Overview
Proton Therapy vs. X-ray
Benefits of Proton Therapy
Conditions Treated
Frequently Asked Questions about Proton Therapy
What is Proton Therapy?
Proton Therapy is an advanced form of radiation therapy that precisely delivers high doses of radiation to a tumor site to kill the cancerous tissues without damaging the surrounding healthy tissue.

How does proton radiation different from traditional photon radiation?
In traditional radiation therapy, X-ray beams are typically used to treat cancer. The X-ray beams go through the cancerous tissue (tumor) destroying both healthy and cancerous areas along the path of the beam. However, in proton radiation, the proton beam stops at the tumor site leaving the healthy cells beyond it unaffected. The proton beam can also be contoured to the exact shape of the tumor, further decreasing radiation exposure and limiting side effects. Proton therapy is particularly effective for localized cancers, cancers near vital organs, and pediatric cancers.

How does proton therapy work?
Proton radiotherapy works by ionizing tissue molecules, which damages the cell nucleus, the surrounding membrane and other components, and thereby inhibits cell growth. Cell division is interrupted or the cell dies. In comparison with the photons used in conventional radiotherapy, protons have certain physical advantages. They release their maximum dose – which attacks the tumor cells – right at the end of their trajectory. The point where they stop is called the Bragg peak. Their speed (or energy) is calculated so that this point occurs at a precisely selected spot within the tumor. No radiation is deposited in the healthy tissue behind the tumor. The dose released in healthy tissue on the way to the tumor is considerably less than with photon therapy. Therefore, on the one hand the sparing of healthy tissue is optimal, and on the other a significantly higher radiation dose can be released precisely within the tumor.

What tumors can best be treated with proton therapy?
Proton therapy is best used where high dose to the tumor and maximum precision is required. If the medical indications favor lower dose and wide-area radiotherapy, proton treatment may bring no distinct advantage. In case of doubt, a comparative therapy plan can be drawn up, and a decision for proton or photon therapy made on the basis of the calculated dose distributions.

What results has proton therapy achieved? What are the chances of a cure?
Protons have been used in medical therapy since 1954, when patients were first irradiated with these positively charged particles in Berkeley, California. Since then, more than 50,000 people have been treated at various centers worldwide, mostly for tumors of the eye (choroidal melanomas), brain, skull base, spine and pelvis. Impressive success has been achieved with eye tumors, with a local tumor control rate exceeding 98% after five years. There has been a similarly striking increase from 40% to more than 80% in the control rate for chondrosarcomas and more than 65% for chordomas of the skull base. These results reinforce the thesis that precise placing of the radiation dose, along with the significantly higher radiation that can thereby be released inside the tumor, enable growth to be halted in even relatively radiation-resistant tumors, or permit them to be destroyed altogether, without damage to surrounding tissue. As facilities spread for treating tumors that cannot be adequately subjected to conventional radiotherapy, we expect an increase in the indications for proton-beam treatment.

What are the side effects?
Proton therapy is painless and does not burn. Patients feel nothing during treatment. There are rare situations when specific sensory centers in the brain are irradiated, which can lead to temporary stimulation during treatment, causing e.g. light flashes or scent sensations.

Will I feel anything during the therapy?
Proton therapy is painless and does not burn. Patients feel nothing during treatment. There are rare situations when specific sensory centers in the brain are irradiated, which can lead to temporary stimulation during treatment, causing e.g. light flashes or scent sensations.

How long does the therapy last?
A course of radiotherapy usually lasts several weeks, with a relatively large number of small individual doses given, until the total dose necessary to destroy the tumor is reached. As a rule this takes 25-37 days of treatment so a course of therapy lasts from 5 to 9 weeks. On each treatment day the therapy lasts about half an hour, most of which time is taken up with the exact positioning of the body so that the tumor can be irradiated with optimally spearing out the surrounding tissue. The proton irradiation itself only lasts a few minutes.



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Proton radiation treatment differs from standard radiation therapy. If given in sufficient doses, conventional radiation therapy techniques will control many cancers. However, because of the physician's inability to adequately conform the irradiation pattern to the cancer, healthy tissues may be damaged with radiation.
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