Web Review: Interview of Dr. Simone : proton therapy for lung cancer

Charles Simone, MD, chief of thoracic service in the department of radiation oncology at the Roberts Proton Therapy Center at Penn Medicine was interviewed on CBS 3 to discuss proton therapy for lung cancer. Learn how protons are changing the way lung cancer is treated.

Lung cancer is the 2nd most common cancer and the number one killer of men and women in North America. It counts for more deaths that breast, colon and prostate cancers combined. Lung cancer can be treated with surgery, chemotherapy and radiation, but targeting that radiation is a critical aspect to a successful outcome. That is where cutting edge proton therapy comes into play.

Proton therapy is a non–invasive, incredibly precise cancer treatment that uses a beam of protons moving at very high speeds to destroy the DNA of cancer cells, killing them and preventing them from multiplying.

« Proton therapy is a type of radiation therapy », Dr. Simone says. « When regular radiation therapy enters the body, it travels a certain depth to reach the tumor, treats the tumor, but everything that is delivered goes out from the other side of the body. With protons, we can have the radiation enter the body, hit the tumor and then completely stop, so that no normal tissue beyond the tumor is treated. Collateral damage is thus much more minimized. ».

« Patients tolerate this kind of therapy very well, because less normal tissue is radiated and there are less side effects. Thanks to that, we are able to treat tumors that we could not treat with only traditional radiation therapy. There are still some challenges : with lung cancer, every time the patients breathes, the tumor moves up and down, and we have to account for that, which we do, and we are able to target the tumor very precisely. »

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Web Review: Breast cancer patient treated with protons at ProCure

Nadine Bye is 70 and has worked hard to get this far. She has survived two brain surgeries and a battle against breast cancer when she was 60. On Tuesday, she had her last proton therapy treatment after being diagnosed with breast cancer for the second time.

 Nadine thought she was done with breast cancer. It had been 10 years and she thought she was in the clear. But in October, she felt a lump near her collarbone. A doctor’s appointment and several tests later, she found out that she had cancer again in her lymph nodes on her right side. It was too complicated to operate on, and doctors decided proton therapy was the appropriate approach.

With breast cancer, one of the main concerns is radiating the breast or chest wall might cause doctors to irradiate the person’s heart or lungs as well. This sometimes can cause heart disease and complications later in life. With traditional radiation, doctors cannot control how deep the radiation penetrates. But with protons, doctors can determine down to the millimeter where protons should stop, sparing critical tissues such as the heart or the lungs.

“The main reason that I wanted to go through proton therapy was it saves other organs,” said Nadine. “And when you’re having treatment from your neck to your waist, you’ve got your lungs and your esophagus and your thyroid and all of those organs that could be affected, and with protons, it doesn’t do that.”

Nadine didn’t know about proton therapy until her doctor suggested it. She had the opportunity to choose proton therapy over other traditional cancer treatments at the ProCure Proton Therapy Center in Oklahoma City, which recently added breast cancer to the types of cancer it will treat with proton therapy.


Web review – Proton therapy for ocular tumors at UCSF

Ocular Melanoma program at University of California, San Francisco (UCSF), uses protons to treat ocular or uveal melanomas, which occur in the iris, ciliary body or choroid regions of the eye.

The UCSF Ocular Melanoma Proton Radiation Program is one of a very select group of programs across the nation and world, which has long-term experience in treating uveal melanomas. They have been using particle radiation therapy since 1978 and have treated more than one thousand patients with uveal melanoma.

Proton or charged particle radiation, which is one type of radiation therapy, is very effective for treating uveal melanoma. Because of the properties of proton therapy, there is minimal dose to the surrounding normal tissues, making it ideal for treating tumors of the eye.

The treatment itself only takes about 2 minutes. The radiation is painless. The patient is positioned in an upright, chair position and uses the mask made for him to keep in place. A small red light appears for the patient to focus on, keeping the eye from moving. This is performed usually once daily over 4 days. The proton treatment is planned to be performed over the course of one week. Ocular melanoma patients treated with proton therapy usually enjoy an excellent chance for tumor control.


  • http://radonc.ucsf.edu/treatment_programs/proton_ocular.html


Web review – Next generation proton therapy in Texas

Intensity modulated proton therapy treatment (IMPT) is now available at MD Anderson Cancer Center in Houston, Texas. This new technology further refines radiation therapy options for complicated head and neck tumors.

Selected for its ability to target tumors precisely while minimizing damage to healthy surrounding tissue, proton therapy has rapidly gained a foothold as an option for radiation treatment in the past decade. The Proton Therapy Center at The University of Texas MD Anderson Cancer Center in Houston, Texas, opened in 2006, is now one of 10 proton therapy centers currently operating in the United States. The center treats over 800 patients of all ages every year.

It continues to innovate the field by being the first and only center in North America to treat patients with the most advanced form of proton therapy, called intensity modulated proton therapy with multi-field optimization (IMPT).

IMPT is best used to deliver a potent and precise dose of protons to the most complicated tumors. It relies on complex treatment planning systems and an intricate network of magnets to focus and aim a narrow proton beam and essentially “paint” the radiation dose onto the tumor layer by layer.

“In under a decade, MD Anderson has established a full spectrum of proton therapy techniques, providing a range of options from which to select the best radiation treatment matched to a patient’s tumor,” says Steven J. Frank, M.D., associate professor in MD Anderson’s Department of Radiation Oncology and director of Advanced Technologies at the Proton Therapy Center. “With IMPT, radiation oncologists can offer the precision and tissue-sparing capabilities of proton therapy to patients with the most complicated tumors of the head and neck.”




