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Radiation therapy or radiotherapy is a treatment given to many cancer patients. Doctors target tumours by using high doses of X-rays to kill cancer cells. However, x-rays damage any type of living cell. This means that on their way to the tumour, x-rays also damage the healthy cells in their path. This leads to side effects such as skin soreness, hair loss, and tiredness/nausea.
Proton beam therapy (PBT) is a different type of radiotherapy. Instead of X-rays, proton beam therapy uses a high-energy beam of protons. The protons, which are so tiny they can only be seen under a special microscope, can pass through normal tissue and can be programmed to stop when they hit the tumour. This makes the therapy more precise; the beams can be targeted directly at a tumour without damaging the surrounding healthy cells.
Courses of PBT typically last anywhere from 3 to 7 weeks and depend completely on the type of cancer that is being treated.
Developments in X-ray technology mean that most cancer patients can be treated safely and effectively with traditional radiotherapy. The precision of proton beam therapy is useful for a select group of patients that cannot be treated safely and effectively with traditional radiotherapy. The precision of proton beam therapy makes it ideal for hard-to-reach tumours in places like the brain, spinal cord, and eyes. In addition, children and young people may benefit from the precision of proton beam therapy because their developing bodies are more sensitive to the side effects of traditional radiotherapy.
The United Kingdom (UK) currently has one low-energy proton therapy facility at the Clatterbridge Cancer Centre NHS Foundation Trust. There are also two high-energy proton therapy centres which can be found at University College London Hospital NHS Foundation Trust and The Christie NHS Foundation Trust in Manchester. Rare complex cancers that cannot be treated with traditional radiotherapy and cannot be treated with proton therapy in the UK are currently referred for high-energy proton beam therapy abroad in places like the United States, Germany and Switzerland.
As with all cancer treatments, there are risks and benefits to consider. The main benefit of PBT is its ability to deliver higher doses of targeted radiation to a tumour. This means that cancer cells can be tackled without high levels of damage to the surrounding healthy cells.
Proton beam therapy is a new treatment, so the long-term benefits are not known yet. It is difficult to establish the exact safety and effectiveness of proton beam therapy through extensive research because the majority of its patients have a rare form of cancer. This makes it difficult to run a clinical trial that is big enough to draw precise conclusions about the treatment. For most cancer patients, there is no evidence to suggest that proton beam therapy is better than traditional radiotherapy.
The main drawback of proton beam therapy is the fact that it requires highly specialised and expensive equipment. Access to high-energy proton beam therapy is very limited in the UK and it is only available through a small number of medical centres across the world.
Before a patient can receive proton beam therapy, they must have their case reviewed by a consultant clinical oncologist and a multi-disciplinary care team. If they believe that the patient is eligible, then a clinical reference panel will refer the patient to a specific therapy centre.
Patients will have to travel to get to these facilities, which are sometimes overseas, this can be difficult if they are not feeling well enough to travel.
The risk of developing side effects and their severity will depend on the location of the tumour that is being treated, the size of the tumour, and whether or not chemotherapy is being administered at the same time. Some side effects of proton beam therapy that can be expected include:
If your child is referred for proton beam therapy, the treatment team should explain the possibility of any side effects to you.
Tree of Hope supports children and young people with an illness or disability. We provide families with help and support in raising money to help pay for specialist care that is not readily available in the UK. If you are looking to pursue proton beam therapy for your child, then we might be able to help you raise the money you need. You will still need to have a consultation and get referred by the appropriate healthcare professional before we can help you though. Find out more about how we help families.
Content Written by: Marissa Mes, PhD Candidate, MSc Health Psychology
UCL School of Pharmacy | Department of Practice and Policy | Centre for Behavioural Medicine
