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Wonder World of Protons and Medical Therapy – Accelerators and Proton Cancer Treatment
© Donald Reinhardt, Sept 26, 2013
It’s is all about the use of the hydrogen nucleus, a simple, single proton. Channel those protons in a magnetic device called an accelerator (cyclotron) and spin those protons around and around like a NASCAR track. Attain higher and higher speeds and then aim and shoot those protons at a specific target and –wow–you have an effective way to treat cancers – narrowly, specifically and effectively – with usually less damage than to surrounding, normal, healthy tissue. That’s just terrific when it is done well and doctors and physicists are making proton therapy work for their cancer patients. See and learn more here and now.
CT scan of a human brain showing dozens of CT scans from the patient grouped together to form a 3-D brain. Note the yellow proton beam aperture which surrounds the red tumor region. Eye region and optic nerves going toward the brain are clearly evident. Photo Credit: National Cancer Institute (NCI)
 
The Proton – What is it?

The proton is the positive-charged particle in the core or nucleus of an atom. It is almost 2000 times heavier than an electron. When we take a hydrogen atom and strip away its only electron what remains is one proton. When we strip electrons from thousands and millions of hydrogens we have those many protons serving as subatomic weapons to focus on and destroy cancers – i.e., uncontrolled cell growths that can kill a person.

What does proton therapy do to tissue specifically?

The spinning protons are accelerated by magnets to a desired and selected high speed, then channeled aside and shot toward a target tissue area, usually a specific cancer. These protons contain a predetermined,  regulated and set amount of MEVs (million electron volts) which powers the photons to the preselected tissue depth. The protons pass through the skin and then travel to reach the cancer tissue/tumor. As the protons travel forward into the tissue some electrons are stripped away from nearby atoms and ionization of those atoms occurs. However, the protons are energized just enough to stop at that tumor location. There the protons release most of their energy, major ionization occurs and there is destruction of the tumor cells. The recent technique or adaptation is “pencil painting” with protons which enables the operator to scan, criss-cross and bombard the tumor region very precisely. This video shows the difference between X-ray tissue entrance and exit by the X-rays and compares that to the protons which stop at the tumor’s location.

What cancers are treatable by proton therapy and which patients are best candidates?

Pediatric patients with various brain tumors have been ideal candidates, but adult treatments are very successful too. Tumors treated by proton therapy seemed to be effectively destroyed with less damage to normal tissue.

Cancers treated include: eye, head and neck, base of the skull, esophageal, lung, non Hodgkin’s lymphoma, bone, intestinal, prostate, and pediatric cancers of various types. Your physician can update you on the latest information related to treatment for a specific cancer.

How effective is proton therapy?

Proton therapy is effective based on documented reports from treatment centers throughout the United States and the world. However, each cancer needs to be evaluated in terms of type cancer, treatment effectiveness, and all the types of treatment available for that cancer. Whenever possible patients should discuss all options with their doctors and evaluate the best course of treatment under those conditions. An informed and take-charge patient is important in the life of any patient. So, remember to be informed and take-charge of your best choices.

Proton Therapy – How long and how often are treatments?

The time of treatment will vary as to session length, number of sessions and weeks of treatment. This all depends on the type of cancer, the number of sites and the data that supports the specific and recommended time line of proton therapy.

Typically, Penn Medicine reports that their average treatment time for one session is about 30 minutes of proton therapy for a typical daily medical session appointment of one hour for 5 days each week. The total course of therapy may cover more or less than a full month and will total about 20 or 30 actual ½ hr proton treatments. This means that a total of several hundred minutes of proton therapy is the whole package of treatment. Post-treatment evaluation and discussions are done over the next month after treatment is complete.

Proton Therapy – What are the after effects or side effects after a proton therapy session?

There are and will be some secondary effects of treatment including: burning and stinging sensations of the skin, skin redness, fatigue and in some people hair loss. There is no residual radiation,  nor associated dangers of radiation post treatment.
Proton therapy additional questions and answers including insurance
Proton therapy is FDA approved and proton therapy may be used in conjunction with chemotherapy, but this depends on the type cancer and the attending physicians procedures and protocols.
Medicare and many health insurers support and fund proton therapy for cancer treatment.
Are there sone proton therapy exerimental or trial programs available for certain types of cancer?
Yes, there are and that is an important question to seek answers for. For example, Penn Medicine in Philadelphia has several such programs underway which are evaluating the use of protons for certain other types of cancer as indicated here. The availability of these additional testing and experimental programs will vary, but most will be run by University-Hospital-based centers.

Where are proton therapy centers located in the United States and other parts of the world?

The following is a list of the 11 proton centers currently active and operating in the US as of September, 2013. These centers are listed according to geographic locale alone. Remember that experience and reputation are important factors in choosing a hospital or proton center for your treatment. Evaluate thoroughly and choose well.

Loma Linda University Medical Center , Loma Linda, California

ProCure Proton Therapy Center in partnership with the Seattle Cancer Care Alliance, Seattle, Washington

MD Anderson Proton Cancer Center, Houston, Texas

University of Florida Proton Therapy Institute , Jacksonville, Florida

Hampton University Proton Therapy Institute, Hampton, Virginia

Roberts Proton Therapy Center at University of Pennsylvania Health System, Philadelphia, Pennsylvania

Francis H. Burr Proton Center at Massachusetts General Hospital , Boston, Massachusetts

ProCure Proton Therapy Center , Somerset, New Jersey/Metro New York

IU Health Proton Therapy Center (formerly the Midwest Proton Radiotherapy Center , Bloomington, Indiana

ProCure Proton Therapy Center , Oklahoma City, Oklahoma  

CDH Proton Therapy Center , Warrenville, Illinois

Sources and Resources

Brotherhood of the Balloon. “More than 6000 Prostrate Cancer Survivors for Proton Therapy.”  Accessed Sept. 25, 2013

Ehrenclou, Martine. 2012. “The Take-Charge Patient.”

Marketwire. 2013. Proton Therapy Is a Cost-Effective Treatment for Pediatric Brain Tumor Patients

The National Association for Proton Therapy Accessed Sept. 25, 2013