Proton Therapy Video Transcript


Basic Topics in Cancer Care
Understanding Cancer: A Video Library of Cancer Information
About Cancer Treatment: Proton Therapy Center: Questions and Answers
Time: 9:30


Welcome to M. D. Anderson's Proton Therapy Center. This video will answer the most commonly asked questions about what proton therapy is and how it works.

First, let's answer the question, "What is a proton?"

Billions of tiny particles called atoms make up all types of matter, including the tissue in our bodies. The center of every atom, called the nucleus, is made of two types of particles neutrons and protons.

In proton therapy, beams of very fast-moving protons are used to treat cancer.

What makes proton therapy different from traditional radiation therapy?

In traditional radiation therapy, X-ray beams are typically used to treat cancer. The X-ray beams go through the cancerous tissue, also called tumor, affecting both healthy and cancerous areas along the path of the beam.

Proton beams enter the body and deposit most of their energy in the tumor. Radiation oncology doctors are able to focus the energy of the proton beam within a tumor — causing little to no damage to healthy tissue.

For many cancers, proton therapy is one of the most precise and advanced forms of radiation treatment available.

Both proton therapy and traditional radiation therapy do not cause patients to become radioactive.

Dr. Cox:
Radiation oncology has progressed a lot in the last 10 or 15 years with image guided therapy. As our imaging has become better, we have been able to target the treatments just to the tumor better and better over all these years. Proton therapy provides the ultimate way of targeting the tumor and missing almost all normal tissue. It's like being able to hit the bull's eye every time and nothing else.

What are the side effects of proton therapy?

Dr. Cox:
When a patient is treated with proton therapy, they will feel nothing.

Patients that are treated with proton therapy will have fewer side effects than patients who are currently treated with X-ray therapy.

Is proton therapy ever combined with other forms of cancer treatment?

Depending on the case, proton therapy may be used in combination with traditional radiation, chemotherapy and surgery. If your type of cancer can best be treated with combination therapy, your doctor will discuss this in detail with you.

What types of cancer are treated by proton therapy?

Dr. Cox:
The types of cancer that will best be treated with proton therapy are those that require a high radiation dose for control and those that are close to sensitive normal tissues.

So it will be beneficial for cancer of the prostate, cancer of the lung, cancer of the esophagus, liver, rectum, sarcomas, some GYN tumors, brain tumors, and children who need radiation therapy.

What is the cost of proton therapy?

The U. S. Food and Drug Administration approved proton therapy for cancer treatment in 1988. Since then, proton therapy has been covered in the United States by Medicare and most insurance providers. Proton therapy may cost more than traditional radiation.

Dr. Cox:
Because of the magnitude of the equipment and the facility in which it's placed, the cost of proton therapy will be greater than the cost of x-ray therapy now, but that's only the immediate cost.

Because we can avoid short term and late side effects of treatment, the overall cost of care long term for the patient may be less.

What is the process for receiving treatment?

At the Proton Therapy Center, the treatment process includes a consult visit, a simulation procedure and treatment sessions.

Before you receive your first proton therapy treatment, you will have a consult visit with the radiation doctor who will manage your proton therapy treatments. During the consult visit, your doctor will examine you and explain your treatment options. Together, you and your doctor will decide which treatment option is best for you.

Next, a radiation oncology nurse will explain the treatment process, review the informed consent that you must sign to participate, and answer any other questions you may have. The radiation oncology nurse will monitor your progress closely throughout the treatment and teach you how to manage the side effects that you may have.

Before you begin proton therapy, you will undergo a simulation, which is a treatment planning session. A special immobilization device will be made during this session to help keep you very still during your proton therapy treatments. The simulation team will make a mask for your face or a cradle for your body, leg or arm, depending on the area of your body that will receive treatment.

Next, the simulation therapist will mark the exact treatment areas either directly on your skin or on the immobilization device depending on where your tumor is located. The marks on your body and the immobilization device ensure that the proton therapy beam targets the correct area each time you receive treatment. For this reason, do not wash off the marks until you are instructed.

You will be positioned in the immobilization device while you undergo imaging procedures, which may include a CT scan, PET scan, MRI and X-rays. The simulation team will use these scans to create a custom treatment plan for you. You will begin the proton therapy treatment five to ten business days after the simulation procedure.

What happens during the treatment session?

In the treatment room, the radiation therapist will position you in your immobilization device and use the markings from your simulation procedure to deliver your prescribed proton therapy dose accurately. Relax. Breathe normally, and do not move during your treatment.

From a control room, the radiation therapist can see and talk to you at all times by closed circuit television and two-way intercom.

If you need medical attention before or after your daily proton therapy treatment, your therapist can arrange for you to see a nurse, or if necessary, a doctor. The first one or two days of treatment take longer than the remaining sessions. You will usually come once a day, Monday through Friday, for up to eight weeks. The length of treatment varies depending on the type of cancer.

Will I have follow-up appointments?

Four to six weeks after you complete all of your proton therapy treatments, you will have your first follow-up appointment with your radiation doctor. Your doctor will examine you, check your progress, discuss any test results, and answer any questions you may have. Tests may be scheduled a day or two before your follow-up appointments.

Please bring the following items with you to all of your follow-up appointments:

Dr. Mendelsohn:
Proton therapy is a relatively new way of treating cancer. We feel that it is highly likely that this will become an important way to treat a large number of cancers, and we're delighted that M. D. Anderson is going to have this available for our patients, and for research that will eventually make this available for patients throughout the country and throughout the world.

Dr. Cox:
It's important to emphasize that this huge technological development is only for one purpose, and that is to benefit patients with cancer.

We will cure more patients, and we will have more patients live their lives with fewer effects of treatment.

If you have questions that are not answered in this video, please ask a member of your health care team.

For additional information about proton therapy, call the following resources: