Proton Therapy: How It Is Beneficial For Prostate Cancer Patients

Medically reviewed by Dr Johann Tang, Senior Consultant Radiation Oncologist

Specific cancers, such as prostate cancer, can be challenging to treat with traditional radiation therapy, as the tumours reside deep within the body. In such circumstances, an oncologist may recommend proton therapy as a suitable prostate cancer treatment due to its ability to precisely target the cancer tumour, reducing damage to healthy body cells.

During treatment, the radiation oncologist will utilise computed tomography (CT) and sometimes magnetic resonance imaging (MRI) to direct high doses of proton beams to the prostate gland and the pelvic lymph nodes, eradicating the cancer cells while reducing radiation exposure to the bladder, rectum, and other gastrointestinal organs.

Learn More: Is Proton Therapy Safer Than Traditional Radiotherapy?

Benefits Of Proton Therapy

Proton therapy offers prostate cancer patients various advantages, as its unique physical properties minimise exposure to non-targeted, healthy tissue near the prostate, reducing the risk for potential side effects. Notable benefits of proton treatment include:

Benefit #1: Reduce Recurrence Rate

Proton therapy can accurately deliver high doses of radiation to the prostate, thoroughly eliminating cancerous cells residing within the body and reducing recurrence rates for various cancer cases.

Benefit #2: Minimise Side Effects

As the proton beams precisely target the cancer cells within the prostate, there is minimal impact on surrounding healthy tissues and vital organs, such as the bladder and rectum. Moreover, it is non-invasive, which may help mitigate treatment-related side effects, such as incontinence, impotence, and rectal/bowel issues.

Benefit #3: Reduced Radiation Exposure

Compared to conventional intensity-modulated radiation therapy (IMRT), patients undergoing proton therapy are exposed to less overall radiation. Unlike proton treatment, which delivers proton beams, traditional radiation therapy utilises photons in the form of X-ray beams, which release radiation along the entire length of the beam.

As a result, the radiation continues to penetrate the body after passing through the tumour, with the ‘exit dose’ potentially damaging healthy tissues and organs near the prostate. Exposure to radiation in these areas can elevate the risk of long-term complications, and the patient may develop new forms of cancer in the future.

Benefit #4: Minimal Downtime

Beyond its clinical benefits, proton therapy offers practical advantages that contribute to a more favourable treatment experience. Sessions typically last between five to ten minutes, with minimal downtime required. Furthermore, the treatment is painless, potentially alleviating any anxiety or discomfort patients may associate with cancer therapy.

Side Effects Of Proton Therapy

However, like other forms of medical treatments, patients undergoing proton therapy may experience potential side effects from treatment. The side effects vary depending on the patient and may include:

• Bladder irritation
• Fatigue
• Increased frequency and urgency to urinate or have a bowel movement
• Skin irritation at the radiation beam entry point.

These side effects usually dissipate within one to two months after treatment is complete. Some can even be managed with over-the-counter or prescription medication.

Who Is A Suitable Candidate For Proton Therapy

Prostate cancer treatment varies by patient and may depend on how advanced the cancer is and whether it has spread to other parts of the body. In many cases, proton therapy is an ideal option, as it can treat prostate cancer in all stages when radiation therapy is indicated even if the cancer cells have spread and prostate tumours with complex shapes.

Proton therapy can treat the following types of prostate cancer:

• Early-stage prostate cancer
• Midstage prostate cancer
• Late-stage (locally advanced) prostate cancer
• Prostate cancer that has spread to adjacent tissues and organs
• Prostate cancer that has spread to the lymph nodes
• Recurrent prostate cancer

However, in specific situations, the medical professional may recommend other forms of treatment. They include:

• Patients with aggressive prostate cancer that causes symptoms – As proton therapy usually takes longer to plan than traditional radiation therapy, an oncologist may recommend the latter for aggressive cases so that treatment can begin sooner.
• Early-stage prostate cancer – Some early-stage prostate cancers require careful monitoring and not treatment. Others may need surgery to remove the tumour.
• Patients with hip replacement implants – The hip implant may affect the accuracy of the CT imaging. Without clear images, it is challenging for the oncologist to deliver the proton beams precisely.
• Patients with pacemakers – Proton therapy may damage the pacemaker device.

If you are unsure whether proton therapy is a suitable treatment for prostate cancer, do not hesitate to consult Dr Johann Tang. As a radiation oncologist in Singapore for over two decades, Dr Tang possesses extensive experience in treating prostate cancer patients with both traditional radiotherapy and proton therapy. Contact us to set up an appointment with our clinic today.