Question 1

Q. What is Proton Therapy?

Accepted Answer

A. Proton therapy is a type of radiation treatment in which high-powered energy beams, known as protons (positively charged particles), are used to kill cancer cells and some non-cancerous types of tumors as well.

Question 2

Q. How does Proton Therapy work?

Accepted Answer

A. Proton therapy is a type of external beam radiation therapy, that is, the radiation beams are provided by a machine or source outside the body. It works in the following way:
Protons are used in this type of treatment instead of x-rays, which are the common form of energy beams used for radiation therapy.
Regular radiation therapy procedure involves the energy beam entering inside the body through the tumor and out on the other side.
In the case of proton therapy, the protons used are larger particles than those used in regular radiation. They release most of their energy within the tumor itself. This burst of energy appears on a graph in the form of a Bragg peak.
After delivering the energy to the tumor, the protons usually do not exit the tumor to enter the healthy tissue on the other side.
This leads to less radiation exposure and potential damage to the surrounding healthy tissues than conventional radiation therapy.

Question 3

Q. When is Proton Therapy needed?

Accepted Answer

A. A proton therapy session may be needed in the following cases:
To kill the cancer cells
To relieve symptoms, like pain, associated with cancer
To shrink the size of the tumor before surgery
To reduce the risk of cancer growing again after surgery or chemotherapy (other forms of cancer treatments)

Question 4

Q. What types of cancers can be treated by Proton Therapy?

Accepted Answer

A. The following types of cancers may be treated using proton therapy:

Brain tumors
Breast cancer
Eye melanoma
Cancer in children
Esophageal cancer
Head and neck cancers
Lung cancer
Liver cancer
Tumors at the skull base
Pancreatic cancer
Prostate cancer
Lymphoma
Sarcoma
Pituitary gland tumors
Tumors of the spine

Question 5

Q. Who performs Proton Therapy?

Accepted Answer

A. Proton therapy is done by a Radiation Oncologist.

Question 6

Q. What is the diagnostic procedure before Proton Therapy?

Accepted Answer

A. The following diagnostic tests may be performed before a proton therapy session:
Physical examination: The doctor checks the physical health of the patient. The patient’s symptoms and medical history are noted.
Imaging tests: Imaging tests like x-rays, CT scans, and MRI scans help in obtaining clear images of the suspected cancerous organ.
Endoscopy: A tube with a camera on one end (endoscope) is used in this procedure to examine the organ internally.
Blood tests: These tests help in the diagnosis of certain medical disorders.
Biopsy: The suspected tissue growth is surgically excised and sent to the laboratory for evaluation under the microscope. This helps in confirming or ruling out the presence of cancer cells present and the type of cancer cells that may be present.

Question 7

Q. How to prepare for Proton Therapy?

Accepted Answer

A. The following preparation is needed before a proton therapy session:

Inform your doctor about any pre-existing medical conditions that you have.
Inform the doctor if you have any allergies.
If you are taking any herbs, supplements, or medications, inform the doctor about the same.
Stop smoking as soon as possible.
The doctor will tell you which medicines to stop and which medicines to take before the therapy session.
You will first be positioned on the examination table in a comfortable position.
You will need to stay still during the treatment.
Restraints and cushions are used to place you in a comfortable position and help you stay still during the session.
The area of the body that is likely to receive the radiation is marked using a temporary marker or permanent tattoos.
An imaging test like an x-ray or CT scan is now performed. These tests ensure that you may in the same precise position during each subsequent proton therapy session.
This procedure helps the doctor determine the exact position of the patient for each proton therapy session and is known as simulation.

Question 8

Q. How is Proton Therapy performed?

Accepted Answer

A. A proton therapy session is performed in the following way:

You will be placed in your correct position according to the body markings made and using imaging tests like x-rays and CT scans.
Once you are in your correct position, the doctor will leave the operating room and go to an adjacent room where you can be heard and seen, and the doctor can monitor your treatment.
A machine called a gantry will direct the proton beams at the precise points of your body.
The radiation is directed from a machine outside the body and therefore proton therapy is referred to as a type of external beam radiation therapy.
The noise made by the gantry machine when it is turned on and delivers the proton therapy dose can be heard by you.
However, you will not feel anything when the radiation is being delivered.
Weekly CT scans are required to check if the radiation dose given to you needs to be changed depending on the changes seen in the size, shape, or weight of the tumor.
Each proton therapy session usually lasts for a few minutes. Although the entire procedure along with the preparation may take approximately 30 to 45 minutes.
Proton therapy sessions are usually done five days a week for several weeks. Although in certain cases, one or few proton therapy sessions may be enough to treat cancer.

Question 9

Q. How to care after Proton Therapy?

Accepted Answer

A. The following are the post-procedure steps following proton therapy:
You can usually go home on the same day after proton therapy.
You may notice side effects like skin irritation and fatigue sometime after the proton therapy sessions.
In the initial period after proton therapy, you may only have a few side effects. But, after multiple treatment sessions, you may feel extremely fatigued.
You may have some redness in the area where proton beams have been directed.
You will be recommended to have regular follow-ups and periodic imaging tests after proton therapy sessions to check if the cancer is responding well to treatment.

Question 10

Q. What are the risks of Proton Therapy?

Accepted Answer

A. Proton therapy could lead to the following side effects:

Headache
Nausea
Vomiting
Diarrhea
Digestion issues
Fatigue
Skin irritation
Redness of the skin
Soreness
Hair loss in the treatment area

Question 11

Q. What is the rate of success of Proton Therapy?

Accepted Answer

A. According to a study, approximately 46% of the patients undergoing proton therapy were cancer-free after three years and 56% of the patients were alive after three years of proton therapy treatment.

Proton Therapy

Symptoms

Diagnosis

Treatment

Risks

After Procedure

Proton Therapy from one of the best multi-speciality hospital: Apollo Hospital Bhubaneswar, Gajapati Nagar, Bhubaneswar

Dr. Sthiti Das

Dr. Sanjaya Kumar Mishra