Are you facing radiation?
Radiation therapy is a long-standing breast cancer treatment with proven success. According to the National Cancer Institute, about 43 percent of women diagnosed with invasive breast cancer (as well as the vast majority of women diagnosed with a non-invasive breast cancer — ductal carcinoma in situ, or DCIS) undergo a lumpectomy (breast conservation surgery) followed by radiation.
Typically, radiation is given five days a week over a period of five to seven weeks. The breast and/or underarm is treated with high-energy X-rays (a.k.a. photon therapy) designed to wipe out any stray cancer cells not excised by the surgeon’s scalpel.
Radiation, though it’s been used successfully for years, isn’t without its side effects. Some women suffer lung damage or permanent breast size decrease. Most women experience soreness (think sunburn) and acute fatigue within days and months of treatment.
These side effects come from X-rays hitting not just cancer cells, but healthy tissue as well. While radiologists are as precise as possible in their delivery, collateral damage can occur; it’s the nature of the X-rays (photons) themselves to injure everything they touch.
A new, more focused radiation
According to an article on OncoLink, the Internet’s oldest cancer-information website, proton therapy is a different type of X-ray. The photons used in standard radiation release their energy steadily as they travel through the body to the site of the tumor, damaging healthy tissue along the way. In contrast, protons release very little energy until they reach their destination — at which point they release it all.
Radiologists use computer software to direct the protons to the exact site in the breast where the tumor grew. That site is blasted with radiation, while surrounding tissue and organs are spared. The result? Cancer cells are killed while healthy tissue is left untouched. No heart, lung, or bone damage; no burns or swelling.
So why isn’t proton therapy more widely available?
Two reasons: cost, and lack of clinical testing.
About 14 clinics nationwide offer proton therapy; according to business consultant RNCOS, that number is slated to more than double by 2020, to 29 centers. Some of the top facilities in the country offer proton therapy, including Boston’s Massachusetts General Hospital; New York’s Memorial Sloan Kettering Cancer Center; and Houston’s M.D. Anderson Cancer Center.
But the equipment needed to deliver proton therapy is massive — and massively expensive. Typically, a hospital will need the equivalent of a city block to house a proton treatment center. The cost of just the machine itself ranges up to $220 million, the price tag for the nation’s newest facility, the Scripps Proton Therapy Center in San Diego.
In addition, with the dearth of patients being treated with proton therapy, there simply hasn’t been enough data collected about its effectiveness. A new clinical trial comparing photon to proton treatment in breast cancer patients is currently recruiting participants, but results of the trial are years in the future. Anecdotal data — reports from patients who’ve undergone the new treatment — is positive. But according to the National Cancer Institute, proton therapy hasn’t gone through the thorough testing necessary for most medical facilities to buy into its effectiveness — especially at such a hefty price tag.
Should you try proton therapy?
If it’s available at a site near you, it’s worth looking into. Though there’s no proven data that proton therapy yields better results than current radiation technology, there’s nothing that says it’s any worse, either.
One caveat: If you’re considering proton therapy, be sure to check with your insurance provider. As a new type of treatment, it may not be covered.
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Breast cancer survivor and award-winning author PJ Hamel_, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network. _