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Specialist treatments < Proton therapy
To make a treatment enquiry to a choice of proton therapy centres, complete our Proton Therapy Enquiry Form
PPM Consult Ltd. promotes selected clinics and certain specialities within individual hospitals in association with Medilux Healthcare Ltd. (MHL), where we believe the standards of care or medical equipment to be exceptional. We provide you with general information but we cannot advise or enter into correspondence about individual cases and we do not arrange or facilitate treatments. We shall not be responsible for the outcome of any treatment or failure to diagnose or treat and we recommend that all patients obtain professional medical advice on their proposed treatments.
Important note to all patients
Proton Therapy
Radiotherapy and radiosurgery both use beams of X-rays. These damage the DNA of the target tumour and of healthy tissue alike, both on the path to the tumour and beyond it, as the beam passes through the body. Various techniques and proprietary technologies have been adopted and improved in order to minimise damage to healthy tissue, including more accurate targeting and treating from many different angles, but the same basic problem is inherent in all external X-ray based treatments.
The limitations of radiotherapy
The advantages of proton therapy
Proton therapy uses protons (hydrogen ions) instead of X-rays. These have considerably less impact on the path to the tumour, deposit a high dose in the tumour and then almost nothing beyond. This means that the dosage is much more concentrated in the desired area, so that:
Potentially serious and distressing side effects which are common in some conventional radiotherapy treatments are greatly reduced.
Proton therapy can treat tumours where X-rays cannot be used because they would damage or destroy sensitive tissue beyond.
The danger of the radiation therapy itself causing cancers later in life is much less. For this reason proton therapy centres initially prioritised treatment of children, but proton therapy is now available to adults too.
The number of days required for treatment can be much less (this varies with different cases and between centres).
Proton therapy can safely deliver higher doses of radiation to stubborn, deep-seated tumours than is possible with conventional radiotherapy
Whilst X-rays can be aimed quite accurately, the intensity of the beam dies away only gradually as it penetrates the body and passes out the other side. For this reason many treatments are given (up to 35) on diffferent days, to allow healthy tissue time to recover between treatments. Unfortunately the tumour can also recover, which can reduce the chance of a cure.
How does proton therapy differ from conventional radiotherapy?
Unike photon beams however, the range of a proton beam can be controlled precisely. It delivers a high energy peak at the selected target, but beyond that the energy level drops very sharply.
Proton scanning
The reduced burden on surrounding healthy tissue enables the number of sessions ('fractions').to be reduced. The radiation dose absorbed by healthy tissue is only 1/3 to 1/5 of X-ray therapy, allowing an increased effective dose to be administered in no more than 15 total fractions
Worldwide, all proton facilities currently planned or under construction will use scanning technology. Using this method, the beam scans the tumour in a grid-like fashion with the utmost precision, with up to 10,000 target points in the tumour.
RPTC in Munich (Rinecker Proton Therapy Centre) has the world’s first system specifically designed and optimised for scanning at all four of it fully movable therapy stations (gantries). This enables them to treat more patients using the optimal scanning method than any other institution worldwide.
The use of proton scanning technology means that proton therapy can now sterilise small areas anywhere in the body. In practice this means that the limits of treatability are set by the uncertainty of current diagnostic methods, rather than the treatment system. For this reason RPTC is already upgrading its still-new combined PET-CT scanning facilities to provide the best imaging method for cancer diagnosis currently available.
What sorts of tumours can be treated?
Tumours in the head/neck area, where proton therapy reduces damage to saliva glands and minimises dry mouth problems after therapy
Prostate carcinoma. When used as the sole treatment, proton scanning achieves the same favourable dose distribution as combined brachytherapy/X-ray radiation. This is important to maximise effective dose to the tumour whilst reducing risk of damage to continence and erectile function.
Tumours of the brain and base of skull, including those close to optic and auditory nerves, pituitary gland, brain stem and cranial nerves.
In principle, the physical and biological properties of protons allow the treatment of any tumour previously treated with X-ray radiation. Proton therapy is especially suitable for tumours where X-ray treatment is difficult or impossible due to associated side effects. This includes, but is not limited to:
Lung and liver tumours. Preliminary indications from the Loma Linda centre in the USA seem to indicate that proton radiation for bronchial carcinomas (lung cancer) is even superior to surgery.
Ocular tumours. This is one of the oldest applications of proton therapy since X-rays would damage the optic nerve and brain behind the tumour.
Local recurrence and individual metastases. In selected cases, proton therapy is the only way to effect partial or total removal in all localizations in the body. It is the most common option for metachronous multiple liver metastases (following carcinomas of the colon), which are not suitable for X-ray therapy because of the risk of liver damage.
Tumours of the abdomen and pelvis, where adverse effects of proton therapy are reduced by 67% to 80% compared to X-ray therapy.
Spinal tumours and metastases. Proton therapy allows the radiation dose to the spinal cord to be drastically reduced, even at the center of the radiation field.
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