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Protons 101: “My doctor would tell me if proton therapy was a good option, right?”
Protons 101 – Where Radiation Dose Goes
Esophageal Cancer Awareness Month – April 2019
News
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about proton therapy
- How is proton therapy different from traditional radiation?
- What is proton therapy?
- How does proton therapy work?
- What kinds of cancer can be treated with proton therapy?
- Is proton therapy an experimental cancer treatment?
- What is the success rate of proton therapy?
- How long does proton therapy take?
- What are the side effects of proton therapy?
- How long does a proton therapy session take?
- How long does the radiation remain in my body?
The biggest difference between traditional and proton radiation therapy is the amount of radiation delivered into the body. The American Society of Clinical Oncology says that proton therapy delivers 60 percent less harmful radiation to healthy tissues than standard radiation treatments. This means proton therapy effectively targets tumors with higher amounts of radiation essential for eradicating cancer. Another difference is the ability of doctors to guide proton beams so that they target tumors from all directions. This not only protects healthy cells, but also reduces the side effects of radiation therapy.
Proton therapy is a type of radiation therapy that uses a precisely controlled, high-energy beam to treat malignant and benign tumors. By relying on positively charged protons instead of standard radiation, doctors can control where proton-based radiation enters the body. Proton particles actually conform to the size and shape of tumors so that damage to healthy surrounding tissue is nearly eliminated. In addition, proton therapy causes fewer side effects, is safe and effective for both children and adults, and decreases the risk of secondary tumors emerging after treatment.
As proton particles enter the body, they immediately begin interacting with negatively charged electrons. This interaction between positively charged protons and negatively charged electrons releases energy that targets cancer cells. Areas where proton/electron interaction releases the highest amounts of energy is called the Bragg Peak. Proton therapy allows doctors to specifically designate the location of a Bragg Peak and inflict the most damage to cancer cells while causing minimal damage to surrounding tissues and organs. Ionization of cancer cells with proton therapy damages cellular DNA, which prevents cancer cells from proliferating further.
Almost any solid tumor can potentially benefit from proton therapy versus other types of radiation treatment. This includes prostate, breast, lung, brain & CNS, head & neck, gastrointestinal, and soft tissue cancers, along with lymphomas and many other types of cancer. Our care team has experience treating all of the listed cancers and more.
No, proton therapy is not an “experimental” therapy. In fact, proton therapy has been treating tumors for over half a century. The U.S. FDA approved proton therapy for treating cancer in 1988. A study conducted by the National Association for Proton Therapy discovered that U.S. centers providing proton therapy have more than doubled in the past few years. Additionally, the number of people receiving proton therapy for malignant tumors has increased by nearly 70 percent.
Gastrointestinal, head, neck, brain, and central nervous system cancers all encompass a variety of different cancers of the brain and central nervous system. Cure rates vary depending upon staging and type of cancer. For lung cancer, proton therapy has been shown to have higher remission rates and a lower risk of secondary cancer than traditional radiation treatment. For breast cancer, five-year survival rates are over 90% overall, although this number varies depending upon the stage and other associated medical issues. For prostate cancer, five-year cure rates for patients with low and intermediate disease are over 97% and 93% respectively.
Most cancer types require 5 to 33 treatments, depending upon the patient’s diagnosis. For breast cancer, we have two primary treatment protocols: 1) an accelerated partial breast treatment that occurs in 10 treatments; and 2) a standard whole breast irradiation that occurs over 25 – 33 treatments. For prostate cancer, we have three treatment protocols: 5, 28, and 44 treatments. Your doctor will determine which option or options are right for your particular diagnosis.
- Gastrointestinal Cancer – There are many sensitive and critical organs and structures in and around the gastrointestinal system. Therefore, it is important to choose the most precise form of radiation treatment possible for your diagnosis. Side effects from radiation to healthy tissue and organs can include nausea, vomiting, diarrhea, difficulty swallowing, radiation-induced second cancers, and more. Proton therapy is frequently able to reduce these side effects as compared to traditional radiation treatment methods such as IMRT or TomoTherapy.
- Head and Neck Cancer – Like the GI system, there are many sensitive and critical structures in the head and neck, so it is extremely important to select a treatment that is as precise as possible. Side effects can include loss of taste or swallowing function, dry mouth, stiff jaw, skin irritation, and – in more severe instances – loss of eyesight or damage to the brain. Proton therapy has been shown to reduce side effects versus other forms of radiation treatment for cancers of the head and neck. Examples include a 50% or more reduction in the need for feeding tubes for Head and Neck cancer patients and a 58% reduction in Grade 3+ (severe) side effects.
- Brain and CNS Cancer – Because brain and CNS cancers occur in areas surrounded by sensitive and critical structures, side effects from treatment can be severe and include damage to eyesight and cognitive function. Proton therapy is able to reduce radiation to critical organs and healthy tissue and so is able to reduce the rates of these side effects during and after treatment.
- Lung Cancer – Proton therapy reduces side effects more than traditional radiation. Side effects for lung cancer can include inflammation of the lungs (pneumonitis) and esophagus (esophagitis). There is a reduction in the rates of pneumonitis and esophagitis in lung cancer patients who undergo proton therapy treatment.
