"Should I get proton therapy?" is a question that my patients often ask me, and you may be thinking about it right now. The short answer is that "it depends." Only you and your oncologist should be making this decision.
Before deciding IF you should receive proton therapy, you need to know WHAT it is. Proton therapy is a form of external beam radiation that uses particles (i.e. protons) instead of photons (i.e. X-rays) to treat tumors. Both forms of radiation can destroy cancer cells by messing up their genetic blueprint (DNA). This makes it difficult for cancer cells to continue to grow and divide, and they ultimately die. 
In general, the higher the radiation dose, the better the tumor control will be. However, such high radiation doses can affect normal tissue near the tumor, which is what we all want to avoid.
Photons (x-rays) deposit the majority of their dose within the first inch after they hit the skin, and they continue to deposit dose after they reach the tumor. Hitting a deep tumor with just one or two x-ray beams is hard (that would be like trying to power-wash your driveway with a water pick). We often need to use many different beams to cover the tumor and this can result in more radiation exposure to normal tissues. This is where proton therapy has the edge. Protons deposit most of their dose at the tumor and more importantly stop traveling after they hit the tumor. This reduces the radiation dose beyond the tumor, allows the use fewer beams, and subsequently greater sparing of normal tissue.
Proton treatment requires sophisticated machinery and expert professionals to deliver it. The synchrotron will accelerate protons to almost the speed of light for maximal penetration. Inside the synchrotron they may travel 300,000 miles, which is equivalent to circling the earth 12-13 times. The protons are then fed to the treatment gantry, which is a massive 190-ton device that directs the proton beam before it enters the patient. Despite its large size (over 40 feet in diameter), the gantries have a precision of 1mm. We also have a highly trained, dedicated group of professionals who operate and maintain the Proton Therapy Center to ensure that everything works to its best level.
Proton therapy is currently available in only seven centers in North America. M. D. Anderson has one of the largest and technically advanced centers in the world. We have four treatment rooms, including one of the only centers with spot-scanning (a.k.a. pencil-beam scanning) capabilities.
The first patient was treated with proton therapy at M. D. Anderson on May 4, 2006, and since then we have treated more than 1,700 patients. We have a lot of experience treating patients with lung cancer, esophageal cancer, brain tumors and prostate cancer, as well as various other tumor sites. Also, we're one of the most active centers in the world for treating children with proton therapy.
Since the Proton Therapy Center is part of M. D. Anderson Cancer Center, we can provide our patients not only with outstanding proton therapy but also outstanding cancer therapy.
So, should you receive proton therapy? Please consult with your radiation oncologist or check out our website for more information.
Other Resources
ProtonPals is a support and outreach group for those who choose proton therapy treatment at The University of Texas M. D. Anderson Cancer Center Proton Therapy Center
Is Proton Therapy Right for You?
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Can Proton be used for Hodgkins Lymphoma, my son is 48 years old and has been fighting cancer for four years, his white count is very low, he has lost a tremendous amount of weight, the marrow in his bones is depleted, he is trying to fight an infection in his hand right now, his hand is swollen, he is sick and having a hard time swallowing, he is still having chemo but can only have small amounts due to his system being weak, PLEASE can you offer any advice the want to put him in the hospital, but he wont go, he watched his father die of cancer in hospital, and I think he is scared, his doctor told me they are doing everything they can, if you can advise me it would be a blessing, desperate Moher
I am being treated for myeloma at M.D. Anderson and was diagnosed in 2007. After a relapse, I failed another therapy and am in my second trial. I have a painful plasmacytoma in my left iliac and ala. Can proton therapy be used on the plasmacytoma instead of photon xray? I am concerned about potential xray damage ro my decent bone arrow in those large bones, as I need all the RBC and WBC growth medium I can get right now.
Could proton therapy be used on that plasmacytoma and will it spare damage to bone marow?
Thanks.
Can proton therapy be used for breast cancer 2nd stage instead of chemotherapy. umor is almost 5 cm. Thanks for your reply.
Can proton therapy be used in patients with metastatic cancer to lungs and liver?
Proton therapy may be indicated for metastatic cancer to lungs and liver, but only under very unusual circumstances. In either site, proton therapy would rarely be used for more than one metastasis. If you would like to speak to someone about a specific medical case, call the Proton Therapy Center at 1-866-632-4782 or AskMDAnderson at 1-877-MDA-6789.
Thank you,
Dr. James D. Cox
Proton therapy may be indicated for metastatic cancer to lungs and liver, but only under very unusual circumstances. In either site, proton therapy would rarely be used for more than one metastasis. If you would like to speak to someone about a specific medical case, call the Proton Therapy Center at 1-866-632-4782 or AskMDAnderson at 1-877-MDA-6789.
Thank you,
Dr. James D. Cox
Is proton therapy considered a treatment option for an adult with stage 2 oligodendroglioma brain cancer?
Proton therapy can be used to treat brain tumors and we have done so at M.D. Anderson. Every case is unique and therefore, it is best to be evaluated by a specialist here at MD Anderson to determine if proton therapy is right for a particular case. Please let us know if we can help.
