Overview

Proton therapy is a novel form of radiotherapy treatment in Singapore. As a form of External Beam Radiation Therapy [EBRT], it delivers a directed stream of positively charged protons to target and destroy cancerous tumour cells with minimal side effects and is typically used for localised tumours that have not spread to other parts of the body.

In comparison to other radiotherapy treatments in Singapore, proton therapy uses positively charged proton particles instead of X-rays. Proton beams do not scatter radiation as they travel through the body, depositing most of their energy at the targeted tumour. This allows radiation doctors to focus the proton beam effectively, minimising damage to nearby healthy tissues and organs and speeding up recovery.

Proton therapy helps to minimise patients’ radiation exposure and reduces side effects such as nausea and fatigue. This allows patients to enjoy a better quality of life and overall well-being across their whole treatment process.

 

Benefits of Proton Therapy

Positively charged subatomic particles are used in proton therapy to destroy cancer cells. Proton therapy is the first plan your healthcare team has to make to ensure the proton beam reaches the right place in your body. Typically, patients will undergo proton therapy five days a week for several weeks. However, in some cases, patients may only need one or a few treatments, depending on their condition.

Compared to the X-rays used in traditional radiotherapy, proton therapy allows for more precise targeting of a tumour. As a result, healthier tissues and organs near the tumour are less likely to be damaged, resulting in fewer treatment-related side effects. Patients with many different types of cancer may be treated with proton therapy in Singapore, including those with the brain, skull base, spine, head and neck, oesophagus, liver, pancreas, breast, prostate, lymphoma, and paediatric cancer.

Recurrent tumours previously treated with radiation can be treated with proton therapy. Patients can leave the treatment room without risk of radiation exposure to others after receiving treatment. Moreover, it can also be used in combination with other treatments, such as surgery, conventional radiation therapy, and chemotherapy. As one of the safer cancer treatments available, most patients who undergo proton therapy can maintain their normal lifestyles, such as working and exercising.

 

Difference Between Traditional Radiotherapy and Proton Therapy

Proton therapy in Singapore may reduce radiation to healthy tissue around the target site by up to 60% while increasing radiation to tumour tissue. By using proton therapy, doctors can control when and where proton energy is released. In this way, cancer cells are damaged as much as possible, while nearby healthy tissue is spared from this harm.

On the other hand, traditional radiotherapy involves beams of X-rays depositing energy along their path before hitting their targets. This includes the skin’s surface and beyond. A beam of X-rays continues beyond the tumour, damaging tissue as it releases energy. This is known as the ‘exit dose’. Thus, treatment not only targets cancer cells but also affects the cells along the X-ray beam before and after the tumour, resulting in health concerns after treatment.

Proton therapy allows the doctor to use a higher dose of radiation than standard radiation therapy while protecting vital organs and surrounding tissues. In traditional radiotherapy, a lower dose of radiation may be required to protect healthy cells. This can influence the effectiveness of the treatment.

Ultimately, though proton therapy may be more costly than traditional radiotherapy, the advantages it brings in contrast to proton therapy may make it more worthwhile. After all, we can never put a price on good health.

 

Proton Therapy Risks

Since doctors can better control where proton therapy releases its highest energy concentration, treatment can be more effective with fewer side effects and risks. This holds true even if the dose is the same as in conventional therapy. The minimised risks make proton therapy useful in treating cancers of the prostate, spine, head, and neck.

While the risks involved are lowered, there are still some side effects patients may experience, depending on the part of the body that is treated and the dose of proton therapy received. Common side effects may include fatigue, hair loss around the body part being treated, redness of the skin around the body part being treated, and soreness around the treated area as well.

The reduced risks of proton therapy in Singapore make it more appealing than traditional radiotherapy. This is especially true when it comes to treating childhood cancers. Traditional radiation treatment methods may have a higher risk of stunting growth in children due to the potential exposure of radiation to healthy cells. Contrarily, proton therapy targets cancer cells without damaging other cells in a growing body. In some cases, providing higher doses has improved outcomes compared to conventional radiotherapy.

 

Recovery and Aftercare      

After a proton therapy session in Singapore, most people are able to return to their regular daily activities. This procedure usually yields benefits within two to eight weeks for most people. Depending on the type of cancer you have and its location in your body, proton therapy will have varying effects on your tumour.

When it comes to fatigue, it usually lasts for three to four weeks after treatment ends but may also persist for up to three months. With regards to head and neck cancer patients, it is important to ensure and follow the regimen the healthcare team recommends for maintaining good oral health, healthy skin, and good nutrition. This can help with the recovery process and is also part of the aftercare measures.

During proton therapy aftercare, it is helpful to use gentle detergents to wash clothing that comes into contact with the treatment area. It is also recommended not to expose the treatment area to direct sunlight, ice bags, or air conditioning vents. For cancer patients, maintaining a healthy diet is crucial. Most importantly, it is not advisable to apply any dressings or tapes to the treatment area unless your doctor has prescribed them. In areas with open sores, your doctor will help cover them with a dressing for protection.

Other Treatments Available

  • Stereotactic Body Radiotherapy [SBRT] is an advanced technique that delivers high dose radiation with extreme accuracy, used to treat small tumours with a well-defined edge, in the brain, spine or lung.

  • Stereotactic Radiosurgery is a non-surgical type of radiotherapy that delivers high dose radiation with extreme precision. It is used to treat small, localized tumours, mainly in the brain.

  • Skin Brachytherapy is a non-invasive treatment for early non-melanoma skin cancer. It is an effective alternative for patients who do not wish to undergo surgery for skin cancer.

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- Dr Johann Tang

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Frequently Asked Question

Since proton therapy in Singapore delivers radiation in a precise area, there is a risk of the treatment missing cancer cells and metastatic lesions that are close to but outside the radiation field.

After a proton therapy session, most people can return to their normal routine. Results usually appear between 2-8 weeks after the procedure. However, your tumour’s response to proton therapy ultimately depends on the type of cancer you have and its location within your body. 

The success rates of proton therapy in Singapore depends on the type of cancer patients are treating. Overall, it may still be more effective than traditional radiotherapy.

Typically, proton therapy in Singapore is administered five days a week for a few weeks. Some conditions, however, may only require a single or a few treatments.

Proton therapy in Singapore does not cause pain, although some patients with physical limitations may feel discomfort due to their position.

Depending on the tumour’s location, proton therapy sessions may take between four to eight weeks.