What is Proton Therapy in Breast Cancer?

Proton therapy is a type of radiation therapy that uses proton beams to kill cancer cells.

Unlike conventional radiation therapy, proton therapy does not use X-rays. Experts think proton therapy may be safer than other radiation treatments because it targets a specific area and has less of an effect on healthy tissue around cancer cells.

What is Proton Therapy?

Proton therapy is a precise beam radiation therapy that uses energy from protons or positively charged particles.

Because of precision, proton beam therapy can increase survival by improving local tumor therapy and reducing injury to other organs, resulting in fewer radiation-related side effects.

Radiotherapy can increase the risk of heart-related complications. Proton therapy reduces the risk of this complication because it delivers less radiation to the heart compared to standard photon radiation therapy, according to a 2018 systematic review.

One review reported that the first recorded use of proton beam therapy in a hospital setting was in Belgium in 1991. Since then, doctors have used proton beam therapy to treat thousands of cancers worldwide.

Proton therapy can cure solid tumors, but not cancer cells that have metastasized to different parts of the body.

How Does It Treat?

Radiation experts use a synchrotron machine to accelerate protons to 60% of the speed of light. The velocity of the protons creates a high amount of energy and pushes the protons through a nozzle directed into the body.

Protons travel to a certain depth in the body, where they deliver high doses of radiation to the tumor.

Radiation creates breaks in the DNA inside cancer cells to destroy them.

When Do Doctors Use Proton Therapy?

Because of their sensitivity, doctors recommend using proton therapy when trying to preserve healthy tissue near the tumor site.

For example, proton therapy has particular benefits in the treatment of cancers of the eye, brain, and spinal cord. It is very important to protect the healthy tissues in these areas.

Proton therapy offers a safe alternative to standard radiation therapy in the treatment of early-stage breast cancer.

The doctor may recommend using radiation therapy after a lumpectomy or mastectomy to kill any remaining cancer cells. In the treatment of left-sided breast cancer, proton therapy is particularly advantageous because it poses less risk to the heart.

Proton beam therapy can also treat the following types of cancer:

  • Brain Cancer
  • Nose and Eye Cancers
  • Lung cancer
  • Esophageal Cancer
  • Breast Cancer
  • Gastric cancer
  • Prostate cancer
  • Bowel Cancers
  • Bladder Cancer
  • Pancreatic, gastric and hepatobiliary Cancers
  • Liver Cancer
  • Kidney Cancer
  • Spinal Cord Cancer

Proton Therapy or Standard Radiation Therapy?

Both photon therapy and standard radiation therapy use radiation to damage or destroy cancer cells. However, these treatments use slightly different methods of delivering radiation.

Standard radiation therapy delivers radiation through high-energy particles such as X-rays or electrons. This method releases radiation to any tissue along its path that can damage healthy cells around the tumor.

Because of its precision, proton therapy may preserve healthier tissue than standard radiation therapy. It also reduces the risk of heart-related complications.

What Happens During the Process?

Before the procedure is done, doctors use MRI scans or CT scans to find areas that need treatment. A technician marks treatment sites on the skin.

The treatment is carried out in a special facility equipped with a particle accelerator and a table that can be placed.

A specially trained technician will operate the particle accelerator and ensure the person’s safety during treatment.

The whole procedure takes about 15-30 minutes. This includes the time it takes for the person to take a position and for the technician to make final adjustments to the equipment. Proton beam exposure only takes a few minutes.

People often receive multiple rounds of proton therapy. However, because proton beams can deliver more radiation doses more accurately, proton therapy usually requires less treatment than standard radiation therapy.

How Effective?

Proton therapy appears to be quite effective against breast cancer.

According to a 2019 study of 42 people who received proton therapy after mastectomy for breast cancer without metastases, the treatment resulted in an overall 3-year survival rate of 97.2%.

A larger-scale 2018 study reported that proton therapy was effective, with no significant difference in survival rates for people who did not receive protons versus proton therapy. However, the authors concluded that because of the high cost of proton therapy, doctors should consider it for people at high risk of cardiac radiation due to the location of their tumors.

Side effects

Proton therapy can cause side effects similar to standard radiation. However, because proton therapy affects less healthy tissue than radiation therapy, it usually causes fewer or milder side effects.

Side effects associated with proton therapy include:

tiredness
skin irritation or dryness
bubbles
swelling
People may experience additional side effects if they receive additional chemotherapy or standard radiation therapy.

Risks and complications
Proton therapy offers a safe alternative to standard radiation therapy with fewer, less serious side effects and a lower risk of damaging healthy cells.

Despite these advantages, proton therapy comes with risks and potential complications and is much more expensive.

Learn about the side effects of radiation therapy here.

Points to be considered

Proton therapy is a type of radiation therapy doctors use to treat cancer. It uses high-energy protons to emit radiation to specific targets in the body.

Doctors can use proton therapy to kill cancer cells left over from a lumpectomy or mastectomy for breast cancer.

This method is more sensitive and offers less risk of damaging healthy tissue compared to standard radiation therapy. This means that proton therapy may cause fewer and less serious side effects.

The advantages of proton therapy are particularly beneficial for left-sided breast cancer. Radiation therapy can affect the heart, but because of its sensitivity, proton therapy has a lower risk of damaging the heart and other healthy tissues around the breast. Researchers need to conduct larger studies involving people at higher risk for radiation-related cardiac events to determine whether proton therapy results in better overall survival for this population.

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