-Andrew K. Lee, MD, MPH
My husband just started radiation (he's on day 3) and I just found your site. He has Stage 4 Glioblastoma. Do you treat Glioblastoma cases and would it be worthwhile to talk about future treatment at your center?
On behalf of the Proton Therapy Team--We are sorry to hear about your husband's diagnosis. To answer your question, we do not typically treat glioblastoma with proton therapy since there is no obvious benefit. Good 3D conformal radiotherapy or IMRT should treat the tumor effectively. We appreciate your interest in the Proton Therapy Center and wish you and your family all the best.
Anita Mahajan, MD
June 2, 2005 Dr. Lang at MD Anderson removed a grade 2-3 astrocytoma tumor from my occipital lobe. Dr. Edward Shaw then treated the area around the cavity with radiation at Wafe Forest Baptist late 2005. I just received the news from Wake on September 13 that the cancer has returned in the form of tentacles around the original tumor site. Ironically, I was just relocated to Dallas with work 8 months ago. I will meet with Dr. Mark Gilbert at MD Anderson on October 10, 2011 to discuss options. I want to get a jump start and ask the question, "Am I a candidate for proton threapy since I have undergone radiation already in 2005?" Thanks and I know I'm in great hands at MD Anderson!
On behalf of the Proton Therapy Team-- In these situations the advantage of protons is decreasing the dose to the distant brain. However, there is no advantage over standard photons for the previously radiated surrounding brain as this area will need to be treated with radiation (and this is where the high risk is). The first question in this situation is there a role for further surgery and is there a role for chemotherapy? Those always come before considering re-irradiation. Thankfully you are seeing one of the world's experts, Dr. Gilbert, in October to help you sort through your options (and if there is any role for re-irradiation). I hope this is helpful.
Paul Brown, M.D., Professor and Co-Section Chief CNS/Peds, Dept. of Radiation Oncology
Hi, my father was recently diagnosed with prostrate cancer. His PSA#s and Gleason are both low and the cancer is localized. We are considering the many options available. Urologists at The Cleveland Clinic have discourage the use of proton therapy because it is still very investigational with more side effects than other forms of XRT. I have also heard that it is not approved for prostate and that there is very little long term data. Any info regarding these issues would be so greatly appreciated.
We're sorry to hear about your father's diagnosis.
Thankfully, there are many good treatment options available with high success rates.
Proton therapy has been shown in prospective randomized trials w/ nearly 9 years of followup to have very good disease control rates with low side effects.
In fact, proton therapy has been used longer to treat prostate cancer in the U.S. than the more commonly availably IMRT.
It is neither investigational nor experimental.
Please let us know if we can be of further assistance.
-Regards, Andrew Lee, MD, MPH (Director, Proton Therapy Center)
I am a retired Gyne-Oncologist, Former Head of the Gyne-Oncology Division at the Carmel Medical Center.
My grandson 11 years old was recently diagnosed to have a grade 4 pons Glyoma at the brainstem that according to the MRI is a non resectable cancer tumor. The Neurosurgeons referred us to the Pediatric oncology center at the Rambam institute for Photon radiation therapy that is due to start next week by fragmented dosed 5 times a week for 8 weeks. According to them this will be palliative treatment with no chances to cure.
My question is if the Proton radiation therapy will be a better treatment option for my grandson and what are his chances to achieve a cure
Do you have any experience with such a case,length of treatment and results.
Thanks for your consideration.
Dr Jack Atad
Haifa
Israel
please respond to my email address as follow:
atadjack@inter.net.il
Hi, I want to know if I will be a candidate for Proton trx or other trx. On August, 2007, I started having sudden severe neck pain without any injury. Had seen Ortho, Physical therapist, Sport medicine, Ortho/Neuro, Neurologist, Neuro/Oncologist, and even steroids injections to my knees, shoulders and neck but to no avail. In Febuary, 2011, an MRI of the C-spine with/without contrast revealed ? Astrocytoma between C4 and C5.
Had been seen in these three Hospitals - Wellstar Health System, Emory Hospital ( both in Atlanta ) and Duke University in North Carolina by their renowed Physicians but none could help me. I have had numerous repeated tests/procedures ( LPs ), but still no definite diagnosis. I am waiting to be schedule a PET Scan at Duke, since there will no biopsy because of the site of the Lesion. Please I really need help and someone who can help me will be highly appreciated. Thanks. Kate.
On behalf of the Proton Therapy team --
Yes, you likely would be a good candidate for proton therapy. However, before proceeding with proton therapy, we would ask that you be seen by our neurosurgical team at MD Anderson Cancer Center as well. You can contact the askMDAnderson office at 1-877-MDA-6789 to make an appointment or to speak with someone directly about any additional questions you may have.
Thank you,
Dr. David Grosshans
My brother was diagnosed with small cell lung cancer Feb. 2011 and had chemotherapy and radiation treatment a recent bone scan showed that the cancer had metastisized to his bones. Is he a candidate for proton therapy?
