New study shows lung cancer proton therapy may reduce risk of heart disease

New study suggests proton therapy for lung cancer lowers risk of heart disease

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When treating lung cancer with radiation therapy, there is a significant concern that the treatment dose will expose the heart to excess radiation. One way to avoid this unnecessary radiation is by using proton therapy, a more precise form of radiation therapy as compared to traditional radiation therapy (x-rays/photons).

Researchers now say there is a link between lung cancer proton therapy and a reduced risk of certain heart diseases, including mini-strokes and heart attacks.

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Proton therapy cancer treatment significantly lowers the risk of second cancer compared to IMRT and 3DCRT

Proton Therapy significantly lowers risk of second cancer

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X-ray (also called photon) therapy has long been known to cause the development of potentially deadly new cancers in patients who undergo radiation therapy to treat their cancer. However, research shows that patients who choose proton therapy for cancer treatment have a significantly lower risk of developing a second cancer later in life.

In a  comprehensive study published last month in Cancer, the prestigious, peer-reviewed journal of the American Cancer Society, researchers at Stanford University found that patients who were treated with x-ray therapy developed more than three times as many new cancers as patients treated with proton therapy.1

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Research shows liver cancer proton therapy can help improve survival rate

Liver cancer patients may benefit from advantages of proton therapy

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Liver cancer proton therapy can improve the overall survival rate for patients, according to a new study. This good news for proton advocates comes on the heels of another study identifying predictors to help reduce liver damage from radiation, which could give doctors better insight when determining a patient’s treatment plan.

In a news release from the American Society for Radiation Oncology (ASTRO), Laura Dawson, MD, President-elect of ASTRO and a professor of radiation oncology at the Princess Margaret Cancer Center in Toronto, remarked on the promise this shows for patients with hepatocellular carcinoma, an often fatal type of liver cancer. “There is hope for patients with liver cancer, with more treatments becoming available in recent years,” said Dawson. “These studies show that protons, like photons, may be used to treat patients with HCC with a high rate of tumor control and a reduced risk of adverse effects.”

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proton therapy for breast cancer treatment

Proton Therapy for breast cancer treatment ‘safe and effective’ concludes new study

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Proton therapy for breast cancer treatment is “safe and effective.” That’s the conclusion of a new study released in the Journal of Clinical Oncology, which highlighted proton therapy’s ability to control cancer cells with much less toxicity in the heart and lungs as compared to conventional (x-ray) radiation therapy.

“In our prospective trial of women with locally advanced breast cancer who required treatment of the internal mammary nodes, proton beam radiation therapy was safe and effective,” says Shannon M. MacDonald, MD, of Massachusetts General Hospital in Boston, and colleagues.

Breast cancer tumors usually occur in the lobules and ducts of the breast, which are used in the production and delivery of breast milk. Breast cancer is the most common cancer among women aside from skin cancer. Men are also susceptible to breast cancer, although the disease is rare among males.

As with other cancers, the best possible outcomes for breast cancer treatment come through early breast cancer care. Proton therapy has unique attributes that reduce radiation exposure to normal, healthy organs3,4. This is especially important in left-sided, node positive breast cancer patients (those who need the internal mammary nodes irradiated), as the cancer is close to critical organs such as the heart and the lungs.

How Massachusetts General Hospital conducted the study

Researchers enrolled 70 prospective patients with nonmetastatic breast cancer who required radiation therapy to the chest wall and regional lymph nodes. The average age of enrollees was 45, with patients ranging from 24 to 70 years old. The vast majority (91%) of evaluable patients had left-side breast cancer, and all but four patients had stage II-III disease. Only one patient did not receive chemotherapy in conjunction with proton radiation therapy.

The study, which lasted from 2011 to 2016, specifically chose patients whose treatment would include irradiation of the internal mammary nodes (IMNs). This made them suboptimal candidates for conventional radiation therapy, since exposure to the IMNs would also increase radiation to the heart and lungs. According to the study’s authors, that has been associated with an increased risk of cardiac events.

