A new treatment for breast cancer: Let's learn about Proton Therapy

If your doctor says you have breast cancer, you may be offered radiation therapy as part of your treatment plan. This treatment is often recommended, especially if you have had a mastectomy , if the cancer is large, or if the cancer has spread to the lymph nodes in your armpit or other areas. It can also help prevent the cancer from coming back after breast-conserving surgery.

What is Proton Therapy?

The most common type of radiation therapy used for breast cancer is external beam radiation. A special, advanced form of this is called proton therapy . It is sometimes called intensity modulated proton therapy, or IMPT.

The specialty of this treatment is that the radiation beam is aimed directly at the cancer tumor. Therefore, the damage to the healthy tissues around the cancer, that is, the organs, is very minimal. Think about it, our breasts are located very close to the heart and lungs. So doctors say that this proton therapy method can cure the cancer while minimizing the damage that radiation can cause to those precious organs.

How is this different from regular radiation therapy?

Simply put, both proton therapy and traditional radiation therapy damage the DNA inside cancer cells and kill them. But the way they do it is different.

Let us understand this difference a little more clearly.

What benefits does this bring to women with breast cancer?

Women with left-sided breast cancer who receive conventional radiation therapy (X-rays) are at increased risk of developing major heart problems, such as ischemic heart disease, which is caused by narrowing of the blood vessels in the heart. A 2017 study found that this risk can begin within the first 10 years of treatment.

So proton therapy is a great help in avoiding such complications.

Some other benefits of this treatment are:

• No pain: This is not a painful treatment.
• No surgery: No need to cut or cut anywhere on the body (non-invasive).
• Can be done with other treatments: This can be done with other treatments you are receiving for cancer (e.g. chemotherapy).
• Breast Implants Not a Problem: This treatment can be done even if you have had a breast implant.

As with all treatments, there are some minor side effects. The most common are fatigue, redness , hair loss, and skin sensitivity at the treatment site . However, these are less common than with regular radiation therapy.

What types of breast cancer can be treated with proton therapy?

This is a very important point. You should definitely talk to your doctor about whether this treatment is right for you, for your type and stage of cancer.

There are several common situations in which this treatment may be considered:

• If you have stage 1, 2, or 3 breast cancer (Stage I, II, or III).
• If the cancer has spread to the chest wall, skin, or armpit glands, but has not spread to other distant organs, it is called `locally advanced breast cancer`.
• If there are cancer cells in the lymph nodes, it is called ``node-positive breast cancer``.

Also, your cancer may be suitable for this treatment even if it is one of the following types:

• Estrogen receptor (ER) positive or negative.
• Progesterone receptor (PR) positive or negative.
• HER2/neu positive or negative.
• Triple positive: Being positive for all three of the following: ER, PR, and HER2.
• Triple negative: Negative for all three of the following: ER, PR, and HER2.

Research on this is still ongoing, so the best way to get the latest information is to talk to your doctor.

How does the treatment work?

Your radiologists and doctors work together to create a treatment plan that's right for you.

1. Simulation Session: A few days before your first treatment, you will be taken to this session. Here, the radiation team will mark the exact area on your body where the treatment will be given. This may be done by drawing lines with a permanent marker or by applying small dots, similar to tattoos.

2. During treatment: You will need to lie still on the bed during the treatment. If you move, the radiation beam may miss the cancer. You may be placed in a special frame to keep you still. A treatment session may last about 30 minutes.

3. Treatment period: Several such treatment sessions will need to be done over a period of about 6 weeks.

Is this treatment available in Sri Lanka?

Proton therapy requires very large, specialized, and expensive machines called cyclotrons or synchrotrons. Therefore, not every country or hospital in the world has this facility.

Since this is a very advanced and new technology, this treatment may not be widely available in Sri Lanka at the moment. However, as technology advances, this facility will come to our country in the future. The best way to get the most accurate and up-to-date information about this is to talk to your oncologist, especially a doctor from a major cancer hospital like Apeksha Hospital.

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