Proton therapy, also known as proton beam therapy or proton radiation, is a modern cancer treatment. It sends a precise dose of radiation to a tumor, destroying cancer cells while causing minimal harm to nearby healthy tissue.

Proton therapy uses protons to kill cancer cells. This is different from the more common radiation that uses photons (X-rays). In traditional radiation therapy, photons travel through the body, delivering cancer-killing energy as they go. As a result, X-ray radiation has both an entrance and exit dose, damaging healthy tissues surrounding the tumor.

Proton therapy targets tumors within the body by using charged particles called protons. Because charged particles have mass, we can predict the distance they travel in the body.

Protons release energy differently than photons by releasing a burst of energy at the end of their path. Protons can travel a specific distance in the body and then stop. This helps reduce radiation to healthy tissues near the tumor.

Myths Surrounding Proton Therapy for Treating Cancer

Like many cancer treatments, there are several myths and misconceptions surrounding proton therapy for cancer treatment. Both curious people and the medical community have questions and concerns about the benefits of proton beam therapy. Let’s explore five common myths about proton therapy and separate fact from fiction.

Myth 1: Proton therapy is experimental

Many people believe that proton therapy is an experimental treatment, even though proton therapy was FDA-approved in 1988. Since then, there have been more than 900 research articles published on its outcomes and effectiveness for treating cancer.

In fact, there are continuous clinical trials looking at ways to improve proton therapy, and many radiation oncologists recommend it for their patients. Doctors can use proton therapy to treat many types of cancer. It can also be one part of a cancer treatment plan. Plans may include traditional radiation, chemotherapy, surgery, and other methods.

For example, in this clinical trial about prostate cancer treatment, published in the International Journal of Radiation Oncology Biology Physics, 99% of low-risk prostate cancer patients treated with proton therapy were cancer free 5 years after treatment. This result was comparable from data published in “Long-term survival and toxicity in patients treated with high-dose intensity modulated radiation therapy for localized prostate cancer,” by Memorial Sloan Kettering for low-risk prostate cancer patients treated with traditional photon radiation with 98% of patients cancer free at 5 years. 

However, when comparing the results of protons and photons at 5 years for intermediate risk prostate cancer and high-risk prostate cancer, proton therapy showed significantly better 5-year survival rates. The intermediate risk results for proton therapy were 94% cancer free at 5 years compared to 86% cancer free with photons at 5 years. The high-risk results were 74% with proton therapy and only 68% with photon radiation.

Some of the most compelling research showing the effective outcomes of proton therapy is in a Phase III randomized trial comparing proton therapy and photon radiation for people with head and neck oropharyngeal cancer. This study from MD Anderson Cancer Center in Houston concluded that proton therapy is the “standard of care” radiation option for patients with oropharyngeal cancer that also reduces the chance of nutrition issues, as well as the need for patients to have a feeding tube throughout treatment.

Research continues to show the efficacy of proton therapy and now includes a focus on determining which subsets of patients will respond better to proton therapy.

Myth 2: Proton therapy is only for children

While it's true that proton therapy is used to treat many pediatric cancers, it's not just for kids. Proton therapy has clear benefits for adults, too, targeting tumors precisely and accurately. Proton therapy is helpful for both pediatric cancers and cancers near sensitive organs. 

Studies show that proton therapy often has fewer side effects. It uses targeted radiation that protects nearby healthy tissues. This is especially important for children because it helps avoid long-term health problems.

For example, a recent study evaluated the outcomes of pediatric patients receiving treatment for low-grade gliomas. The research found that proton therapy reduces the radiation dose to brain tissue that is still developing in children compared to modern photon radiation treatment plans. It reduces side effects experiences by patients without compromising the effectiveness of the treatment.

Research shows that proton therapy can effectively treat many types of cancer in adults. This includes head and neck cancers, lung cancers, and lymphomas. It also helps to reduce damage to nearby healthy tissues and organs.

In one of the studies mentioned earlier, results showed that proton beam therapy (IMPT) improved outcomes for patients treated for head and neck oropharyngeal cancer.