The benefits of proton therapy, however, significantly reduce exposure to the heart and lungs. It’s an advanced form of radiation therapy that precisely targets a tumor using a single beam of high-energy protons to kill cancer cells. Unlike conventional photons, which have almost no mass and extend beyond a tumor through the body, protons are relatively heavy and will hit their target – then stop. This spares nearby healthy tissues and organs from receiving unnecessary radiation.

Summary of the study’s results

Proton therapy for breast cancer treatment received high marks from this study. Of the 69 evaluable patients, the 5-year cancer recurrence rate was just 1.5% and the 5-year overall survival rate was 91%. Those positive results go hand-in-hand with low rates of severe side effects. Study authors reported no patient developed grade 3 pneumonitis (inflammation of the lungs) or grade 4 or higher toxicity in the lungs. They also reported no significant changes in cardiac function or key cardiac biomarkers.

Dr. MacDonald and colleagues concluded that “Proton beam radiation therapy (RT) for breast cancer has low toxicity rates and similar rates of disease control compared with historical data of conventional RT.”

Dr. Ben Wilkinson, MD, FACRO, Radiation Oncologist and Medical Director at Provision CARES Proton Therapy Knoxville says the findings of this study support the success he’s seen at Provision.

“Among mostly young women with left-sided breast cancer receiving regional nodal irradiation, proton therapy produces excellent target coverage with miniscule cardiac doses and low rates of lung toxicity,” Dr. Wilkinson says about the study’s conclusion. “When we treat breast cancer, those lymph nodes run very close to the heart. Proton therapy allows us to deliver the dose to the tumor site and spare the surrounding area – the heart, lung, chest wall, and even the esophagus.”

What’s next for proton therapy research?

The authors of the study from Massachusetts General Hospital say their findings open the door for more extensive studies in the future. “No early cardiac changes were observed,” they note, “Which paves the way for randomized studies to compare proton beam radiation therapy with standard radiation therapy.”

In fact, the results of the study bode well for a more comprehensive trial already underway to compare proton therapy with conventional x-ray therapy. The Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial, which began in 2016 and will continue until at least 2022, is being conducted by the University of Pennsylvania, in conjunction with the Patient-Centered Outcomes Research Institute.

According to the U.S. National Library of Medicine, it is a pragmatic randomized clinical trial of patients with locally advanced breast cancer. More than 1,000 patients will be randomly assigned to receive either proton therapy or x-ray therapy. Each patient will have a 50-50 chance of getting into either treatment group. Both groups will be followed for at least 10 years after completing radiation therapy. The trial’s ultimate goal to is to study the patients’ quality of life outcome to help decide which is the best treatment option for future patients with breast cancer – proton therapy or x-ray therapy.

The Benefits of Proton Therapy for Breast Cancer Treatment

Proton therapy shows remarkable promise and advantages over conventional therapy in the treatment of breast cancer. It is a type of radiation that stops at a very specific point in the targeted tissue; conventional radiation continues beyond the tumor. In breast cancer, this means on average no radiation to the heart and on average 50% less radiation to the lung5 as compared with conventional radiation.

Proton therapy is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. It is not a substitute for a lumpectomy. Rather, it is used as an alternative to conventional radiation therapy. After surgery a breast cancer patient may receive 2-6 weeks of proton therapy.

Sources:

  1. Phase II Study of Proton Beam Radiation Therapy for Patients with Breast Cancer Requiring Nodal Irradiation. Journal of Medical Oncology
  2. Pragmatic Randomized Trial of Proton vs. Photon Therapy for Patients with Non-Metastatic Breast Cancer: A Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial. ClinicalTrials.gov
  3. MacDonald S, Specht M, Isakoff S, et al. Prospective pilot study of proton radiation therapy for invasive carcinoma of the breast following mastectomy in patients with unfavorable anatomy – first reported clinical experience. Int J Radiat Oncol. 2012;84(Suppl 3):S113-S114. Abstract 281
  4. Moon SH, Shin KH, Kim TH, et al. Dosimetric comparison of four different external beam partial breast irradiation techniques: three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, helical tomotherapy, and proton beam therapy. Radiother Oncol. 2009;90:66-73.
  5. Early Toxicity in Patients Treated with Postoperative Proton Therapy for Locally Advanced Breast Cancer. U.S. National Library of Medicine, National Institutes of Health

 

Proton therapy for treating left-sided breast cancer plays a crucial part in sparing damage to your heart.