On behalf of the Proton Therapy team --
Mr. Hammoud,
My name is Daniel Gomez, and I am one of the radiation oncologists specializing in lung cancer at the proton center.
To answer your question, generally proton therapy is not utilized in this setting of metastatic small cell lung cancer to the bones. However, if you would like full evaluation of your brother’s case, I would recommend that you contact the proton therapy center directly at: 1-866-632-4PTC, and they will request further information.
Please feel free to ask me any further questions that you may have.
Thanks,
Daniel
My daughter has recently been Diagnosed with Adenoid cystic cancer. I have read that the proton radiation is better for this type. Can you please comment? Thanks
My 81 year old father was recently diagnosed with inoperable pancreatic cancer. We do not know as of yet, if the tumor has spread, etc. Would he be a good candidate for the proton therapy?
Thanks.
Gaylynn
My dad was diagnosed with Stage 4 lung cancer (squamous cell) a couple of weeks ago. He has just finished radiation to the tumor this week...and I just found your site on proton therapy. Is proton therapy a possibility when you have already had previous radiation therapy? Also, can it be used on spots where it has spread?
Thank you,
Shanna
My husband has gone through four different types of chemotherapy and had six weeks of radiation at MD Anderson in August. He has a recurring dendritic follicular sarcoma encapsulated around the portal vein. The center of his tumor died, but the rim remained active. In December, the uptake from the PET scan was 12. Last week, it was 85. Needless to say we were crushed the tumor was growing again. It measures 12.7 cm now. I realize he had an extremely high dose of radiation before, but is the proton therapy in any way a possibility now? Would it be considered too much radiation or is this a different type of radiation we might possibly consider? Thank you so much.
Kim
My husband has been diagnosed with Stage 3-A lung cancer with 2 lymphnodes involved. There appears to be no other metastisis according the PET Scan. Is proton radiation a possiblility for this condition?
My 22 year old daughter has astrocytoma..she has had 2 resections. Her life has not changed much so far, other than afternoon drowsiness from the seizure meds. No radiation or chemo has been used. Could Proton radiation used for her cancer? What other options would MDA offer?
Thanks,
DH
On behalf of the Proton Therapy Team: I'm sorry to hear about your daughter's diagnosis. We have seen great results treating adenoid cystic cancers with proton therapy. I encourage you to contact our Proton Therapy Center at proton@mdanderson.org or 1-866-632-4782 to speak to a member of our staff about your daughter's specific case. You can also learn more about proton therapy at www.mdanderson.org/proton. All the best to you and your daughter. -Steven Frank, MD
I was searching for information and came across your website. My son has a pineal germinoma which was treated with 8 weeks of chemotherapy and then stereotactic radiosurgery. Initially the outcome was good and the tumour shrank to virtually nothing. But a year later it has started to grow again and we have been told that this time it will be much more difficult to treat. Would Proton therapy be beneficial in the treatment of this tumour. We live in the UK but I have heard that proton therapy is going to be introduced to 3 centres here soon.
Thanks,
Suzanne
Hello there,
My 80 year old vivacious father was just diagnosed with cancer. He has two tumors located on the left lung, about 1/2 inch in size. 3 xrays, a CT scan, a biopsy was taken. This Saturday will be the Pet Scan. There is pleural effusion. We are waiting for staging after the PET scan.
Would Proton Therapy help? He is precious and I appreciate any guidance for options that MDA offers.
Many many thanks,
Sharon
Please can you advise, We live in the UK and Proton Therapy is not available. My Husband aged 44 was diagnosed Sept 11 with Stage 4 Colon Cancer with Mets to his Liver and Lungs, his CEA marker at that time was 1052 , six months on that has been reduced now to 29. He has had 12 cycles of Chemo, 5FU plus avastin and early scan results show a reduction in all tumour sites. We await a meeting with our consultant next week to discuss the next treatment plan, my question to you is would Proton Therapy be a viable option for his type of Cancer. Would very much appreciate your reply. Kindest regards.
I was just diagnosed with an optic nerve sheath meningioma. In researching treatment, I came across proton therapy. Is this form of radiation better for treatment than the photon? I am due to see a radiation oncologist and neurosurgeon next week. I have also requested an appointment but would like to know if this is more of the recommended treatment as I begin planning and weighing treatment options.
Thank you for replying!
MD Harris
Hello, Have a quick question. I have just received a diagnosis of non small cell ling cancer-adenocarcinoma two weeks ago. I met with my oncologists and he believes that Tarceva will be the best program. I meet with him on 4-26-12 to review PET scan and discuss dosages, etc. Was wondering if the Proton Therapy might be an effective treatment for my condition? This is all very new to me and am just beginning to search for what treatments are available. Thank you for your time and any information you might share.
Bob Walker
I have been diagnosed with metastasized head and neck cancer. No recurrence in the head neck area. There are two small (7-8mm) lesions on the lung and several small lesions on bones (spine, ribs, scapula, sacrum, pelvis). The one on the pelvis is the only large one at 3cm. Would Proton Therapy be an option?