For Physicians


Proton Therapy is an extremely precise and advanced form of External Beam Radiation Therapy which uses protons, charged particles, rather than photons or x-rays to kill cancer cells. The precision of protons and the lack of exit dose of radiation are extremely advantageous when treating tumors close to vital organs which should be spared from radiation exposure, such as the brain, heart, esophagus, or lungs.

Provision CARES Proton Therapy centers are committed to partner with community physicians and medical professionals to help you identify and refer patients for whom proton therapy will be most beneficial. We understand the numerous and competing demands for time a medical practice has on referring physicians. We strive to make our referral process as efficient and convenient for you and your staff as possible.

Provision CARES Proton Therapy centers are very proud to be among the nation’s most prestigious cancer centers leading the fight against cancer with the most advanced technologies and experienced clinical teams. In addition to other modalities of treatment, our cancer centers are among the limited number of facilities across the country currently able to treat patients with the precision of proton therapy.

Left Breast Treatment Comparison

These dosimetry treatment plans represent an actual patient who presented to the physician team at Provision CARES Proton Therapy Knoxville. The treating physician developed an x-ray (IMRT/VMAT) treatment plan and a proton therapy treatment plan to assess with which modality to treat the patient. When compared, the results highlight the differences in doses of radiation to healthy tissue. Some of these are listed below.

STRUCTURE MEASUREMENT X-RAYS (IMRT/VMAT) PROTONS DIFFERENCE
Left Lung V20 Gy (volume of the lung receiving 20 Gy of radiation) 26.31% 9.4% 2.8 X the radiation with x-rays than protons
V30 Gy 16.84% 3.89% 4.3 X the radiation with x-rays than protons
Mean 13.67 Gy 5.77 Gy 2.37 X the radiation with x-rays than protons
Heart Mean 7.26 Gy 0.08 Gy 90.75 X the radiation with x-rays than protons
LAD (Left Anterior Descending Artery) Max Pointe Dose 41.96 Gy 4.68 Gy 8.96 X the radiation with x-rays than protons

Multiple studies have shown a direct correlation between even small doses of lungs (as low as 5 Gray)12  and disease. These side effects can include radiation induced pneumonitis and the potential for secondary malignancies. Just as critical is radiation to the heart as a study published in the New England Journal of Medicine demonstrated an increase in heart complications at doses as low as 1 Gy with the impact increasing linearly with dose.3

  1. Allen, Aaron M.; Czerminska, Maria, et al. Fatal Pneumonitis Associated with Intensity-Modulated Radiation for Mesothelioma. Int J. Radiation Oncology Biol Phys. 65, No.3, pp. 640-645, 2006.
  2. Yorke, Ellen D.; Jackson, Andrew, et al. Correlation of Dosimetric Factors and Radiation Pneumonitis for Non-Small-Cell Lung Cancer Patients In a Recently Completed Dose Escalation Study. Int J. Radiation Oncology Biol Phys. Vol. 63, No. 3, pp. 672-682, 2005
  3. Darby SC; Ewert DM, et al. Risk of Ischemic Heart Disease in Women After Radiotherapy for Breast Cancer. N Engl J Med. Vol. 368; No. 11; 2013. Pp: 987-998.

Refer a Patient

Our radiation oncologists are happy to discuss your patient with you at any time during or after the course of treatment. We want to foster the best continuity of care possible and facilitate your patient’s transition back into your practice.

Partner With Us

For general information or to learn about our collaborative partnerships, future developments, or investment opportunities, contact us.



A Review of Proton Radiation Therapy and the Path to Widespread Clinical Adoption

A. N. Schreuder, S. G. Hedrick, J. R. Renegar, T. J. Netherton, H. Chen, M. D. Blakey, M. E. Artz, B. H. Robison, A. G. Meek, M Fagundes

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Recent Advances in Clinical Proton Beam Therapy- Exploiting the Benefits of Pencil Beam Scanning

Niek Schreuder. Vice President and Chief Medical Physicist, Provision Health Care

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Which patients would benefit most from proton therapy?

Most solid mass tumors that can be treated with conventional forms of external beam radiation can be treated with proton therapy, however, proton therapy is primarily beneficial to treat solid tumors close to critical structures and vital organs. To learn about the benefits of proton therapy in some of the most common treatment sites, click the links below.

The following list is not comprehensive. If you do not see your patient’s diagnosis listed but still believe proton therapy may be an appropriate treatment, please call the referral line and one of our Care Coordinators will facilitate a records review with our radiation oncologists.

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Pencil Beam Scanning

Provision CARES Proton Therapy cancer centers build on the physical advantages of protons by using pencil beam scanning (IMPT) to further control the accuracy and intensity of proton delivery to tumor sites such as the brain, cancers in children, or the prostate, while minimizing the impact on the patient’s quality of life.

This level of conformality allows even very complex or concave shaped tumors (like those adjacent to the spinal cord or embedded in the head and neck or skull base, especially including nasal and sinus cavities, oral cavity, salivary glands, tongue, tonsils and larynx) to be treated while sparing the most surrounding healthy tissue and organs.

By limiting or eliminating unnecessary exposure to radiation, proton therapy has been shown to decrease secondary, treatment-related cancers.

Patients typically report experiencing a much better quality of life during and after treatment with proton therapy compared to conventional radiation therapy. For example, prostate cancer patients were surveyed on quality of life metrics.

Request Information

For information or to schedule a consultation, contact us to speak with a Care Coordinator.

Partner With Us

For general information or to learn about our collaborative partnerships, future developments, ProNova proton therapy system, or investment opportunities, contact us.