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COVID-Free Clinic

In connection with the spread of the new coronavirus (COVID-19) and in the light of the current situation and information, the Proton Therapy Center has adopted several measures and recommendations in order to protect the safety of our patients and staff.

Thanks to these measures we have promptly introduced, we have been able to continue to operate ensuring optimal continuum of cancer care to adult and paediatric patients worldwide during the COVID-19 pandemic.

🤝 It is prohibited to shake hands due to the risk of transmission of the virus.
🤭 Do not touch your face. Use the disinfectant to clean your hands.
🗣️ Cough or sneeze into your elbow, covering your mouth.
🥵 If you have a fever, call us and let us know before coming to the clinic.
😷 Everyone entering the building is required to wear a mask.
🌡️ Upon arrival to the clinic, patients’ temperature is taken.

It is prohibited to shake hands due to the
 risk of transmission of the virus.
Do not touch your eyes and face. 
Use the disinfectant to clean your hands.
Cough or sneeze into your elbow, 
covering your mouth.
If you have a fever, call us and let us know before coming to the clinic.
Everyone entering the building is required to wear a mask.
Upon arrival to the clinic, patients’ temperature is taken.

Starting March 16, 2020, we have introduced a new system which allows employees to keep a safe distance from each other, a strict hygienic entry regime, and higher level of disinfection of the premises. As an extra precaution, doctors work on rotation in two separate shifts minimising the risk to both medical staff and our patients.

Patients need to follow their appointments schedule strictly, so that the centre is never crowded.

Additionally, in order to meet our commitment and at the same time protect everyone at the Proton Therapy Center (patients and staff), it is necessary that all patients coming from abroad undergo COVID-19 testing. Our treatment coordinators will be happy to help you find the closest clinic to your home.

Patients Coming From Abroad

The first step is to assess suitability for proton irradiation, which you can do remotely from the comfort of your home. This assessment is free and it only takes a few business days.

Should you be suitable for treatment at our facility, we can offer you a remote consultation with one of our oncologists to discuss treatment in greater detail.

Should you decide to go ahead with treatment at our facility, we will provide you with an official document which will allow you to travel.

Although airway transportation is limited, there are some flights coming to Prague. Alternatively, it is possible to reach us by car.

Should none of the options above be suitable for you, we cooperate with Meditrans ambulance service which can transport patients to Prague from anywhere in Europe and UK. Should this be your preferred option, our treatment coordinators will be happy to arrange it for you.

We hope you will appreciate and support our efforts. Only with mutual cooperation the therapy will be safe for you, other patients, and the Proton Therapy Center employees.

We are delighted to say, thanks to the favourable epidemiological conditions in the Czech Republic, the situation will soon return to normal.

We will be happy to provide you with more detailed information. Please do not hesitate to contact us.

Prague Proton Therapy Center and the COVID-19 Crisis – Delivering Advanced Cancer Treatment During Challenging Times

The COVID-19 pandemic has had a massive impact upon health care systems all over the world, hindering cancer diagnoses for millions of patients, and slowing the progress of advanced innovations in care that could improve the lives of future generations.

During these challenging times, the Proton Therapy Center in Prague continues to treat cancer patients from many countries, giving hope to cancer sufferers that may otherwise be unable to access such advanced treatment in their home countries.

Proton Therapy Center in Prague Adapts to the New Normal

Operating a state-of-the-art proton therapy facility in Prague during and after the peak of the COVID-19 crisis in Europe has forced its treatment team to be flexible in response to the unprecedented challenge of the COVID-19 world-wide pandemic.

With the implementation of strict safety protocols and adaptations for patients and staff, our team at the Proton Therapy Center has successfully maintained continuous treatment throughout the pandemic.

To ensure that success, we have instituted many safety precautions, including daily screenings of every staff member, patient, and visitor to the centre; strict enforcement of mask wearing, social distancing, and hand sanitizing; limiting visitors; and frequent alcohol-based cleanings of all treatment and public areas throughout the building.

Our team has also increased its telehealth platform use, in order to reduce the risk of in-person virus transmission. (The rise of telemedicine in fact will likely become one of the defining influences of the pandemic on health care around the world.)

At this time, we continue to be extremely vigilant – in order to create a safe treatment space for our vulnerable cancer patients. The health of our patients is always our top priority, and it remains our plan to keep every safeguard possible in place until the risk of infection finally abates.

The Benefits of Proton Therapy in Prague

Proton therapy has emerged as the most promising advancement for patients with a wide range of cancers.

