Proton therapy is a treatment strategy that is similar to external beam radiation, but which uses a distinctly different kind of radiation. Instead of high-energy photos, this treatment uses protons. There are several reasons to choose proton therapy over other types of radiation, including better targeting of the tumor and less damage to healthy tissue surrounding the tumor.
Certain types of cancer are more often targeted with proton therapy, including head and neck, eye, brain, prostate, and lung cancer, and this includes asbestos-related lung cancer. Mesothelioma patients may also benefit from proton therapy, but there are limitations depending on the stage of the disease. This is a newer type of treatment and while it shows great promise, researchers are continuing to refine the technique to make it more effective for more illnesses.
What is Proton Therapy?
Proton therapy, which is also called proton beam therapy, is a type of radiation therapy used to treat certain patients with cancer. It is a type of external beam therapy, which means that a beam of radiation generated by a machine is aimed at the patient’s body, penetrates skin and other tissue, and ultimately hits the tumor and kills cancer cells.
Protons are charged particles at the centers of atoms. When they are targeted at living cancer cells, they ionize or create a charge in the molecules in those cells. This leads to damage, especially to the genetic material of the cells. Healthy cells can potentially recover from this damage, but cancer cells are more vulnerable and usually die after the damage is done.
Protons from an external beam can be given a specific amount of energy, which means that their speeds and how far they travel inside the body can be controlled. By giving the protons calculated amounts of energy, the machine and the doctors operating the machines can precisely direct the beam to the tumor and ensure that it will not penetrate very far beyond the tumor into healthy tissue.
An Alternative to Standard Radiation
Other types of radiation therapy use not protons, but particles called photons, which make up high-energy radiation like X-rays and gamma rays. These are very effective at killing cancer cells, but they also damage healthy cells and are more difficult to control. Unlike protons they cannot be given a specific amount of energy, so controlling where they go in the body is more difficult.
As radiation from X-rays or gamma rays enter the body during treatment, it penetrates and damages tissue on the way in, in the tumor, and on the other side of the tumor as it passes through the cancerous tissue. Essentially, traditional radiation therapy is much more damaging to healthy tissue than proton therapy is. Because proton therapy gives doctors greater control of where to deposit the damaging radiation, they can also give a higher dose of radiation to the tumor than is possible with traditional radiation therapy.
Treatment for Mesothelioma
Treatment with proton therapy is very specific to a tumor. This is beneficial for any patient with one or two tumors. However, for those patients whose cancer has metastasized, or spread throughout the body with multiple tumors, this treatment is not very effective. These patients benefit more from systemic chemotherapy, which uses drugs to circulate through the body, targeting all tumors.
Proton therapy may be used to treat some patients with mesothelioma, depending on how far it has spread. Unfortunately for many mesothelioma patients, a diagnosis comes when the cancer is in the later stages and metastasis has already occurred. These patients are not good candidates for proton therapy. However, for those patients whose pleural mesothelioma has not spread outside of the chest cavity, proton therapy may be a good choice for shrinking the tumors while avoiding damage to the vital organs nearby, including the lungs and heart.
Treatment for Lung Cancer
Patients with asbestos-related lung cancer are often good candidates for proton therapy and research has found that this treatment can be effective and safer for them than traditional radiation therapy. In one study, for instance, lung cancer patients undergoing proton therapy were less likely to develop serious side effects than those receiving traditional radiation therapies.
Radiation therapy to the chest cavity comes with the risk of certain serious complications. These include pneumonitis and esophagitis, inflammation of the lungs and esophagus, which both cause serious symptoms that may be permanent. The studies of proton therapy on patients with lung cancer showed that these side effects are reduced.
What to Expect
If you are going to be receiving proton therapy for mesothelioma or lung cancer, it helps to know what to expect. As with traditional radiation therapy, you will first need to meet with the medical team that will be administering the treatment. You will be examined and given a chance to ask questions and then you will undergo the simulation that precedes treatment.
The simulation is essentially a planning session for the medical team. They will create molds and masks that will be used during treatment to help you stay in place. It is important for any kind of external beam treatment that you stay very still and these devices make it easier. Your skin will also be marked so that the correct area is targeted during treatment. During simulation you may also undergo imaging scans with a CT scanner, PET scanner, or MRI to help guide the treatment.
For the actual treatment you will be positioned with the molds and other devices that are used to help you stay securely in place. The beam of proton will then be aimed at the right area on your skin. The medical team will leave the room, but will be monitoring your treatment through computers. The actual treatment will not hurt and will take anywhere from between 30 and 90 minutes. Most patients will undergo multiple treatment sessions, up to once per day for eight weeks.
Potential Side Effects
Although the side effects and complications are greatly minimized with proton therapy as compared to treatment with traditional radiation, there is still a risk for some side effects. Proton therapy causes less damage to healthy tissue because of the greater control doctors have over how the radiation travels through the body. However, some possible side effects are irritation, redness, hair loss, or swelling at the area of the skin at which the protons are targeted.
Proton therapy is an exciting development in the treatment of cancer and many people struggling with asbestos-related cancers may be able to benefit from it. With more targeted treatment to the tumor, higher doses, and less damage to healthy tissue, this treatment strategy is shrinking tumors more effectively and with fewer side effects.
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