Proton Beam Radiation

What is proton beam radiation?

Proton beam radiation is a type of radiation therapy that uses proton beams to shrink tumors and kill cancer cells. Proton beams can be controlled so that most of the radiation stops inside the tumor. This helps protect healthy tissue around it.

Proton beam radiation can be used for many types of tumors. It can be especially helpful in children because the precise targeting reduces radiation exposure to developing healthy tissues.

How proton beam radiation works

Radiation is a type of energy used to treat cancer. The most common type is called photon radiation, which uses high-energy x-rays. These rays go all the way through the body and can damage healthy tissue around the tumor.

Proton beam radiation uses protons to send most of its energy right to the tumor. This helps the care team aim high doses of radiation at tumors with less damage to nearby tissues and organs.

Benefits of proton beam radiation

Proton beam radiation may help:

• Give a higher dose of radiation to the tumor with less harm to healthy tissue and organs
• Reduce side effects and the risk of long-term and late effects of treatment

Proton therapy may be recommended for:

• Very young children who are not able to have conventional radiation therapy
• Tumors located in the brain or near critical organs or blood vessels
• Tumors that require very high doses of radiation

Before proton beam radiation

Cost and availability

Proton beam radiation may cost more than standard radiation. It is not always covered by insurance. Check with your insurance company about coverage. Your care team can connect you with resources that may help.

Not every medical center offers proton beam radiation.

Radiation simulation

Before treatment starts, your child will have radiation simulation. This helps the care team set up and plan treatment. The care team may:

• Use imaging tests such as CT (computed tomography) scans and MRIs (magnetic resonance imaging) to decide how your child should lie on the table
• Make marks or tattoos to help aim the radiation
• Make a cushion, mask, or mold to help your child stay still

Getting ready

The care team will talk with you about how to prepare for each proton beam radiation treatment. You may be asked to have your child:

• Wear loose, comfortable clothes
• Remove metal objects such as jewelry or hair clips
• Stop eating or drinking if anesthesia will be used
• Practice staying still during treatment

During proton beam radiation

The care team will place your child on the table the same way they were positioned during simulation. They will use any cushions, masks, or molds created during simulation to help your child stay still. They will use imaging to make sure your child is in the correct position.

The care team will leave the room right before treatment begins. They will use video cameras, microphones, or intercoms to monitor your child. They can give your child instructions and support. Your child can talk to the care team if needed.

The proton therapy machine uses a part called a gantry to aim the proton beams. It may make humming or clicking sounds as it moves. The radiation does not hurt.

Each session lasts 20 – 30 minutes. Most of this time is used to get your child into the right position. The radiation takes a few minutes. If your child needs anesthesia or sedation to help them stay still, the session may take longer.

After proton beam radiation

If your child had anesthesia, they will stay in the treatment area or a recovery room until they wake up. Once your child is fully awake and alert, the team will give instructions for going home.

After all treatments end, your child will have regular checkups to monitor growth and organ function. The care team will also watch for any long-term effects of the radiation.

You can help care for your child at home by:

• Making sure they get plenty of rest
• Giving medicines as directed
• Keeping treated skin clean and dry
• Using lotions or creams approved by the care team
• Encouraging them to eat small meals and drink plenty of fluids

Risks of proton beam radiation

All radiation therapy has some risks. These may include:

• Damage to healthy tissue near the treatment area
• Unplanned radiation dose to tissue outside the treatment area

The care team plans treatment carefully to limit these risks. Your child will have regular checkups to watch for any changes.

Side effects of proton beam radiation

Proton beam radiation may have fewer short-term side effects than photon radiation. Side effects depend on the part of the body being treated. They may happen during treatment or after treatment ends.

Possible side effects include:

• Fatigue (feeling tired, weak, or worn out)
• Skin changes
• Hair loss
• Nausea and vomiting
• Trouble eating
• Soreness or swelling in the treatment area

Some side effects of proton beam radiation may appear months or even years after treatment ends. These are called late effects. These can include:

• Changes to growth
• Changes in how organs work
• Increased risk of developing another cancer

When to call your care team

Call your care team if your child has:

• New or worsening pain
• Fever or signs of infection
• Trouble eating or drinking
• Severe skin changes
• Trouble breathing

Questions to ask your care team

• Is proton beam radiation an option for my child?
• How can proton beam radiation help my child?
• How long will treatment last?
• How many treatments will my child need?
• How can I best prepare my child for radiation treatments?
• What are the risks of proton beam radiation?
• What problems should I watch for?
• Will my child need anesthesia for the radiation treatments?
• How should I care for my child at home during and after treatment?

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