Compared to traditional (photon) radiation, proton therapy enables more precise targeting of cancers, which results in fewer side effects and improved health outcomes. It has proven highly effective in treating difficult-to-target cancers such as paediatric, head & neck, brain, thoracic, gastrointestinal, and breast tumours.

Proton therapy has been demonstrated to have fewer side effects across many cancers compared to conventional radiotherapy, reducing costly side effects and hospitalisations during treatment. It has also been shown to lead to fewer secondary radiation-induced tumours and better preserves quality of life across several cancers compared with photon therapy.

Cancer survivors are living longer due to effective treatments, and it is more important than ever to preserve quality of life for long-term survivors.

Robust data have emerged over the past decade demonstrating the superiority of proton therapy across numerous individual cancer types. Compared with conventional radiotherapy, proton therapy can:

  • improve overall survival and reduce high-grade complications for head and neck cancers;
  • improve tumour control and survival for base of skull cancers and chordomas;
  • reduce side effects for brain tumours;
  • improve survival for both locally advanced and early-stage lung cancer;
  • improve survival and reduce high-grade complications and costly hospitalisations for oesophageal cancer,
  • improve survival and reduce complications for hepatocellular carcinoma,
  • reduce side effects for pancreatic and gastrointestinal tumours,
  • lead to excellent long-term outcomes with fewer long-term side effects for prostate cancer;
  • reduce acute and chronic lifelong side effects for paediatric cancers; and
  • expand curative options for patients with recurring tumours.

To find out if proton therapy in Prague is appropriate for you or a loved one, please do not hesitate to contact us.

Sources:

Berman AT, Teo BK, Dolney D, Swisher‐McClure S, Shahnazi K, Both S,
et al. An in silico comparison of proton beam and IMRT for postoperative radiotherapy in completely resected stage IIIA non‐small cell lung cancer. Radiat Oncol. 2013;8:144.

Blanchard P, Gunn GB, Lin A, Foote RL, Lee NY, Frank SJ. Proton therapy for head and neck cancers. Semin Radiat Oncol. 2018;28:53–63.

Chang JY, Li H, Zhu XR, Liao Z, Zhao L, Liu A, et al. Clinical implementation of intensity modulated proton therapy for thoracic malignancies. Int J Radiat Oncol Biol Phys. 2014;90:809–18.

Colaco RJ, Hoppe BS, Flampouri S, McKibben BT, Henderson RH, Bryant C, et al. Rectal toxicity after proton therapy for prostate cancer: an analysis of outcomes of prospective studies conducted at the University of Florida Proton Therapy Institute. Int J Radiat Oncol Biol Phys. 2015;91:172–81.

Fagundes MA, Pankuch M, Hartsell W, Ward C, Fang LC, Cahlon O, McNee‐ ley S, et al. Cardiac‐sparing postmastectomy proton radiation therapy for women with stage III, loco‐regional, breast cancer: a dosimetric comparison study. Int J Radiat Oncol Biol Phys. 2013;87:S245.

Gomez DR, Chang JY. Accelerated dose escalation with proton beam therapy for non‐small cell lung cancer. J Thorac Dis. 2014;6:348–55.

Ho JC, Nguyen QN, Li H, Allen PK, Zhang X, Liao Z, et al. Reirradiation of thoracic cancers with intensity modulated proton therapy. Pract Radiat Oncol. 2018;8:58–65.

Hong TS, Wo JY, Yeap BY, Ben‐Josef E, McDonnell EI, Blaszkowsky LS,
et al. Multi‐Institutional phase II study of high‐dose hypofractionated proton beam therapy in patients with localized, unresectable hepatocellular carcinoma and intrahepatic cholangiocarcinoma. J Clin Oncol. 2016;34:460–8.

Huynh M, Marcu LG, Giles E, Short M, Matthews D, Bezak E. Current status of proton therapy outcome for paediatric cancers of the central nervous system—analysis of the published literature. Cancer Treat Rev. 2018;70:272–88.

Jakobi A, Bandurska‐Luque A, Stützer K, et al. Identification of patient benefit from proton therapy for advanced head and neck cancer patients based on individual and subgroup normal tissue complication probabil‐ ity analysis. Int J Radiat Oncol Biol Phys. 2015;92:1165–74.

Leroy R, Benahmed N, Hulstaert F, Van Damme N, De Ruysscher D. Proton therapy in children: a systematic review of clinical effectiveness in 15 pediatric cancers. Int J Radiat Oncol Biol Phys. 2016;95:267–78.

