Treating gastrointestinal cancers with proton therapy
By using proton therapy to treat gastrointestinal (GI) cancers, a higher dose of radiation is able to be delivered directly to where it needs to be — to the cancerous cells — while sparing healthy tissues and critical areas of the body such as the liver, kidneys, small bowel and stomach. When treating GI tumors, treatment will often be a combination of surgery, chemotherapy and radiation therapy.
Treating GI tumors with proton therapy has potential advantages. For some tumors, proton therapy may help doctors spare unnecessary radiation dose to healthy tissues and critical areas of the body including the liver, kidneys, bowels, bladder and bone marrow.
What are the benefits of proton therapy treatment for gastrointestinal cancers?
Reduced radiation dose to healthy tissues may lead to fewer short- and long-term side effects of radiation, though research is still ongoing. Proton therapy is not currently recommended for all types of gastrointestinal tumors.
It is not generally recommended that radiation of any form take the place of surgery for the most common GI cancers. Newly diagnosed colon, rectum, pancreas and stomach cancers require multidisciplinary treatment including surgery for the best chance of cure. However, for some types of gastrointestinal cancer, proton therapy may be an option because of the nature or location of the tumor.
Types of gastrointestinal cancers treated with proton therapy
Unlike many cancers of the GI tract, the primary treatment for most squamous cell cancers arising from the anal canal is curative chemoradiation. For tumors diagnosed at an early stage, cure rates are high. However, the dose of radiation required to cure anal cancer can cause many short and long-term side effects.
Treating esophageal cancer with an adequate dose of radiation can be difficult because of the close proximity of the esophagus to critical structures, such as the heart, lungs and spinal cord. Because protons deposit their highest dose of radiation at the tumor or area of concern, proton therapy can be an excellent choice for treating patients with esophageal cancer.
The most common primary liver cancers are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (IHC). The best option to cure primary liver cancers is with surgery, and the two main surgical options include resection to remove the liver or a liver transplant. Radiation is one option to treat primary liver cancers that cannot be treated with surgery.
Many types of radiation are used to treat primary liver cancer including intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT) and selective internal radiation therapy with yttrium-90 (SIRT).
Proton therapy may have advantages in the treatment of primary liver tumors. The special properties of the proton beam allow doctors to treat a liver tumor while minimizing or eliminating exit dose through the healthy liver. This is important for patients who have underlying liver damage from cirrhosis or other previous treatments to the liver and may allow doctors to give a higher dose to the tumor more safely.
Recurrent gastrointestinal cancers that have been previously irradiated
Radiation therapy is commonly used in the preoperative or postoperative treatment for many common GI tumors such as stomach, pancreas, rectum and anal canal. Occasionally, these cancers can recur and require further treatment.
Proton therapy allows doctors to minimize or eliminate the exit dose of unnecessary radiation that can affect normal tissues behind the tumor target. This may minimize the short- and long-term damage to the bowel, liver, kidneys, bladder, genitalia and bone marrow.
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Why MD Anderson Proton Therapy Center
The MD Anderson Proton Therapy Center has years of experience treating gastrointestinal cancers. Patients will have access to a multidisciplinary team that includes radiation oncologists, radiation therapists, nurses and others. We will evaluate patients and create a plan that fits each patient's specific needs. Patients cases will also be reviewed by medical oncology and surgery when indicated.
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