Fewer patients required a feeding tube (28% vs 42%) and more patients minimized their weight loss (24% vs 14%) with proton radiation treatment for head and neck oropharyngeal cancer.³ Researchers concluded that proton beam therapy (IMPT) has emerged as a standard of care for oropharyngeal cancer.

Myth 3: Proton therapy is only for small tumors

Another common myth is that proton therapy is only effective for small tumors, but this is incorrect. Proton therapy can be effective for large tumors, including lung cancers and lymphomas. In truth, proton therapy is most effective for solid tumors that are localized and well-defined. While it's not necessarily better than standard radiation for every type of cancer, it's often the best option for tumors near critical organs.

Lung cancer treatment has the potential to affect many critical structures in a sensitive area of the body. It is important to protect the surrounding healthy tissue from excess radiation. The precision and targeted aspect of proton beam therapy enables physicians and care teams to deliver optimal radiation treatment to lung cancer tumors, while avoiding healthy tissue in the healthy lung. Read more about proton therapy for lung cancer here. 

For lung cancer survivor Toni Renna, the decision to choose proton therapy for lung cancer was easy. Looking for an alternative to major surgery, Toni and her family found proton therapy. Physicians explained that proton therapy would limit the dose of radiation to the surrounding healthy lung tissue, as well as to reduce the amount of radiation to the heart.

Myth 4: Insurance does not cover proton therapy

Some people assume that insurance does not cover proton therapy, which can be true, but often is not the case. While some insurance companies may be hesitant to cover proton therapy due to its higher cost compared to standard radiation, many insurance plans, including Medicare and Tricare, do cover it. 

A study on insurance approvals for proton therapy found that the approval rate was higher than expected. Many patients were able to receive coverage after appealing their initial denial. Using the appeals process is important. It allows oncologists to share evidence for each person's case.

Unfortunately, there are still instances where proton therapy is not approved by insurance companies for cancer treatment. For example, many veterans, depending on the region where they are seeking care, are denied access to proton therapy. 

VHA helps millions of veterans each year. However, it falls short of Medicare in offering advanced cancer treatments like proton therapy, according to the National Association of Proton Therapy (NAPT).

Organizations such as NAPT and the UF Health Proton Therapy Institute aim to educate people and advocate for better access to proton therapy. Read more about the advocacy efforts to increase access to proton therapy, a lifesaving, life-changing cancer treatment.

To learn about the prior authorization process for proton therapy, read our blog, “Is proton therapy covered by insurance?”

Myth 5: Proton therapy is not widely available

Finally, some people believe that proton therapy is not widely available. However, according to the National Association of Proton Therapy, there are currently 46 operating proton therapy centers and more are under construction.

While there may be limited availability in some areas, the number of proton centers is growing exponentially, and many patients choose to travel for treatment. Proton treatment centers often work with patients to help them find resources and travel arrangements to make treatment possible. 

At the UF Health Proton Therapy Institute, we help patients find nearby places to stay. We also help arrange travel to and from treatment thanks to local and national organizations. Additionally, we offer discounts to local restaurants and attractions. This way, patients can enjoy their time in Jacksonville, Fla., while not in treatment.

Kama Anderson, a patient treated at the Institute for meningioma, said, “We found Jacksonville a soothing place to receive treatment and heal.” Kama and her husband found the Institute's services helpful. They made their treatment and living in a new city for two months more comfortable.

The Truth About Proton Therapy

Proton therapy can help many people who have cancer, and it may be more available than you think. Work with your cancer treatment team to see if proton therapy is right for you. Doctors might suggest it for your whole treatment plan, or they might use it in conjunction with other cancer treatments. 

By separating fact from fiction, we can better understand the benefits and limitations of proton therapy and make informed decisions about our cancer treatment options.

To learn more about the different types of radiation treatment, read “What is the difference between proton radiation and radiation therapy?” 

You can also contact the UF Health Proton Therapy Institute to learn more about cancer treatment in Jacksonville, Florida.