Phan J, Sio TT, Nguyen TP, Takiar V, Gunn GB, Garden AS, et al. Reirradiation of head and neck cancers with proton therapy: outcomes and analyses. Int J Radiat Oncol Biol Phys. 2016;96:30–41.

Takagi M, Demizu Y, Terashima K, Fujii O, Jin D, Niwa Y, et al. Long‐term outcomes in patients treated with proton therapy for localized prostate cancer. Cancer Med. 2017;6:2234–43.

Tai‐Ze Yuan, Ze‐Jiang Zhan, et al. New frontiers in proton therapy: applications in cancers. Cancer Comm. 2019; 39, 1-7.

Taylor CW, Kirby AM. Cardiac side‐effects from breast cancer radiotherapy. Clin Oncol (R Coll Radiol). 2015;27:621–9.

Toramatsu C, Katoh N, Shimizu S, Nihongi H, Matsuura T, Takao S, et al.
What is the appropriate size criterion for proton radiotherapy for hepatocellular carcinoma? A dosimetric comparison of spot‐scanning proton therapy versus intensity‐modulated radiation therapy. Radiat Oncol. 2013;8:48.

Waddle MR, Heckman M, Diehl NN, Stross W, Miller D, Kaleem T, Miller RC, May BC, Peterson JL, Vallow LA, Tzou KS. Survival after proton and photon radiation therapy in patients with head and neck cancers: a study of the national cancer database. Int J Radiat Oncol Biol Phys. 2018;100:1330.

Study Shows Proton Therapy For Prostate Cancer To Be Safe

Researchers at the Willis-Knighton Proton Therapy Center published their latest research results using proton therapy for prostate cancer in the International Journal of Radiation Oncology, Biology & Physics, entitled “Prospective Safety and Patient-Reported Quality-of-Life Outcome for Prostate Cancer Treated with Image-Guided Compact Pencil-Beam Proton Unit“.

The purpose of the study was to evaluate the side effects and patient-reported quality-of-life outcomes for prostate cancer patients treated with advanced pencil-beam scanning proton therapy, the same technology found at the Prague Proton Therapy Center.

The study examined prostate cancer patients treated between 2014 and 2017. These patients were asked to complete quality-of-life (QoL) questionnaires at baseline and subsequently at follow-ups. In addition to this, patient characteristics and tumor histology were obtained by medical chart review.

Urinary symptoms and erectile dysfunction (ED) were assessed and additionally, genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated by physicians according to Common Terminology Criteria for Adverse Events and collected at each follow-up.

A total of 113 patients were involved in the study, and the median patient age was 68.4. Median baseline PSA was 5.9 ng/mL. Median Gleason score was 7.

The most common urinary complaints prior to treatment were increased frequency and urgency, and these symptoms improved after treatment at follow-up. Forty percent (40.3%) reported no/mild ED at baseline. This trended down slightly after treatment but remained stable at follow-ups (28%-32%). The rate of impotence refractory to medication at follow-up was low and similar to that at baseline (3%-6%). Acute grade 2 GU and GI toxicities were 6.6% and 0.8% at the end of treatment.

In conclusion, proton therapy using image-guided, modern pencil-beam proton therapy for prostate cancer was shown to be extremely safe. The use of proton therapy may improve urinary symptoms with minimal impact on sexual QoL in patients with localized prostate cancer.

This study adds to the growing body of evidence supporting the use of proton therapy for prostate cancer. To find out if proton therapy is appropriate for you or a loved one, please contact Proton Therapy UK and the oncologists at the Prague Proton Therapy Center.

Czech Proton Center Physicists Collaborate With Research Partners Across Europe To Improve The Quality Of Proton Therapy Treatment

There is a growing investment in proton and heavy ion therapy worldwide, with 89 proton centers and 12 carbon-ion centers currently in clinical operation. 31 proton centers (about 35%) and four carbon centers (around 33%) are located in Europe. Unanswered questions exist: and these questions range widely in scope and include physical, biological, and societal aspects.

In an article submitted to Medical Physics and Imaging entitled: ‘Mapping the Future of Particle Radiobiology in Europe: The INSPIRE Project’, 30 co-authors – including Marie Davídková of the Department of Radiation Dosimetry, Nuclear Physics Institute of the CAS, Prague, Czech, and Vladimír Vondráček of the Proton Therapy Center Czech – describe the goals of the ‘The INSPIRE Project’. The “Infrastructure in Proton International Research” (INSPIRE) project was created to provide an infrastructure for European research, in order to unify research efforts on the topic of proton and ion therapy across Europe, and to facilitate the sharing of information and resources.

