In this day of cutting-edge technology, people with cancer have access to a wide array of treatments such as radiation therapy, chemotherapy, surgery, etc., depending on where their tumor is and how advanced it is. One of the most widely used treatments, especially in the last decade, is radiation therapy (also called X-ray therapy, Intensity Modulated Radiation Therapy -- IMRT and photon therapy, if you want to get fancy).

Radiation therapy uses a type of energy called ionizing radiation to kill cancer cells and shrink tumors. The way radiation therapy works is by injuring or destroying the cancerous cells and damaging their genetic material, thus making it impossible for them to continue to grow and divide. However, while this kind of therapy is very effective in killing the cancerous cells, its main side effects happen while the radiation is traveling through the patient’s body, before and after it hits the tumor. A lot of energy is released, and therefore healthy tissues are damaged among the path of the radiation. This is especially problematic for cancers that are in vital and sensitive areas of the body such as the brain, heart or spinal cord.

One alternative to radiation therapy that does not have the same side effects while having even better success in destroying the cancer is proton therapy. It is a type of particle beam therapy in which high doses can be released to the tumor itself, while doing less damage to the normal tissues in front and behind the tumor. Several research studies have shown that with proton therapy, patients experience fewer short-term and long-term side effects, and have a lower occurrence of secondary tumors which can appear several years after the initial treatment was received.

In prostate cancer patients for example, the evidence suggests that protons offer the best control of cancer with a lower toxicity level (damage to healthy tissues) than radiation therapy. For children with cancer, research also demonstrates a significant decrease in healthy tissue being irradiated when protons are used instead of radiation therapy. This is especially important because children’s bodies are more vulnerable to the undesirable effects of radiation, such as developmental and growth problems, as well as potential reduction in IQ.

Most people mistakenly think, like I did, that proton therapy is a new type of treatment. In fact, it has been approved by the Federal Drug Administration (FDA) since 1988. However, while hundreds of thousands of cancer patients receive radiation therapy every year in the U.S., only 4,000 receive proton therapy, as there are only around seven centers that provide that kind of treatment in the whole country. The reason for this very low number is the prohibitive cost of the technology that allows the proton beams to be so concentrated: it costs around $280 million to build a proton therapy center, while other types of cancer treatment centers can be built at a fraction of the cost.

So what does this mean? It means that given that there are around 1.4 million cancer cases in the U.S. per year, more than 250,000 of them can benefit from proton therapy, if it was available (these are the patients with cancers for which existing protocols for proton therapy exists). So clearly, the supply is way much lower than the demand.

One company that is working hard to bringing proton therapy to patients is called Procure. It recently opened a new proton therapy center in Oklahoma City, has one under construction in Chicago, and has four others in development in Detroit, South Florida, New Jersey and Seattle. Last week, I had the pleasure of touring Procure’s state-of-the-art center in Oklahoma City and the adjacent Integris Cancer Institute of Oklahoma. In my next post, I will talk about the out-of-this-world things that I saw there!