Gastrointestinal Cancers

Proton Therapy for Gastrointestinal Cancers

Gastrointestinal tract cancer, also called GI cancer, refers to cancers which occur anywhere within the digestive tract, such as the esophagus, stomach, pancreas, liver, colon, rectum and anus. GI cancers can be challenging to treat due to their location close to sensitive structures. Typically, a combination of treatments is used to treat GI tumors including surgery, chemotherapy, and radiation therapy.

The precision of proton therapy allows physicians the flexibility to treat tumors with higher doses of radiation while keeping healthy surrounding tissue out of the radiation fields. This reduction in dose to critical structures can result in reduced side effects.

The GI tract tumors most appropriate for proton therapy include:

  • Anal Cancer
  • Esophageal Cancer
  • Gastric Cancer
  • Liver Cancer
  • Pancreatic Cancer
  • Rectal Cancer

Symptoms of Liver Cancer

  • Weight loss (without trying)
  • Loss of appetite
  • Feeling very full after a small meal
  • Nausea or vomiting
  • An enlarged liver, felt as a mass under the ribs on the right side
  • An enlarged spleen, felt as a mass under the ribs on the left side
  • Pain in the abdomen or near the right shoulder blade
  • Swelling or fluid build-up in the abdomen
  • Itching
  • Yellowing of the skin and eyes (jaundice)

Symptoms of Rectal Cancer

  • Change in bowel habits – Constipation, diarrhea, and bowel incontinence, although usually symptoms of other, less serious, problems, can also be a sign of colorectal cancer.
  • Blood on or in the stool
  • Unexplained anemia
  • Unusual stomach or gas pain
  • Unexplained weight loss
  • Fatigue
  • Vomiting

Symptoms of Anal Cancer

  • Rectal bleeding
  • Rectal itching
  • A lump or mass at the anal opening
  • Pain or a feeling of fullness in the anal area
  • Narrowing of stool or other changes in bowel movements
  • Abnormal discharge from the anus
  • Swollen lymph nodes in the anal or groin areas


As with many cancers, GI cancers may be detected through various imaging tests, including ultrasounds, computerized tomography (CT) scans and magnetic resonance imagining (MRI). Physicians may take bloodwork for lab tests. Scopes may be used by a physician, usually a Gastroenterologist, to look inside the esophagus or colon in procedures such as endoscopy, esophagogastroduodenoscopy, colonoscopy, or sigmoidoscopy. A physician may complete a biopsy as well, which involves the removal of a tissue sample that is then examined for the presence of cancer.


Cancers of the GI Tract are often treated with a combination of modalities including surgery, chemotherapy, and radiation. Proton therapy can be an excellent non-invasive option and provide superior treatment plans to conventional radiation.
In many cases, due to its ability to target only the tumor site and avoid exposing healthy surrounding tissue to unnecessary radiation, proton therapy allows physicians to treat tumors that would not otherwise be possible. The precision of proton therapy can treat the tumor but stop radiation from reaching sensitive organs such as your bladder, bowel, small intestine, stomach, spinal cord, and kidneys. This means less likelihood of side effects like nausea, cramping, dehydration, inability to absorb nutrients from your food, diarrhea etc.

Clinical Benefits of Proton Therapy for Esophageal Cancer

10% increase in overall survival at 5 years in stage I-III disease1

10% increase in local cancer control at 5 years in stage II-III1

15% decrease in distant metastasis at 5 years in stage II-III1

26% reduction in pulmonary toxicity compared with X-ray therapy (IMRT)2

21% reduction in the risk of severe, treatment related lymphopenia, particularly in lower esophagus3

3-4-day reduction in average hospital stay after surgery4

Sources and Studies:

1.Comparative Outcomes After Definitive Chemoradiotherapy Using Proton Beam Therapy Versus IMRT for Esophageal Cancer: A Retrospective, Single-Institutional Analysis. Read More

2.A Multi-Institutional Analysis of Trimodality Therapy for Esophageal Cancer in Elderly Patients. Read More

3.Lymphocyte-sparing Effect of proton therapy in patients with esophageal cancer treated with definitive chemoradiation. Read More

4.Multi-institutional analysis of radiation modality use and postoperative outcomes of neoadjuvant chemoradiation for esophageal cancer. Read More

Clinical Benefits of Proton Therapy for Rectal/Anal Cancers

More than 50% reduction in radiation dose to critical structures including bone marrow.1

Sources and Studies:

1.Scanning proton beam therapy reduces normal tissue exposure in pelvic radiotherapy for anal cancer. Read More

Clinical Benefits of Proton Therapy for Liver Cancers

Associated with excellent local control and favorable survival rates.1

Able to treat larger tumors (>6cm) ineligible for stereotactic radiation (SBRT) or ablation.1

Sources and Studies:

1.Multi-Institutional Phase II Study of High Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma. Read More

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