More specifically, this article highlights the radiobiological capabilities of the INSPIRE partners, providing details of physics (available particle types and energies), biology (sample preparation and post-irradiation analysis), and researcher access (the process of applying for beam time). The collection of information contained within this article was created to provide researchers both in Europe and worldwide with the tools required to select the optimal center for their research needs.

The INSPIRE project comprises 17 European partners, 11 of which offer beam time through transnational access. Most of these partners are either clinical centers or have very close connections to clinical centers. ‘Transnational access’ (TNA) provides researchers with an opportunity to access beam time and funding for experiments at INSPIRE partners. The beam time is offered to all researchers and is not limited to INSPIRE partners. Whilst the beam time is largely accessible for European researchers, up to 30% of the hours are available to researchers outside the EU. The application process is managed through the INSPIRE website.

As evidenced by this body of work, it is clear that whilst there are a number of differences between the partners there are also a number of similarities. This allows for investigations into the cause of variance in published radiobiological data, such as the planned joint experiment of the INSPIRE partners.

Efforts are being made to further increase in vivo capabilities, whilst in vitro research is invaluable for identifying and probing mechanisms, in vivo research is crucial for clinical adoption. Also required here is a closer relationship with clinical partners, ensuring clear direction for future research.

A complete list of the INSPIRE partners can be found on the INSPIRE website.

To find out if advanced proton therapy for cancer in Prague is appropriate for you or a loved one, please do not hesitate to contact us.

Nasopharyngeal Cancer Successfully Treated with Pencil-Beam Proton Radiotherapy at the Prague Proton Therapy Center. An Effective Treatment with Less Side Effects.

The Prague Proton Therapy Center Medical Team have released their latest results in treating Nasopharyngeal Cancer with Pencil Beam Proton Radiotherapy, entitled ‘Proton pencil‑beam scanning radiotherapy in the treatment of nasopharyngeal cancer: dosimetric parameters and 2‑year results‘. The article was published in the European Archives of Oto-Rhino-Laryngology and Head & Neck in June 2020.

Radiotherapy plays a crucial role in the treatment of nasopharyngeal cancer. Due to the high curability of nasopharyngeal cancer, the focus is now upon preserving quality of life, particularly in view of this high curability, and the long life spans ahead for patients suffering with these particular forms of cancer. Conventional x-ray/photon radiotherapy for nasopharyngeal cancer can cause side effects such as mucositis, dysphagia, skin reactions, weight loss, xerostomia, hearing loss, necrosis of temporal lobes, cranial nerve injury, optical tract impairment, and pain. Modern conventional techniques can reduce these side effects, however hospital admission is still required during radiotherapy or chemoradiation in 42% of cases. Patients with nasopharyngeal cancer are particularly suitable candidates for the healthy-tissue-sparing benefits of proton therapy, due to the high number of sensitive and critical body structures within immediate vicinity of the malignant spread.

40 patients with Nasopharyngeal Cancer were treated at the Prague Proton Therapy Center between 2013 and 2018 using Proton Therapy Pencil-Beam Scanning technology. The purpose of the study according to the authors is to ‘present the feasibility of Pencil-Beam Scanning proton radiotherapy in the treatment of Nasopharyngeal Cancer, dosimetric parameters, early treatment outcomes, as well as acute and late side-effect profiles.’ The median age of the 40 patients treated was 47. The majority of patients treated had locally advanced tumours, and pencil-beam proton therapy was used to treat the primary tumour and the bilateral neck lymph-node areas. 85% of patients received concomitant chemotherapy. The two year overall survival was 80%. Disease-free survival was 75%, and local control was 84%. Acute toxicity was generally mild despite large target volumes and concurrent application of chemotherapy.

Computer tomography (CT) was utilised for treatment planning and image registrations with planning magnetic resonance and positron emission tomography (PET) with fluorodeoxyglucose scans were performed prior to contouring. The contouring of targets and organs at risk was performed using advanced particle therapy (Elektra AB).

