What is Proton Therapy

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Prostate Cancer Treatment

This video explains the process of being treated for prostate cancer at the SCCA Proton Therapy Center. From initial diagnosis and medical records acquisition to treatment, the video should address questions you may have about proton therapy for prostate cancer.

More than 241,000 new cases of prostate cancer are diagnosed in men every year. For most patients with prostate cancer, radiation therapy is a treatment option. Proton therapy is a type of radiation therapy that can decrease the risk of damage to surrounding organs caused by excess radiation.

Precision of Proton Therapy 

Proton therapy is precise, and therefore better able to avoid surrounding organs. The radiation dose deposited by protons increases gradually until it peaks suddenly, called the Bragg Peak, and then falls to zero. Radiation oncologists can control where the Bragg Peak occurs, pinpointing it to peak exactly within the prostate.

The images below show the amount and location of radiation that the body receives during treatment with proton therapy (right) and X-rays/IMRT (left). Proton therapy limits the radiation delivered outside the prostate.

Pencil Beam Scanning

For many patients, innovative pencil beam scanning (PBS) is a great option. PBS "paints" the prostate with a very thin, very precise beam of protons that's accurate within millimeters, reducing even further the amount of radiation to healthy tissue. PBS sends rapid pulses of protons to each planned spot within the prostate until the entire cancer is treated. Click on the image below for a short video.

What are the Advantages of Proton Therapy? 

While proton therapy and IMRT (X-ray radiation therapy) both treat prostate cancer by killing cancer cells when they attempt to divide and multiply, there is an important difference. IMRT can deliver excess radiation that can cause side effects to the sexual organs, bladder and bowel. Protons can be better controlled to release most of their energy within the prostate.

One study found that patients with prostate cancer treated with proton therapy do not experience testosterone suppression from the radiation treatment (1). Testosterone is the major male hormone that controls sex drive and overall energy and stamina. Clinical trials have also shown that patients with lower risk prostate cancer can be treated with proton therapy with a cure rate of 90-99%, and a 1-2% risk of serious side effects (2) and great quality of life reported. 

Radiation exposure to healthy tissue from IMRT can cause side effects years, even decades, after treatment is completed. These side effects include erectile and bladder dysfunction, and a small risk of secondary cancers (3).

SpaceOAR vs. Rectal Balloon

If you've heard about the rectal balloons used during proton therapy, you need not worry about that daily discomfort. Some of our patients use SpaceOAR, the first FDA-cleared spacing device to protect the rectum in men undergoing radiation therapy for prostate cancer. The SpaceOAR System is intended to temporarily position the anterior rectal wall away from the prostate during radiotherapy for prostate cancer, creating space to protect the rectum from radiation exposure. Placed through a small needle at UW Medicine, the hydrogel is administered as a liquid, but quickly solidifies into a soft gel that expands the space between the prostate and rectum. The hydrogel spacer maintains this space until radiation therapy is complete. The spacer then liquefies and is absorbed and cleared from the body in the patient’s urine.

Certain prostate cancer patients do not need any kind of spacer placed. Talk to your physician to determine which approach is most appropriate for you.

See additional resources below for more.

Bladder and Testicular Cancers

Bladder and testicular cancers can also be treated with protons. We will evaluate each case individually. Our radiation oncologists use other forms of radiation to treat cancers, so they will provide you with an expert recommendation for your consideration. 

What can you expect with Proton Therapy at SCCA Proton Therapy Center?

  • Proton therapy - including pencil beam scanning - is given in a state-of-the-art center with specialized medical equipment.
  • Treatment and care are given by a team of specialized doctors, nurses and healthcare professionals.
  • Most patients do not feel pain or discomfort during treatment. Side effects, if they occur, can be treated with medication prescribed by your radiation oncologist.
  • The time spent delivering proton therapy to the prostate is only a few minutes, but the entire treatment process may take 20 minutes.
  • Many of our patients are able to work full time. 

If you have your most recent Gleason score and PSA test results handy, please give us a call at 1-855-528-7248.

 

Please be advised that we will need your medical records to determine if you are a candidate for proton therapy.

 

Additional Resources:

Proton Therapy for Prostate Cancer

 

FAQs on Prostate Specific Antigen (PSA)

 

SpaceOAR FAQ

 

Treatment Options for Metastatic Prostate Cancer

STAMPEDE (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy) is a large clinical trial that is assessing new treatments for men with high-risk prostate cancer.

Learn about the STAMPEDE clinical trial here.

To read a prostate cancer survivor story, please click here.

 

References: 

1. Acta Oncol. 2013 Apr;52(3):492-7. doi:10.3109/0284186X.2013.767983. Hypofractionated passively scattered proton radiotherapy for low- and intermediate-risk prostate cancer is not associated with post-treatment testosterone suppression. Kil WJ1, NicholsRCJr, HoppeBS, MorrisCG, MarcusRBJr, Mendenhall W, MendenhallNP, LiZ, CostaJA, WilliamsCR, HendersonRH.

2. Int J Radiat Oncol Biol Phys. 2014 Mar 1;88(3):596-602. doi: 10.1016/j.ijrobp.2013.11.007. Five-year outcomes from 3 prospective trials of image-guided proton therapy for prostate cancer. Mendenhall NP1, Hoppe BS2, Nichols RC2, Mendenhall WM2, Morris CG2, Li Z2, Su Z2, Williams CR3, Costa J3, Henderson RH2.

3. Radiat Oncol. 2013 Jul 8;8:172. doi: 10.1186/1748-717X-8-172. Second primary cancers after radiation for prostate cancer: a review of data from planning studies. Murray L, Henry A, Hoskin P, Siebert FA, Venselaar J; BRAPHYQS/PROBATE group of the GEC ESTRO.

Lung Cancer; Prostate Cancer

“Ultimately, the patient chooses the treatment path, but it is my duty to ensure that patients have all the information needed to feel confident in the decision.”

Prostate Cancer; Ocular Cancer

“I know what it's like for a loved one to be a patient: scared, in the dark, vulnerable, and anxious. That's why I always strive to give each patient the same compassion, patience, time, and personal care that I would want a doctor to give to my family.”

Gastrointestinal Cancers; Prostate Cancer

“As a radiation oncologist, my goal is to guide patients through this difficult time by providing the most compassionate, personalized care possible and making sure they have access to the latest, innovative clinical trials and state-of-art technology.”

Related Studies

Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial Parker CC, James ND, Brawley CD, et. al. Read Study
Randomized trial comparing conventional-dose with high-dose conformal radiation therapy in early-stage adenocarcinoma of the prostate: long-term results from proton radiation oncology group/american college of radiology 95-09 Zietman AL, Bae K, Slater JD, Shipley WU, Efstathiou JA, Coen JJ, Bush DA, Lunt M, Spiegel DY, Skowronski R, Jabola BR, Rossi CJ. Read Study
A phase II study of hypofractionated proton therapy for prostate cancer Kim YJ, Cho KH, Pyo HR, Lee KH, Moon SH, Kim TH, Shin KH, Kim JY, Lee SB, Nam BH. Read Study
Conformal proton therapy for early-stage prostate cancer Slater JD, Rossi CJ Jr, Yonemoto LT, Reyes-Molyneux NJ, Bush DA, Antoine JE, Miller DW, Teichman SL, Slater JM. Read Study
Current standards and future directions for prostate cancer radiation therapy Pinkawa M, Schoth F, Böhmer D, Hatiboglu G, Sharabi A, Song D, Eble MJ. Read Study