Love for music bonds teen with proton radiation technicians

Music produced an instant connection between 13-year-old Hannah Maupin and her proton radiation technicians.

They had cued up her iPod as Hannah climbed atop the treatment table for the very first time. And the voice of Rich Mullins, a contemporary Christian musician who had recorded albums in the 1980s and ’90s, leapt from the treatment room’s speakers.

Some of the proton radiation techs looked at one another in surprise.

“Rich Mullins is not a musician that most 13-year-old kids know,” said Leah Maupin, Hannah’s mom. “But several of the technicians knew him. And right away they had a bond with the music.”

Hannah’s iPod segued to another song. And the sounds of the Christian rock band Casting Crowns poured through the proton treatment room, helping to further ease Hannah’s apprehensions about her first proton treatment.

“The first one, I was kind of nervous,” Hannah recalled. “I wasn’t entirely sure what to expect. When the [proton] radiation started, I had the urge to twitch,” she said laughing.

But the kind words and guidance of the techs, and just talking with the seventh grader and getting to know her as a person — not as a patient with Hodgkin’s lymphoma — stirred a warm friendship that Hannah and her mom recall with great fondness.

It was on April 16 that Hannah bid farewell to the doctors, nurses and proton radiation technicians at Indiana University Health Proton Therapy Center in Bloomington, Indiana. She had just received her 28th and final proton treatment.

Through tears and laughter, the staff celebrated Hannah’s last day at IU. And Hannah conveyed her thanks, too. With music.

“Casting Crowns was playing in Evansville a week earlier, and Hannah and I drove down to the concert,” Leah said. “Hannah got a CD with signatures of all the band members so she could give it to the techs on her last day.”

Hannah and her mother had arrived in Bloomington seven weeks earlier from their home in Corvallis, Oregon. Hannah, an honors student at Santiam Christian School, had experienced a relapse of her cancer during the summer break. “It came back with a vengeance,” Leah said.

Hannah’s cancer had spread to lymph nodes in her chest and abdomen where critical organs and tissue are located. “Her lymphoma was wrapped around her heart,” said Leah.

Last year, Hannah endured five rounds of chemotherapy at Oregon Health & Science University (OHSU) in Portland, Oregon, “to decrease the burden of disease,” Leah recalled. Then, in January 2013, Hannah experienced seven days of high-dose chemotherapy followed by a stem cell rescue at OHSU before heading off to Bloomington, the town where Leah had been born and raised.

Hannah’s radiologist at OHSU supported IU’s proton treatment approach, having the proton beams enter from Hannah’s back in order to spare healthy tissue.

The proton radiation technicians took Hannah’s mind off her daily treatments and found ways for Hannah and her mom to enjoy their time in Bloomington. “One of the techs figured we would like the climbing wall,” Leah said. “So, when Hannah’s siblings came out from Oregon to see us, we all went climbing.”

Another tech helped connect Hannah to the Bloomington Archery Club, whose members welcomed her like their long-lost daughter.

Hannah had always wanted to try archery. Suddenly, she had a host of tutors, helping Hannah practice her draw, aim and release. “I loved going there,” she said. “I wouldn’t have missed it for anything.”

“Our time in Bloomington was the best possible scenario for a difficult situation,” Leah added. “We felt loved and blessed

Young boy with cancer needs help to get treatment

A young boy from the UK needs potentially life saving treatment in America. His parents are trying to raise £100,000 to send him to the US, as he may not qualify for NHS funding.

An inoperable tumor was found in Sam John’s brain. The 16-year-old boy from Hampshire needs to get proton therapy and travel to America, as this kind of treatment is not yet available in the UK.

Unfortunately, Sam may not qualify for NHS funding. A medical review panel are currently reviewing his case to decide whether to fund the treatment abroad.

The National Specialised Commissioning Team, the NHS body which approves the treatment, said: “The panel assesses each case against nationally agreed criteria to identify which patients would most benefit, carefully considering factors such as the severity, behaviour and location of the cancer and timing of the treatment. If there is no indication that proton beam therapy treatment would provide a cure or significant improvement to an individual’s quality of life then treatment using the therapy is not advised.”

Sam’s parents have been told their son is less likely to receive the funding because he is already 16. So they’re trying to raise the money to send Sam to America on their own.


Little girl with cancer amazes her doctors

Four-year-old Katie Dodd from the UK is fighting cancer in the US, where she is getting life saving proton therapy treatment.

Last August, Katie started to have severe back pain. In September, she woke up and realized she could not move her legs anymore. She was taken to the hospital, where an MRI scan revealed she had a 6-centimeter tumor on her spine.

Doctors established she needed pioneering proton beam therapy in America (this kind of treatment is not yet available in the UK). The little girl fortunately qualified for NHS funding, which took care of the £114.000 cost of her treatment.

She is being treated at Wolfson Children’s Hospital in Jacksonville, Florida. Her parents say their daughter remains “unfazed” by her treatment and is working harder than ever at her physiotherapy with her dad. She has even started to crawl.

He mother says : “Her crawling is only a few steps and the weight of her body is carried by her arms so it is very tiring for her. Her legs don’t have the strength to carry her body yet as her muscles have wasted since September 2012. Hopefully with more practise and her confidence building, this is another step in the right direction.”

Katie is now regularly talking about “when her legs are better”. She has impressed her doctors with her calmness in the sessions and has not needed any anaesthetic to prevent her from moving, which is very rare for a child her age.

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