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Proton Therapy: Treatment, Cost and Side Effects

Last Updated: Jan 20, 2025

What is the treatment ?

Proton therapy or proton beam therapy is kind of a radiation therapy. In this therapy, a proton beam is used to irradiate the diseased cells or tissues. The protons which are the positively charged particles which are produced in the particle accelerator. These proton beams are superior to the traditional radiotherapy methods because they do not scatter and thus do not harm the adjacent tissues and organs. They are targeted on the tumour cells and tissues. The proton beams damage the DNA of the cells. This results in effectively controlling the reproduction of the tumour cells. The protons are also revolutionary for the cancer treatment because they do not penetrate deep into the body which reduces the risk of damage to the organs of the patient. They can also be employed to kill a tumour deep which is located deep inside the body tissues. The treatment is also preferred over other traditional treatments because it has very few side effects.

The main use of the proton therapy is in the eradication and destruction of the cancerous and tumorous cells present in the body. A combination of chemotherapy, radiation and therapy and surgical removal of the cancerous cells is used to cure cancer. The proton beam therapy has also been used to treat cancer in children. Some of the cancers in which proton therapy is commonly used to destroy cancerous cells are lung cancer, pediatric cancer and lymphoma.

How is the treatment done?

Firstly, the oncologist plans the proton beam therapy sessions to be conducted for the treatment. In every atom, there is a nucleus which surrounded by the electrons. By the process of ionization, these atoms acquire positive charge which is thus referred to as protons. A machine called a synchrotron or a cyclotron, which runs the hydrogen atoms at very high speeds, ionises the atoms and they ionise. The process of ionization alters the characteristics of the atom which makes it helpful for the treatment. These protons are used in the treatment to kill the cancerous cells. These protons beams affect both the normal and diseased cells alike in the process. The normal cells have the ability to heal themselves. However, the cancer cells are quite unstable and are unable to repair themselves. As a result, they experience more damage and this causes them to be destroyed or to stop their reproduction.

Although the radiation treatment using X-rays is based on the similar principle, the proton beams are preferred as they have many advantages over X-rays. The energy distribution of the proton beams can be directed and deposited in tissue volumes. Another advantage of using proton beams is that they can be energized to specific velocities. The velocity of the particle helps to determine the penetration of the cells and the deposition of the energy to the body tissues. This is especially helpful in the treatment of the deep cancerous tissues. The regulation of the energy of the particles also facilitative to reduce the energy deposited to the tissue cells when the patient is in recovery and the dosage required is less than the initial dose. The exposure to the proton radiation is also for a short time as they have a very short lifespan.

Who is eligible for the treatment?(When is the treatment done ?)

The patient is initially assessed to know if their infected organ can be exposed to the rays. Depending upon that, the eligibility is decided.

Who is not eligible for the treatment?

Any patient who has had recent surgeries will not be exposed to this treatment not until they have been assessed and declared to fit to attend,

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Are there any Side Effects?

The proton beam therapy has been in use for almost 40 years now. There have been side effects reported after the therapy. The side effects are experienced usually depend on the duration of exposure and the organ which is exposed. The therapy is usually painless. However, the occurrence of pain has been reported in some cases. The acute side effects are vomiting, soreness in mouth, throat and oesophagus. This can sometimes also affect swallowing. Intestinal discomfort is common. There is a possibility of infertility as the genital organs are very sensitive to the radiations. Swelling and damage to the epithelial tissues are also reported in the initial phases of the treatment. Apart from the acute side effects of the initial stages, there are some side effects which can occur in the long term. These are fibrosis, epilation or loss of the body hair, aberration in the functioning of the tear glands, salivary glands and the sweat glands, retention of fluid in the body or lymphedema, the risk of cardiovascular diseases, cognitive decline and polyneuropathy.

What are the post-treatment guidelines?

A typical session of the proton therapy can last anywhere from 15 minutes to 30 minutes depending on the organs which are to be treated, the number of treatment segments and the number of x-rays or CT scan done during the positioning process. Also, it is not required to be admitted to the hospital for the procedure to be carried out. In some cases, the patient can simply go back home after the therapy session.

How long does it take to recover?

The recovery period completely depends on the intensity of the issue and number of treatment segments the doctors suggest.

What is the price of the treatment in India?

The proton treatment is an advancement in radiation treatment which is available in only a few select hospitals in India. The revolutionary technology has been recently adopted for the treatment of cancer in India. The proton beam therapy is a costly treatment which can cost anywhere from Rs 20 Lac to Rs 40 lac per cycle in India. The cost of the treatment also depends on the expertise of the doctor, the precision of the equipment and the number of the sessions required to kill the cells. The doctor can perform 1 to 5 sessions of proton therapy to eradicate the cancerous cells.

Are the results of the treatment permanent?

The proton beam therapy is safe and can be used on children also. It has been observed that the proton therapy has been successful 74 times out of 100 in completely curing the cancerous cells of diving at the initial stage of cancer. However, the proton beam therapy has been only been about 45 per cent successful in the case of high-risk cancer in the advanced stages. It has been observed that although the therapy is effective in eradicating the cancerous cells, it is essential to be combined with chemotherapy to completely cure cancer. Without the use of chemotherapy, proton therapy has been only half successful in inhibiting the growth of the cancerous cells. With the combination of chemotherapy, the proton therapy has shown good results in suppressing the growth of the cancerous cells.

What are the alternatives to the treatment?

The alternatives to the proton beam therapy are the other radiation treatments available. These include the traditional x-ray therapy, image-guided radiation therapy, tomotherapy, surgery and chemotherapy. A new advanced version of the proton therapy called Intensity Modulated Proton Therapy is also an option. It is a very precise targeting radiation therapy which also involves the use of proton beams. IMPT is a highly advanced treatment of cancer and effectively reduces the risk of damage to the adjacent healthy tissues. It facilitates the treatment of the cancerous which are in close proximity to vital organs of the body. Image-guided radiation therapy is also an alternative in which imaging is used to target the cancerous cells. This ensures the precision and the effectiveness of the treatment. However, it must be understood that the treatment of cancer is carried employing a combination of chemotherapy, medication, radiation therapy and surgery. Also, the availability of the treatment is also a deciding factor in the treatment of cancer.

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Written ByDr. Jayashri S MBBS,MS - Obstetrics and GynaecologyGynaecology
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