Treatment plans were developed with a full optimisation approach and all patients were treated with a three-field arrangement, chosen to maximise reduction of radiation to healthy tissues. All patients were treated using daily image guidance with position corrections performed via a robotic treatment couch. CT check-ups were conducted once weekly. Check-ups were based on image fusion with the planning CT. New plans were prepared when dose distribution changed due to tumor regression changes in cavity contents or changes in patient contours, and were made on an individual basis.

The median follow-up time was 24 months and all patients were treated without interruption. The two-year overall survival, disease-free survival, and locoregional control were 80%, 75%, and 84% respectively. Acute toxicity was evaluated at the last follow-up visit using the Radiation Therapy Oncology Group (RTOG) scale, and was generally mild. Skin toxicity and dysphagia were reported as the most frequent acute side effects. The insertion of a PEG was necessary in four patients. Late toxicity was extremely low across this patient group.

The 2-year overall survival of patients treated in this study was 80% and is comparable to published data for  nasopharyngeal cancer. The doses used in this patient group were similar to those used for conventional (photon) radiotherapy; therefore overall survival is expected to be similar. Importantly, 65% of the patients treated were referred to the Prague Proton Center with highly advanced tumours that excluded the use of conventional IMRT radiotherapy. This patient group was therefore burdened with a sample selection bias of highly advanced cases. With this sample bias of patients with highly advanced cancer in mind, the results are considered very promising.

In comparison to published late toxicity for conventional photon chemoradiotherapy with respect to xerostomia, hearing impairment, temporal lobe necrosis, auditory/salivary gland/skin/mucositis/oesophagus disturbances, the late toxicity profile in the PTC patient group is so far mild.

This study supports the results of previous research studies demonstrating the effectiveness of proton therapy in treating nasopharyngeal cancer. Patients with nasopharyngeal cancer appear to be suitable candidates for proton radiotherapy, mainly due to the reduction of acute and late side effects. With respect to the published literature, this study is the largest patient population treated with pencil-beam scanning proton radiotherapy to date.

In conclusion, pencil-beam scanning proton therapy for nasopharyngeal cancer patients is feasible with mild acute toxicity. Treatment plan dosimetry is positive and the treatment outcome is promising despite the high number of patients with extremely advanced disease states. The authors conclude that ‘Proton therapy should be considered in young patients or patients with advanced disease close to critical organs at risk of serious toxicity’. To find out if Pencil-Beam Proton Therapy in Prague is appropriate for you or a loved one, please do not hesitate to contact us.

Viktoria’s Germinoma Cancer Journey

Hello world 😊

My name is Viktoria.

I am from Bulgaria and I am 7 years old.

Six months ago I bumped into a world in which there is no difference in age, sex, race or nationality. Into this world we are all equal and each day we are fighting because it is not just a battle but it is a war.

This fight is like a solo sport but so many people help me, some of them I have never had the chance to meet and say thank you.

You are one of them and I want to thank you with all my heart for doing this for me!

P.S. My mam always says that people have good hearts and I believe in that too because of you!

Viktoria Todorova

The Benefits Of Proton Therapy For Childhood Cancers Clearly Acknowledged By Medical Professionals

In a February 2020 study published in the Journal of Paediatric Oncology, the role of proton therapy in treating paediatric cancer was examined across a wide variety of cancer types. This study highlighted that with improved management of the disease, survival rates continue to improve across childhood cancer types. Reducing treatment-related long-term side effects and reducing the risk of secondary treatment-related cancers thus have become a major focus.

The use of proton radiation as medical therapy was first proposed in the 1940s, with the first treatment occurring in 1958. Since then, proton radiotherapy has undergone dramatic changes and has been increasingly sought after in childhood cancer patients with potentially-curable malignant cancers. Real gains in endocrine outcomes, neurocognitive outcomes, quality of life, and other metrics have been reported. For instance through the use of proton therapy, the radiation dose to normal healthy tissues is estimated at 60% lower than with conventional radiotherapy. Additionally, the benefits of proton radiotherapy are now being widely accepted by insurance companies and other health service providers. A survey conducted across 54 proton centres in 11 countries in 2016 estimated that between 2,000 and 2,500 child patients were treated with proton therapy in 2016, a number that has doubled since 2012.

This article highlighted the superiority of proton therapy at treating essentially every form of childhood cancer – from central nervous system cancers such as Medulloblastoma, Ependymoma, Atypical teratoid/rhabdoid tumours, Craniopharyngioma, and CNS germ cell tumours, to non-central nervous system cancers such as Rhabdomyosarcomas, Ewing’s sarcoma, Base of skull chondrosarcoma and chordoma, Hodgkin’s lymphoma, Neuroblastoma, Retinoblastoma, and Osteosarcoma.