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As with other cancers, the best possible outcomes for breast cancer treatment come through early breast cancer care. However, if breast cancer is diagnosed, treatments can include chemotherapy, hormone therapy, targeted therapy, surgery, and radiation. As there is not one perfect formula to eliminate the disease, many patients will need to undergo a combination of these treatment methods.

When it comes to radiation therapy, it is important to know your options and which type of radiation treatment is best for you.

Proton therapy is an advanced form of radiation therapy that is noninvasive and precisely targets your tumor using a single beam of high-energy protons to kill cancer cells. Proton therapy’s unique characteristics as a positively charged particle can precisely deposit radiation directly in the cancerous tumor with no exit dose. Both x-rays and protons damage cancer cells, but unlike standard radiation therapy, proton therapy deposits the majority of the radiation dose directly into the tumor. This spares nearby healthy tissues and organs from receiving unnecessary radiation, thus reducing damaging side effects and complications, compared to conventional radiation.

This is especially important in left-sided breast cancer, as the cancer is close to critical organs such as the heart and the lungs.

According to research published in JAMA Internal Medicine, women who have received breast cancer radiation treatment via x-rays face a 0.5% to 3.5% higher risk for heart attack or other cardiovascular issues. The risk is highest among women who’ve had conventional radiation to the left breast because of the target’s close proximity to the heart.

A European study in The New England Journal of Medicine revealed that the harmful cardiovascular effects typically begin to emerge as soon as five years after cancer radiation treatment.

With proton therapy treatment for breast cancer, on average, there is no radiation to the heart and 50% less radiation to the lung as compared with conventional radiation.

Furthermore, a 2014 clinical trial by Loma Linda University found that 90% of proton therapy cases result in “good: to “excellent” cosmetic result for partial breast radiation patients during the five years following treatment.

Proton therapy is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. Proton therapy is not a substitute for a lumpectomy and works with other modalities such as chemo-therapy and surgery. Rather, it is used as an alternative to conventional radiation therapy. After surgery a breast cancer patient may receive 2-6 weeks of proton therapy.

For left-sided breast cancer patients, this could be the key to a healthier life after treatment.

Experts Agree: Proton Therapy is an Excellent Choice for Treating Pediatric Cancers

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The American Society for Radiation Oncology (ASTRO), the world’s premier organization in Radiation Oncology, states that “solid tumors in children are considered among the highest priority for proton therapy”in its Model Policy.  Based on this prioritization, a group of 24 internationally recognized leaders in the various specialties in oncology, convened in 2015 to define proton therapy’s role in pediatric cancers, identify which cases yield the most benefit from a limited resource, and set priorities for future development in the field.

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Proton Therapy: The Successful Treatment For Prostate Cancer You Should Be Getting

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Prostate cancer is the second most common cancer in American men after skin cancer. Approximately one out of every nine men will be diagnosed with prostate cancer at some point during their life. However, it’s rare for those who are younger than 40 to develop prostate cancer. Nearly 6 out of 10 prostate cancer patients diagnosed are over the age of 65. In this article, we’ll explain why proton therapy is an ideal treatment option for many prostate cancer patients.
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Latest research shows benefit of proton therapy for children with head and neck cancer

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Thousands of cancer patients have and could benefit from proton therapy, and children definitely top the list.

This week, exciting news has emerged from the renowned Children’s Hospital of Philadelphia confirming that proton therapy effectively treats pediatric cancers of the head and neck and reduces the side effects often experience with conventional radiation treatment.

It’s one more step toward growing and full recognition of proton therapy in the medical community as a state-of-the-art treatment option for cancer. (more…)