Understanding Proton Therapy: Benefits, Applications, and Costs

Proton therapy is expected to be the next big thing in the future of medical science. The advanced mode of treatment deserves all the hype it garners as it is the result of intense research and thorough study of innumerable researchers and doctors all across the globe. The concept of proton therapy was proposed by Robert Wilson in the year 1946. The implementation of the procedure was however kept on hold till the early 1950s when some clinics dared to pursue a trial on some brain cancer patients and eye anomalies. It uses cyclotron technology to target the affected part with high focus and cause maximum damage and destruction without harming the neighboring tissues. A cyclotron is a particle accelerator where the acceleration of charged particles is caused so that the particles speed outwards from the source by following a spiral path.

Ever since then, the procedure has been implemented on nearly two lakhs of people, among which 170,00+ candidates have been successfully cured with the procedure. A high proportion of the candidates belong to the United States alone where almost 75000 candidates have been successfully treated by the therapy. The success rate of proton therapy is a record-breaking 93.25% which is downright impressive. The therapy is highly appreciated by eminent doctors, surgeons, and radiologists owing to its seamless mode of operation and high accuracy. Researchers are constantly trying to make the best out of the procedure so that it can be made both affordable for the common people as well as widely implemented for some diseases. In recent decades, proton therapy is expected to emerge as a breakthrough for many conditions and diseases.

Understanding Proton Therapy: A Targeted Approach to Treatment

Better explained as proton beam therapy, the procedure in simple terms, is a focused beam of protons used for destroying the growth of unwanted cells that cause tumor formation. Overgrowth or uncontrolled growth of cells causes the formation of tumors that might be benign or malignant. Proton therapy is used as a replacement for X-Ray therapy and is included as one of the most promising forms of radiation therapy. The procedure implements the usage of the proton and focuses it. Thus, a beam of high energy is concentrated into a target place. In medical science, the positive charge photons are focused onto the target tumor which leads to its destruction. Proton therapy is mostly implemented as an advanced mode of cancer treatment. The use of ionization therapy has thus proved to have high accuracy than the previous modes of radiation therapy.

Since the therapy uses highly focused beams, it is used to treat such tumors that are difficult to access. The tumors which are mostly diagnosed in junction with nerves or major organs and need extreme precision are mostly treated with proton therapy. Thus, some of the cases where proton therapy is highly implemented are:

• Pediatric Care
• Skull Cancer (cancer on the basal side)
• Brain Tumors
• Neck Tumor
• Breast Cancer (left-side)
• Prostate Cancer
• Lymphatic Tissue Tumor
• Prostate Tumor
• Hepatocellular Carcinoma
• Gastrointestinal Malignancy
• Reirradiation of Recurrent Cancer

How does it work?

Proton therapy offers an upgraded approach over the traditional photon therapy implemented otherwise. The procedure is preferred over other procedures because of the characteristics of the protons which gives a clinical advantage. The protons can be medically manipulated to achieve distinct dosages to the candidate. Manipulation of the dosages is very important as every tumor expresses different requirements and needs to be treated differently. For example, the dosages for the same tumor are different and need to be manipulated as per the target, distal or proximal.

In this type of external beam radiotherapy, the surgeon shall use a particle accelerator to target the tumor with the high-energy beam. The proton beams are sent via a machine that is meant for emitting radiation beams. The beams penetrate through the skin and hit directly at the target position, ensuring tumor destruction. Along with this, the area surrounding the tumor also gets destroyed, which is ideal for containing the overgrowing mass to a specific area. Destruction of the area around the tumor also ensures that the tumor will not spread and the major organs will be saved from any further damage.

This has become possible due to the unique nature of the protons interacting with masses inside the human body. Proton interaction inside the human body portrays a curative solution by concentrating the energy and manipulating the dosages so as to achieve lesser complications and better results.

Conditions for which Proton Therapy is used

Proton therapy is still a subject of research. Even though it has shown immense success in the trials, it is still being researched intensively by researchers all around the world. The implementation of the procedure, however, needs supreme supervision as it involves an extremely high-energy beam for the destruction of cells. Any deviation or any kind of anomaly shall result in complications and irreplaceable damage. Thus, certain conditions should be taken into consideration. The proton therapy is thus suggested in the following cases:

• When the tumor is detected in any part of the nervous system, treating it with a conventional method involves immense risk and is life-threatening in most cases. Thus, to treat it better, the tumor can be destroyed with the help of proton therapy in a seamless way.
• When the tumor clings to a major organ. Many times, tumors (benign or malignant) are detected in the brain or heart, or lungs, in which case operating or performing other forms of radiotherapy becomes challenging. In such cases, proton therapy is highly suggested as an alternative.
• Eye tumors or malignant lesions can be treated with proton therapy. Operations performed inside the eye involve the risk of rendering the candidate partially or completely blind, in which case, implementing proton therapy gives an easier alternative for both the surgeon and the candidate.
• Proton therapy is also preferred over other conventional methods in case the candidate is diagnosed with breast cancer on the left side. This is because operating on the left side of the breast will pose a serious threat to the nerves and major arteries of the heart and the lungs.

Apart from this, the surgeons have to be extremely careful in choosing the candidate, whether the procedure deems fit or not. The procedure can be performed on candidates in conjunction with other surgical procedures as well. However, for this, the candidate needs to lay still for 30 minutes during which the beam will be focused on the individual to destroy the cells and the tissues as required. Besides, the candidate needs to be thoroughly tested for underlying medical conditions that do not interfere with the therapy or create future complications. Although there are very few cases of side effects, yet, every possibility for the same should be ruled out.