Childhood cancers are simply better treated with protons, resulting in less impact on quality of life outcomes, developmental delays, memory impairment, clinically significant endocrinopathy, hearing difficulties, and intelligence quotient (IQ) declines. Additionally, the use of proton therapy was shown to reduce the risk of secondary cancers.

The clinical data now shows that proton radiotherapy is as effective in controlling cancer as conventional radiotherapy, and there is now increasing evidence that the toxicities of proton treatment are also lower. While randomised trials are simply ‘not possible, feasible, or even ethical’ in the United States, other methods of studying patients are being adopted through important registry work both in the United States and abroad.

Further study is essential to continue to improve outcomes in this ‘most deserving’ paediatric population. To find out if proton therapy is appropriate for you or a loved one, please contact Proton Therapy UK and the oncologists at the Prague Proton Therapy Center.

Sources:

Endo M, Robert R. Wilson (1914–2000): the first scientist to propose particle therapy—use of particle beam for cancer treatment. Radiol Phys Technol 2018;11(1):1–6.

Goitein M, Cox JD. Should randomized clinical trials be required for proton radiotherapy? J Clin Oncol 2008;26(2):175–6.

Greenberger BA, Yock TI. The role of proton therapy in paediatric malignancies: Recent advances and future directions. Semin Oncol. 2020 Feb 21. pii: S0093-7754(20)30002-6.

Gross JP, Powell S, Zelko F, et al. Improved neuropsychological outcomes following proton therapy relative to x-ray therapy for paediatric brain tumour patients. Neuro Oncol 2019.

Kahalley LS, Ris MD, Grosshans DR, et al. Comparing intelligence quotient change after treatment with proton versus photon radiation therapy for paediatric brain tumours. J Clin Oncol 2016;34(10):1043–9.

Kahalley LS, Peterson R, Ris MD, et al. Superior intellectual outcomes after proton radiotherapy compared with photon radiotherapy for paediatric medulloblastoma. J Clin Oncol 2019 JCO.19.01706.

Langen K, Zhu M. Concepts of PTV and robustness in passively scattered and pencil beam scanning proton therapy. Semin Radiat Oncol 2018;28(3):248–55.

Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA, editors. SEER Cancer Statistics Review, 1975-2015, Bethesda, MD: National Cancer Institute; 2018.

A Suitable and Effective Treatment Option for Localised Prostate Cancer | Proton Therapy in Japan

There are an estimated 17 million new cases of cancer globally each year. The top four cancers occurring worldwide are lung, breast, bowel, and prostate cancer, respectively. In men, prostate cancer is the most common form of non-skin cancer.

There are a variety of treatment options available when treating prostate cancer, and surgery and radiotherapy are the main treatment options presented to patients. These techniques are, however, associated with sexual, urinary, and bowel-related side effects.

One of the standard treatments for localised prostate cancer is conventional radiation therapy. However, conventional radiation therapy brings considerable acute and late adverse effects to the gastrointestinal (GI) and genitourinary (GU) tract. These side effects continue to be a major concern for both patients and physicians. For instance, in a study conducted by Fiorino et al., the risk of experiencing ≥grade 2 GI and GU side effects is about 5%–20% when undergoing conventional radiotherapy. 

With the materialisation of modern conventional radiotherapy techniques, the risk of toxicity on organs at risk, namely the bladder, rectum, and seminal vesicle, have decreased to 5%–10%. The use of proton beams in radiation therapy further reduces this risk with its characteristic Bragg peak, whereby protons can be controlled to stop directly within the tumour, analogous to its energy.

In order to improve life expectancy and overall quality of life, the Japanese government have applied efforts into funding advanced research for the treatment of cancer, with one such effort being proton beam therapy.

Currently there are 14 proton beam facilities within Japan, and as of April 2018, proton beam therapy for prostate cancer is included in Japanese public insurance coverage, thereby removing the financial burden for patients who will undergo this procedure. The number of patients being treated for localised prostate cancer with proton therapy in Japan continues to increase in popularity, due to its promise as a superior treatment for localised prostate cancer.

