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The Pros of Protons

Updated: Oct 7, 2018

Dr. Thanasis Bagatzounis explains why undergoing a Proton Therapy is the right choice

I have been practicing medicine for almost 30 years, devoted exclusively to the treatment of cancer. Being a specialist in Radiation Oncology, I am focusing currently on cancer therapy with the proton technology.


Proton therapy fascinates me, as it offers solutions to many difficult clinical problems and is actually indicated for treatment of tumors located in difficult anatomical areas. I mean tumors lying close to sensitive organs and structures of the body.

The advantage of protons is that we can adjust the depth of penetration of this particle irradiation, so that we do not damage healthy organs, like the small intestine or the kidneys.


In this way we can deliver very high doses to the tumor in order to destroy it without having significant side effects, or no side effects at all, from radiotherapy. I will refer to some clinical examples.


A classic example are tumors of the skull-base, as in this case of a young person, in which it has invaded the bone and has partially destroyed it. It is a chordoma of the base of the skull, which cannot be treated surgically, of course can a part of the tumor be removed but due to the anatomical location of the tumor, it is difficult or impossible to remove the entire tumor. Since this tumor type is radiation-resistant it requires high doses and this is achievable only with protons. Classical radiation passes through the tumor and hits other sensitive organs, so that high radiation doses cannot be given.


Another classic example is the childhood medulloblastoma, a rare tumor that can spread, usually diagnosed within the cerebellum, at the back of the brain. It often metastasizes through the cerebrospinal fluid within the spinal canal. In this case, this whole area has to be irradiated. With classical radiation, we usually damage healthy organs, such as the heart, liver and intestine, which of course is harmful to the child. With protons, we can only hit our target without damaging healthy organs.


Sometimes we have to deal with tumors growing slowly and not metastasize, but because of their anatomical location near important organs, as in this example the eye, they can be cured only with surgical amputation. We can offer an alternative treatment option.


And since proton therapy solves difficult problems, it can of course cure easily every kind of cancer, such as prostate cancer, as on this example, where the prostate and the lymphatic pathways of the pelvis have to be irradiated. Additionally, as we see here again, the small intestine is not being irradiated, which is not achievable with classical photon irradiation.

 



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