- Breast Cancer – Proton therapy reduces side effects compared to traditional radiation such as IMRT or TomoTherapy. Side effects for breast cancer can include skin irritation or more serious complications such as a cardiac event, lung cancer, or pneumonitis. There is up to a 96% reduction in radiation dose to the heart for breast cancer patients and an associated reduction and risk of cardiac-related side effects.
- Prostate Cancer – Proton therapy reduces side effects compared to traditional radiation treatments such as IMRT or Cyberknife. Side effects for prostate cancer patients can include things such as erectile dysfunction and incontinence. With proton therapy, there’s a 21-25% reduction in urinary, sexual and bladder-related side effects versus IMRT.
This is dependent on your cancer type, body, and treatment plan. The session can be as short as 15 minutes or as long as around 45 minutes. Most patients average 20 – 25 minutes per session for treatment.
Radiation does not remain in the body unless the person has an implanted source of radiation. Unless you are subjected to a constant, external source of radiation, particles comprising radiation decay rapidly or are excreted from the body. The reason why patients receiving standard radiation treatments suffer side effects such as fatigue, nausea, vomiting, and weight loss is not due to radiation remaining in their bodies, but because non-proton radiation damages healthy cells and tissues surrounding the targeted area. Since doctors precisely control where to send proton beams, they can effectively reduce or even eliminate damage to healthy tissues, which diminishes the severity of side effects associated with radiation.
Clinical Trials
- What is a clinical trial?
- How can I sign up for a clinical trial?
Clinical trials are used to answer questions about the efficacy or superiority of certain types of treatments. For example, a clinical trial for a new drug may test whether the drug is safe and if it works better than alternative drugs for the treatment of a disease. Trials involving proton therapy often ask how much protons reduce side effects versus other forms of radiation or how much proton therapy can improve survival over other treatments. The answers from these trials can help physicians optimize when to use protons and help convince insurance companies to pay for proton therapy treatment.
We are constantly looking for ways to move the field forward either by initiating our own clinical trials or by participating in trials led by other proton centers. Click here to find out which trials we have open. If you’re interested in participating in a trial listed, please contact one of our patient navigators at (888) 847-2640 and ask about eligibility.
finances/insurance
- Will my insurance cover proton therapy?
- Can I receive proton therapy if I don't have insurance?
- Do you offer financial assistance?
- Do you offer charity care?
Insurance coverage for proton therapy varies among health insurance agencies. In general, Medicare covers all or part of proton therapy treatments. People wanting proton therapy should contact their insurance company or Medicare representative to find out if they are covered. Also, federal regulations prohibit health insurance companies from denying coverage for individuals with pre-existing conditions.
Yes, proton therapy treatment is available to patients who do not have insurance. Our patient coordinators will work with you to help you figure out how to cover the cost of treatment. We also offer clinical trials that can help reduce the costs of going through this treatment.
Our goal is that every patient who would benefit from proton therapy is able to receive treatment. We know that the cost of care can often be seen as a barrier. For that reason, we offer a generous financial assistance program so that finances do not become a burden or barrier to care. We encourage patients to speak with our financial care team about their particular situation and how we can help ensure they are able to get the clinical care they need, regardless of financial situation.
Our goal at Oklahoma Proton Center is to make treatment accessible for every patient who needs it regardless of their financial situation. Any patient can apply for the Oklahoma Proton Center Charity Care program and, depending upon their unique situation, get their costs reduced or spread out through a personalized payment plan. The center has helped hundreds of patients since opening. To find out more about our generous charity program and to apply for assistance today please contact Oklahoma Proton Center and ask to speak with a financial coordinator.
aftercare
- What is aftercare like?
Cancer is a journey that doesn’t end when initial treatment is complete. We have a comprehensive survivorship program that includes clinical follow-ups with our doctors, as well as community events, reunions, milestone celebrations, and advocacy opportunities.
OK Proton Center
- Why should I choose Oklahoma Proton Center?
- What should I expect during a consultation?
- Who owns Oklahoma Proton Center?
We are one of the most prestigious proton therapy centers in the U.S., with a rich history of collaborating with leading Oklahoma City physicians who specialize in treating cancer. Only five proton facilities are currently operating in the Southwest, and Oklahoma Proton Center is one of them. We treat our patients with dignity, respect, and a deep understanding of how difficult it is to be diagnosed with cancer. After an extensive consultation and examination session with each patient, doctors develop a personalized treatment plan designed to address a person’s unique needs. The goal of all treatment plans is to keep side effects to a minimum while aggressively targeting cancer tumors with proton therapy.
The consultation is an opportunity for a patient to meet with one of our doctors to discuss their case and learn if proton therapy is the best option for treatment. The consultation process takes one to three hours, depending upon the complexity of the case and the number of questions to be answered. The patient will also have the opportunity to meet other members of the care team who will be involved in the treatment process. Our patient navigator will let each patient know what they individually need to be prepared for prior to and during their consultation.
Oklahoma Proton Center is owned by the Oklahoma Proton Foundation, an independent 501c3 not for profit. The Oklahoma Proton Foundation has a mission of funding research, education, and charitable care for cancer patients. The Foundation is run by a board consisting of four independent directors.