Proton Therapy in Singapore
What is Proton Beam Therapy
Proton therapy, also referred to as proton beam therapy, is an approach to treating tumours with radiation. Unlike conventional X-ray radiation therapy, proton therapy employs protons to potentially target cancerous tissues while sparing surrounding healthy cells.
Doctors in Singapore may use proton therapy alone or combine it with X-ray radiation therapy, surgery, chemotherapy, or immunotherapy to address certain types of cancers.
How Does Proton Therapy Work?
In conventional cancer radiation therapy, X-rays are used to target and potentially destroy the cancer cells. However, in proton therapy, positively charged particles (protons) are used to potentially disrupt cancer cells’ DNA, rendering them incapable of repair or replication.
During proton therapy, protons are extracted from hydrogen atoms and accelerated within a particle accelerator, such as a synchrotron or cyclotron. A specialised apparatus, typically a gantry capable of full rotation, utilises a powerful magnet to concentrate the proton stream into a narrow beam that is approximately 5 millimetres in width. This beam is then directed at the tumour and the radiation emitted by protons damages the tumour’s DNA.
Proton therapy is typically administered on an outpatient basis, necessitating patients to visit the centre for each session and return home thereafter. The frequency of therapy sessions will differ depending on the cancer type and stage, with some cases requiring 1 to 5 proton beam sessions characterised by larger daily radiation doses over a shorter treatment period.
During a proton therapy session, patients are positioned on a treatment table and positioning aids, such as body moulds or masks, are used to keep their head and body still. The radiation oncologist then aligns the gantry to target the proton beam at the tumour’s location. An imaging scan will then be taken to confirm that the patient is in the right position and the beam is properly aligned. Then, the radiation therapist will proceed to operate the proton beam machine from an adjacent room.
The duration of a therapy session typically ranges from 15 to 30 minutes. However, this will depend on factors such as tumour size and complexity. While the actual proton radiation delivery is brief, preparation and calibration processes may extend the appointment duration to an hour or more.
What Does Proton Therapy Treat?
Proton therapy is often used to target localised tumours positioned near important parts of the body. It is also used for paediatric cases due to its reduced risk of harming healthy, developing tissue. Additionally, proton therapy may be used for addressing noncancerous (benign) tumours in children and adults.
Here are the common types of cancers that proton therapy is commonly used to manage:
- Breast cancer
- Central nervous system cancers (including chordoma, chondrosarcoma, and malignant meningioma)
- Eye cancer, including uveal melanoma or choroidal melanoma
- Head and neck cancers (including nasal cavity and paranasal sinus cancer and some nasopharyngeal cancers)
- Lung cancer
- Liver cancer and metastatic tumours of the liver
- Pancreatic cancer
- Prostate cancer
- Spinal and pelvic sarcomas (cancers that occur in the soft tissue and bone)
What Are the Benefits of Proton Therapy?
While the potential advantages of proton therapy over traditional radiation therapy are still being researched, there may be some notable benefits, such as:
- More accurate targeting of tumours and cancer cells
- Reduced radiation to surrounding healthy tissue and organs
- Reduced short- and long-term side effects of radiation treatment
- Improved ability to treat an area that has received prior radiation
- Improved quality of life during and after treatment
- Reduced risks for children with cancer, who often suffer lasting side effects from cancer treatments
- Reduced likelihood of developing radiation-induced secondary tumours
- Possible alternative for patients who have reached the limit of traditional radiation therapy
What Are the Potential Risks of Proton Therapy?
While receiving proton therapy itself is painless and the risks involved are generally low. However, patients may experience certain side effects, such as:
- Fatigue
- Hair loss around the area that is treated
- Redness, irritation, soreness, swelling or dryness around the area that is treated
These side effects will depend on the location and size of the tumour as well as the type of healthy tissue near the tumour.
Proton Therapy Aftercare
If you’re feeling fatigued due to proton therapy, it typically persists for three to four weeks post-treatment, although it may extend up to three months, depending on your condition. Despite this, most individuals can resume their regular activities following a proton therapy session.
To care for the treated area, it is advisable to use mild detergents for washing clothes that frequently come into contact with the treatment site. Additionally, it is best to avoid exposing the area to direct sunlight, ice packs, or air conditioning vents. You should also refrain from applying dressings or tapes to the treatment site unless prescribed by your doctor; in cases of open sores, your doctor will provide suitable dressings for protection.
Maintaining good nutrition, oral hygiene and skin health, as recommended by your healthcare team, is also crucial for the recovery process and forms an integral part of post-treatment care. Patients should also remember to be consistent with their follow-up appointments to ensure optimal monitoring and support throughout their recovery journey.
