tests like CT scans or MRIs to determine the specific area of the body requiring treatment. Using the images, the team can decide the right path for the proton beams to reach the cancerous tumor.

Cost Of Proton Therapy

Proton therapy is a new form of radiation therapy. So, it is gaining popularity slowly. As it is not common in hospitals, you need to spend more money compared to conventional radiation treatment (using x-ray). People in the USA need to talk to their insurance provider as not all policies cover the cost of the therapy. You need to work with your insurance provider to determine the different treatment options and the costs covered by insurance. It will help you get an idea about the total amount you need to pay for the therapy. In normal cases, the proton beam therapy costs start around $30,000 and can reach up to $1,20,000. While radiation therapy costs only $8,000 to $12,000.

The treatment is not widely available. So, you have limited choices around the world. In India, the therapy is available only in Apollo Hospitals, Chennai. It costs around INR 25, 00,000. But, several hospitals are introducing the therapy option. So, in the future, you may have several options.

How Does Proton Therapy Work?

It is the main question that plagues your mind. To understand more about the concept, you need to know the fundamentals. All human tissue cells are made of molecules. The atoms act as the building block of molecules. You might have read about the atom containing a center part called nucleus. Negatively charged particles called electrons orbit the nucleus of the atoms. When you pass energized protons near the electrons orbiting the nucleus, it attracts them and pulls the electrons out of the orbits. This phenomenon is known as ionization. Ionization changes the characteristics of the atoms. It subsequently changes the characteristics of the entire molecule in which the atom resides.

So, ionization changes the DNA of the molecules. It leads to the destruction of certain cell functions like the ability to divide and multiply. While both normal and cancerous cells can undergo the repair process, the cancer cells suffer more damage due to ionization. As a result, the cancerous cells can suffer cell death compared to the normal cells. It is the principle used in proton therapy. While targeted, it destroys cancerous cells more and prevents damage to normal cells.

Radiation Therapy Vs Proton Therapy

You might have understood the similarity between the working of radiation therapy and proton therapy. Both work on the same principle of damaging the DNA of cells to destroy them completely. But, the protons in the other therapy deposit their energy slowly while they travel towards the cancerous tumor. Due to Bragg Peak, the unique physical characteristic, the protons deposit the majority of the radiation dose in the cancerous tumor alone. It does not travel further through the body. So, the radiation does not affect healthy tissue. The therapy, unlike radiation therapy, does not destroy healthy cells or organs. It reduces the unwanted complications and side effects associated with it. It also has a direct impact on the tumor. So, the therapy has enhanced tumor control.

The standard radiation therapy uses x-rays to deposit the radiation to the travel. It continues traveling through the body until it exits out. So, the radiation dose, travels throughout the body, resulting in the unnecessary destruction of healthy tissues and organs. In simple words, protons end their travel after depositing the radiation dose while the x-rays continue.

Proton Therapy Procedure

When your doctor suggests proton therapy, you need to undergo it in two stages. The two stages of the therapy are:

Stimulation Session

It is also known as the treatment preparation stage. So, it happens before the actual treatment. Before undergoing the therapy, your physicians come up with a radiation plan customized to manage your problem. It involves positioning as well as identifying the specific treatment area in your body. Therefore, the doctor uses the following sophisticated imaging tests for guidance:

• CT Scans
• PET Scans
• MRI

It will help your physician identify the tumor source and its size. Your physician works with the radiation physicist and dosimetrist to develop an ideal treatment plan. It includes the beam configuration, dosage, etc. to manage your problem.

Treatment Sessions

After the preparation phase, you need to start the radiation session. You need to visit your radiation oncologist at least once every week while you get the treatment. You can continue your everyday routine while you undergo the treatment sessions. So, you can return to work and perform normal activities after the treatment. It is because proton therapy causes less damage, leading to fewer side effects. So, it is not disruptive to your daily routine, unlike other therapies.

During Proton Therapy

In normal cases, you undergo the therapy at least five days a week. You need to continue the treatment for several weeks. But, in some cases, you only need to undergo one session or a few sessions of the treatment depending on your condition. The actual procedure only takes a minute. But, you have to spend half an hour to forty-five minutes preparing for each treatment session. You need to take weekly verification CT scans to see if the dose works for you. In some cases, your doctor recalculates the dose based on weight changes, tumor shape or size. So, the doctor assesses your situation to make further changes.

During preparation, the technicians position you on a table. They use cushions as well as restraints to hold your body still. Then, the technicians use imaging tests like CT scan or x-ray to ensure your body remains in the exact position before every session. After keeping you still, the therapy team leaves the room. They go to the area that allows constant monitoring. So, the therapy team can see and hear you properly. Depending on the machine used by the treatment center, you can experience the following:

Rotating Machine

The machine rotates around the patient. In some treatment centers, the therapy sessions are conducted using a machine called a gantry. In such cases, you need to lie on a table. It slowly slides into the circular opening of the machine. The machine rotates around the patient to find the specific spot requiring the therapy in your body. Once it finds the spots, it directs the proton beams on the tumor.

Fixed Machine

Some hospitals use a therapy machine that does not move. If you undergo the therapy with a fixed beam machine, then the machine remains still while the table you lie down moves. The table you are positioned moves using remote control by the radiation therapy team. Depending on your situation, the table moves several numbers of times.

During both types of treatment, you will never feel the radiation. Proton therapy treatment does not cause any pain during the sessions.

Recovery After Proton Therapy

After the treatment session, you can continue with your daily life. The therapy is safe as you will not have a radioactive presence or give off radiation. You can mingle with others without any fear of radiation exposure. So, you can perform your regular functions without any fear or hassles. The side effects reported by the patients undergoing proton beam therapy are less severe compared to radiation therapy. So, you can tolerate the treatment extremely well. You continue with your work, exercise or other activities during the course of the treatment.

You tend to develop side effects only over a period of time. Patients tend to experience a few side effects at first. But, after several treatment sessions, you can feel exhausted. The severe fatigue makes you take a longer time to complete the normal activities. You feel less energetic. The session can also cause skin problems that look similar to sunburn rashes. The skin redness appears in the area where the doctor directs the proton beams. The therapy session starts showing results within two to eight weeks. The response for the treatment depends on the type of cancer you suffer and its exact location within the body.

Results Of Proton Therapy

You need to undergo periodic imaging tests. It is suggested by your doctor during as well as after the proton therapy. It is used to determine if your cancer responds to the treatments or not. The frequency of scans depends on the individual patient’s situation.

Conclusion

Proton therapy is one of the safest and effective treatment options for managing various types of cancer. Unfortunately, the treatment has a high cost associated with it. So, the treatment option is available only in selected hospitals. It is not widely available, which makes it difficult for all patients to get access to the treatment option. Though it costs high, the treatment enhances the quality of life. The patients can experience improved health. Patients lose less time due to adverse effects and future complications due to therapy compared to conventional radiation therapy. But, the lack of clinical trials as well as the long-term evidence restricts the information on the effectiveness of the technique. So, most patients refrain from spending a lot of money on the therapy. With the full development of technology, more patients can get benefits from it.

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