In a January 2019 literary review of proton therapy for localised prostate cancer in Japan by Japanese researchers in the Journal of Clinical Medicine, proton therapy for prostate cancer was highlighted as superior to other forms of conventional radiotherapy across multiple studies. The incidence of acute and late toxicities concerning the GI and GU tract, as well as radiation doses to organs of risk such as the bladder, bowel and seminal vesicles, were shown to be significantly lower compared to conventional radiotherapy treatments. Proton therapy has also shown its benefits in patients’ prognosis and quality of life. Biochemical control of patients who completed proton therapy are significantly favourable in prostate cancer patients, including high and very high risk cases. The researchers concluded that proton beam therapy is an effective and suitable treatment option for localised prostate cancer.

To find out if proton therapy is appropriate for you or a loved one, please do not hesitate to contact us.

Resources used:

Cancer Research UK. World Cancer Statistics. Available online (accessed on 12 June 2020).

Fiorino, C.; Sanguineti, G.; Cozzarini, C.; Fellin, G.; Foppiano, F.; Menegotti, L.; Piazzolla, A.; Vavassori, V.; Valdagni, R. Rectal dose-volume constraints in high-dose radiotherapy of localized prostate cancer. Int. J. Radiat. Oncol. Biol. Phys. 2003, 57, 953–962.

Hoshina, R.M.; Matsuura, T.; Umegaki, K.; Shimizu, S. A Literature Review of Proton Beam Therapy for Prostate Cancer in Japan. J. Clin. Med. 2019, 8, 48. 

Sakurai, H.; Ishikawa, H.; Okumura, T. Proton beam therapy in Japan: Current and future status. Jpn. J. Clin. Oncol. 2016, 46, 885–892. 

Takagi, M.; Demizu, Y.; Terashima, K.; Fujii, O.; Jin, D.; Niwa, Y.; Daimon, T.; Murakami, M.; Fuwa, N.;
Okimoto, T. Long-term outcomes in patients treated with proton therapy for localized prostate cancer. Cancer Med. 2017, 6, 2234–2243.

Proton Therapy: An Effective Treatment For Prostate Cancer You Should Insist On

Amongst males in the UK, prostate cancer is the 2nd most common cause of cancer death, with around 12,000 deaths in 2017. Prostate cancer accounts for 14% of all cancer deaths in males in the UK. Prostate cancer patients are usually presented with conventional treatment options such as surgery and conventional x-ray radiotherapy. Another option is proton therapy.

This article will explain why proton therapy in Prague is an effective treatment option for many prostate cancer patients.

The Prostate and Prostate Cancer

The prostate surrounds the urethra and is located beneath the bladder. Cancer begins to develop in the prostate when the cells of the gland begin to grow uncontrollably and form a malignant tumour. Left untreated, prostate cancer can spread to other parts of the body such as the bladder, rectum, bones, and lymph nodes where it can become life threatening.

Modern medicine, however, has made the survival rates of prostate cancer reasonably high.

Common Types of Prostate Cancer

The vast majority of prostate cancers involve adenocarcinomas – these are cancers which develop immediately within the gland cells. It is possible to develop other types of prostate cancer, including:

  • Ductal adenocarcinoma – begins in the ducts of the prostate gland
  • Transitional cell cancer – begins in the bladder and spreads to the urethra, prostate, and nearby tissues
  • Squamous cell cancer – begins in the flat cells of the prostate gland
  • Small cell prostate cancer – a type of neuroendocrine cancer made up of round, small cells

Risk Factors and Prevention

Risk factors such as age, ethnicity, and family history have been known to influence the chances of an individual’s chance of developing prostate cancer. Individuals over the age of 50 are more likely to develop prostate cancer.

A family history of prostate cancer can have an impact on your chances of developing cancer. Only 5% of prostate cancer cases are inherited, but up to 20% of cases are familial, meaning common lifestyle factors and shared genes may have had an influence on the development of cancer.

To lower your risk of developing prostate cancer, it’s recommended to eat a low-fat diet and exercise regularly. However, it’s best to monitor your health by receiving routine checkups and prostate screenings (such as the PSA blood test) from your doctor.

Proton Treatment for Prostate Cancer Patients

Also known as proton beam therapy, proton therapy involves the focusing of proton particles into a beam, which is then delivered to the cancer cells in a non-surgical procedure. The positively charged particles can be controlled to stop at the tumour site, enabling the cancerous tissues to be destroyed with high levels of radiation without causing damage to near healthy tissue and vital organs.

Proton therapy is considered more accurate than other types of radiation therapy, and also non-surgical and noninvasive with minimal side effects. What’s more, the treatment requires little to no recovery time, nor does the radiation have an impact on the patient’s energy levels in comparison to other cancer treatment options. Those who choose proton therapy experience fewer complications than those who choose other types of treatment such as surgery or conventional x-ray radiation.

