Proton therapy

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What is proton therapy?

Proton therapy is a type of radiation therapy for the treatment of tumors. In this process, protons, which are positively charged, energized atom particles, are aimed at targeted tissue. When entering the body, they slow down and transfer their energy directly at the tumor cells, destroying them. Therefore, only few side effects occur through proton therapy.

How does proton radiation work?

During proton therapy, protons are accelerated and pin-pointed at the desired area at circa 180,000 km/h. Thereby it is not only possible to determine the direction of the proton ray, but also, how far it should penetrate the patient’s body. In addition, during the procedure the patient can lay on a treatment table beneath the equipment.

The protons penetrate into the body at pre-calculated depths. Throughout body, the particles are slowed down. Due to their physical traits they provide more energy, the slower they become. On the way to the radiated area, the energy is very low, however it increases explosively as soon as the particles have reached the target, known as the “Bragg-peak” phenomenon.

What advantages does Proton therapy have over conventional radiation?

The so-generated proton radiation works on a fundamentally different principle than conventional radiation therapy with x-ray and photon radiation. Photon radiation uses electromagnetic waves, whose direction can be precisely controlled, but penetrate throughout the entire body. The range cannot be controlled. Thereby, energy in front of and behind the tumor will be emitted. Healthy tissue will be unnecessarily radiated.

Proton radiation, in contrast, can be directed in three dimensions, which means that the penetration depth can be directly targeted at the treatment region within the tissue. Through this, the emitted energy concentrates on the area in which the tumor is localized and can destroy tumor cells precisely. The leftover tissue remains preserved. Thereby, the radiation dose, which impacts the tumor tissue, can be increased while the radiation effect on healthy tissue decreases.

Which types of cancer can be treated with proton radiation?

The main usage for proton therapy is the treatment of cancer illnesses. Principally, proton therapy is applicable for all types of tumors that can also be radiated by conventional means. For specific tumor types or localization, the usual radiation methods host significant risks:

Proton radiation saves healthy adjacent tissue

Proton therapy is especially indicated if a tumor has close proximity to sensitive and important tissue. This tends to be the case in the following types of cancer:

• Tumors in the head and neck area
• Brain tumors
• Eye tumors
• Thyroid tumors
• Pelvic tumors
• Spinal tumors
• Salivary gland tumors

Through conventional radiation healthy, functional tissue is destroyed. Patients often suffer from the effects of radiation, such as dry mouth as a result of damage to the salivary gland. There is also danger that bone marrow can be damaged when spinal tumors are treated with conventional methods.

Proton therapy for prostate cancer

In addition, for small organs in which a tumor should be targeted without damaging the organ’s function, proton therapy offers good possibilities. For example, in the case of a prostate tumor, proton therapy enables the preservation of as much healthy tissue as possible – a significant improvement of the quality of life.

Proton radiation for children

Children should, as possible, only be radiated with protons and not with conventional radiation. The risk of damage to structures that are still in growth, such as developing bones or organs, are thereby reduced.

Locations for proton therapy in Germany, Austria and Switzerland

In Germany there are currently five proton therapy centers, including Essen, Heidelberg, Munich, Dreseden and Berlin. Further centers are in Giesen/Marburg, Cologne/Bonn/Aachen, in addition to Hamburg/Schleswig Holstein are several in planning. Further centers in German-speaking areas are in Vienna, Austria and Villigen, Switzerland.

Cost adoption of proton therapy

The cost acquisition of proton radiation through health care providers must always be discussed on location at the appropriate proton therapy center. Supply contracts exist with certain legal health insurance companies. All of the treating doctors need to initially determine the necessity and advantages of proton radiation treatment. In case a supply contract with the health care provider exists, all of the complete costs will be assumed by the health care provider. In specific cases, the German Health Insurance Medical Service / MDK will intervene. For private and self-paying patients, an individual estimate will be generated.

Sources:

https://de.wikipedia.org/wiki/Protonentherapie#Bestehende_Einrichtungen

http://mit-marburg.de/arzt-patienteninformationen/therapieanlagen-weltweit/

https://www.wpe-uk.de/patienten/behandlung-von-kindern/

http://www.rptc.de/de/protonentherapie/bestrahlung-mit-protonen.html

https://www.klinikum.uni-heidelberg.de/HIT.123830.0.html

http://www.krebsprotontherapie.de/vorteile-der-protonentherapie/