Inside the Treatment: A Look at Proton Therapy Sessions

Though the procedure has high success rates, every candidate willing to undergo the procedure should be aware of complete information regarding the procedure as well as how it is going to affect the person undergoing the procedure. One must thoroughly consult the surgeon to understand the risks that might be involved (if any) and the possible follow-up care that will be necessary. The candidate must also understand that irrespective of the efforts, expenditure, time, and exhaustion, the treatment might not yield a completely satisfactory results. Post-procedure result highly depends on the condition of the individual as well as the lifestyle and follow-up care undertaken by the candidate.

A standard proton therapy procedure is performed for a period of five to eight weeks. However, depending on the tumor being treated, the treatment may proceed for at least two weeks or extend for more than eight weeks. The therapeutic procedure of proton beam therapy is counted as an outpatient service which is provided to the candidates approximately five days every week. The number of days the candidate is exposed to the therapy may also vary from person to person as it depends on the tumor and the extent to which it is showing growth.

The procedure of Proton Therapy is divided into three sessions which include:

• Stimulation Session: Where the candidate is prepared for the therapy. This included diagnosis and 3D and 4D imaging scans to study the shape, size, and position of the tumor.
• Treatment Session: During this, the initiation of the treatment begins. The candidate is scheduled to have one treatment every week. The side effects are very less which means, the candidate can get back to work after an hour of rest.
• Proton Therapy: The candidate is made to lie down on either the Rotating Machine or the Fixed Machine, where the candidate is exposed to the accelerated high-energy beam. Though the treatment lasts approximately for a minute or more, preparing the candidate takes the rest of the time.

Global Cost Comparison: Where to Find Affordable Proton Therapy

Though proton therapy has been gaining ground all over the world, the major issue with availing of the procedure is the cost. No matter how effective the procedure is, not many people can avail of the treatment due to the high cost of treatment. On average, proton therapy cost has been estimated to be between $30,000 to $120,000. Many people resort to alternative radiotherapy methods for two reasons: one involves the lack of exposure to the benefits of the process, and the other is difficulty in affording the procedure. However, the therapy may be covered by some medical insurance, which implies, that if the candidate has specific insurances that cover the expenses, availing of the procedure becomes much easier.

The reason for such expense is fairly explainable once we understand the amount of investment it requires for a clinic to install the treatment facility. The clinic or the multispecialty hospital is required to have the necessary infrastructure to house such an extensive procedure, and thus, has to be planned accordingly. Apart from this, the device and the machinery required to project the therapy, along with necessary precautions, is also expensive as in most countries it needs to be imported from the United States. Overall, the expenditure involved in equipping as well as establishing a suitable therapy center ranges from about $25 million to about $200 million. This is also the reason, why most of the clinics and most of the countries prefer other radiation therapies over proton therapy, which makes the procedure less frequently available. However, some of the developed countries as well as the developing countries have come up with lucrative options that are enough to lure suitable candidates to avail themselves of this miraculous procedure. Among them, India, Turkey, Spain, Switzerland, Lithuania, Singapore, and Malaysia top the list. Thus, here is a brief insight on the proton therapy cost one has to incur in different countries all around the world:

Countries	Cost in USD
Cost in India	70,000
Cost in Turkey	425,000
Cost in Spain	380,000
Coost in Switzerland	151,026
Cost in Lithuania	361,000
Cost in Singapore	375,000
Cost in Malaysia	87,000

 

Which are the best hospitals that offer Proton Therapy?

The success of proton therapy largely depends on the hospital chosen for the treatment. Some hospitals may charge high fees but compromise on the quality of care due to inadequate facilities. However, several globally recognized hospitals are known for providing excellent medical care and adhering to the necessary protocols to ensure a high success rate for proton therapy. Here are some of the top hospitals offering proton therapy:

• MD Anderson Cancer Center, USA
• Mayo Clinic, USA
• University of Pennsylvania Health System, USA
• Institut Curie, France
• University Hospital Zurich, Switzerland
• National Cancer Center Hospital, Japan
• Royal Marsden Hospital, UK
• Singapore General Hospital, Singapore

These institutions are renowned for their state-of-the-art facilities, experienced medical staff, and adherence to rigorous treatment protocols, making them top choices for proton therapy.

Who are the best medical specialists who can perform Proton Therapy?

Proton Beam Therapy though seems simple, is a complex process and requires a lot of expertise. Thus, finding the right doctor is equally important as it is finding the right hospital. Such specialists are well-trained to understand and distinguish the candidate’s requirements. This is an important step as every candidate will be requiring a specific mode of treatment and the surgeon has to well-curated the therapy before proceeding with it. Thorough diagnosis and in-detail study of the condition of the patient also need to be understood before deciding the extent of the procedure. This is done to prevent any chance of future complications. Thus, here are some of the best medical specialists who can perform proton therapy and have been graced with high success rates:

• Safia K. Ahmed, M.D.
• Samir H. Patel, M.D.
• William G. Rule, M.D.
• C. Richard Choo, M.D.
• Aman Anand, Ph. D
• Lauren A. Dalvin, M.D.
• Paul D. Brown, M.D.
• Brian J. Davis, M.D. Ph. D.
• Jean Claude M. Rwigema, M.D.
• Jiajian Shen, Ph.D.

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