Proton Therapy vs. Conventional Radiation Therapy

Unlike proton therapy, conventional radiation treatments use x-rays to deliver radiation to the cancerous tumour. Unfortunately, these x-rays cause damage not only to the cancerous tissue, but also the surrounding healthy tissue. Proton therapy uses positively charged subatomic particles called protons. Unlike conventional radiation therapy, the clinician can use the proton beam to target the cancer cells in the body specifically, allowing for a more successful and far less damaging procedure.

Proton Therapy Shown to Enhance Quality of Life

According to an American national survey, those who received proton therapy to treat prostate cancer reported experiencing a better quality of life involving urinary and bowel function during and after their proton therapy treatments, in contrast to patients who received x-ray radiation treatments. More than 70% of prostate cancer patients who received proton therapy additionally noted that the treatment had no impact on their quality of life overall.

Proton Therapy Success Stories

It’s one thing to hear about the success rate of proton therapy treatment for those with prostate cancer in comparison to conventional treatments. It’s another thing to hear the success stories straight from those who have survived and continue to survive today. To learn more about the experiences of others who underwent proton therapy in Prague, click here.

Proton Therapy has the Potential to Reduce the Risk of Long-Term Medical Problems Associated with Anal and Rectal Cancer Treatments

Proton beam Therapy (PBT) is increasingly used for the treatment of paediatric, central nervous system, skull base, and head and neck tumours. Today, there are over 75 particle therapy facilities in operation worldwide, with more in development. Whether proton therapy can play an important role as well in the treatment of anal and rectal cancer is under active investigation.

Anal and rectal cancers are surrounded by radio-sensitive organs, limiting the treatment options available to medical practitioners responsible for treating these forms of cancer. Proton radiotherapy has the potential to remove these limitations, and could be used to treat certain rectal and anal cancers with greater efficacy than conventional radiotherapy.

In a study published by medical researchers at the Harvard Medical School, the potential use of proton therapy was shown to reduce toxicities associated with treatment, increase patient compliance with treatment, minimise treatment interruptions and enables for the possibility of dose escalation (also known as hypofractionation).

The authors observe that currently, “… the maximal efficacy of radiation plans for primary and recurrent anorectal cancer is constrained by delivery techniques and modalities which must consider feasibility challenges and toxicity secondary to exposure of organs at risk.”

Given the minimal difference in biological effect between both protons and x-ray radiotherapy modalities, protons have drawn interest as a way of sparing adjacent organs at risk from unnecessary radiation, while delivering “tumoricidal” doses, and increasing the therapeutic effect of treatment.

Researchers are highly optimistic about proton therapy as an effective treatment for anal and rectal cancers (especially as intensity-modulated proton therapy and pencil-beam scanning techniques become more prevalent). Additionally, decreased doses to bone marrow and bowel may “improve tolerance of multi-modal treatment” and allow for dose escalation, in turn improving clinical and patient-reported outcomes.

In summary, proton therapy has the potential to more effectively treat anal and rectal cancers. Proton therapy can result in less short- and long-term side effects, and due to its precision, allows for dose escalation (hypofractionation), thereby increasing the chance of completely eliminating the disease.

To find out if proton therapy is appropriate for you or a loved one, please do not hesitate to contact us.

Sources:

Colaco RJ, Nichols RC, Huh S, et al. Protons offer reduced bone marrow, small bowel, and urinary bladder exposure for patients receiving neoadjuvant radiotherapy for resectable rectal cancer. J Gastrointest Oncol 2014;5:3-8.

Raldow AC, Hong TS. Will There Be a Clinically Significant Role for Protons in Patients With Gastrointestinal Malignancies? Semin Radiat Oncol 2018;28:125-30.

Verma V, Lin SH, Simone CB, et al. Clinical outcomes and toxicities of proton radiotherapy for gastrointestinal neoplasms: A systematic review. J Gastrointest Oncol 2016;7:644-64.

Vaios EJ, Wo JY. Proton beam radiotherapy for anal and rectal cancers. J Gastrointest Oncol. 2020;11(1):176‐186. doi:10.21037/jgo.2019.04.03

Wolff HA, Wagner DM, Conradi LC, et al. Irradiation with protons for the individualized treatment of patients with locally advanced rectal cancer: A planning study with clinical implications. Radiother Oncol 2012;102:30-7.