Proton Therapy

Proton therapy can be especially beneficial for treating brain and spine tumors that require radiation. Accurate delivery of high doses of radiation to brain and spine tumors is critical to avoid damaging nearby healthy cells that cause unwanted side effects. Proton therapy delivers proton particles to the exact shape, size, and depth of the tumor with virtually no exit dose. As a result, this advanced form of radiation spares more surrounding normal tissue than conventional radiation. By reducing radiation to these organs, proton therapy decreases side effects and/or allows higher doses of radiation that may improve patient outcomes.

At MedStar Georgetown, we offer proton therapy with HYPERSCAN, the fastest and most accurate system available in proton therapy—and the only one in Washington, D.C. As a result, our radiation oncologists offer the most advanced proton therapy care in the region, making it an excellent treatment option for many types of benign (non-cancerous) and malignant (cancerous) primary brain tumors, including:

• Acoustic neuromas
• Gliomas/astrocytomas
• Meningiomas
• Pediatric brain tumors
• Recurrent brain tumors
• Skull base tumors
• Other brain tumors

Our radiation oncologists offer the most advanced treatment options to patients with tumors impacting the brain or spinal cord. Working in collaboration with other specialists, we’ll customize a radiation treatment plan that will be most effective at targeting your cancer while protecting your quality of life. Talk to our brain tumor experts today to find out if proton therapy is right for you.

Radiation therapy is often an essential part of breast cancer treatment for many patients. Unfortunately, the heart and lungs are often unavoidably exposed to low doses of radiation therapy with standard radiation. And, at least one major study has shown a correlation between increased doses of radiation to the heart and future heart problems. However, proton therapy has decreased exit dose, as the radiation particles conform to the shape and size of the tumor and then stop—the radiation doesn't continue into the healthy tissue beyond the tumor site. As a result, proton therapy has been proven to be safe and effective, while reducing radiation exposure to the lungs and heart.

Proton therapy may be especially beneficial for patients who:

• Have left-sided tumors
• Require treatment to lymph nodes
• Are younger
• Have other heart or lung conditions
• Have recurrent breast cancer

Our experts are dedicated to finding the best treatment for each individual patient, considering all options that aim for the best outcome with the least impact on quality of life. At MedStar Georgetown, we offer all of the latest breast cancer radiation treatments under one roof and your doctors will determine which will offer you the best benefit. If you have breast cancer, talk to our radiation oncologists today to see if proton therapy may be a good fit for you.

Treating gastrointestinal cancers with proton therapy has been a strong focus of our program and research. Because most gastrointestinal cancers are in close proximity to sensitive organs, such as the liver, stomach, and kidneys, minimizing radiation exposure to healthy tissue is especially important. At MedStar Georgetown, our proton therapy system with HYPERSCAN is the most advanced form available, and the only one of its kind in the area. This high level of precision allows us to deposit high doses of radiation directly to the tumor site with less exit dose, improving treatment accuracy while preserving critical organs that may be near GI tumors.

There is increasingly strong evidence to suggest that proton therapy may offer several improved outcomes and fewer short and long-term side effects for certain types of gastrointestinal cancers, including:

• Esophageal cancers: Proton patients receiving proton therapy for operable or inoperable esophageal tumors may benefit from fewer side effects and complications.
• Liver cancers: Proton therapy offers numerous benefits for tumors beginning in the liver (primary liver tumors) and in select cases of metastatic liver cancer. Data suggests that in certain instances proton therapy may improve outcomes, reduce the side effects associated with treatment, and lower the risks of complications down later in life.
• Pancreatic cancers: At MedStar Georgetown, we continue advancing how proton therapy may be used to treat complex gastrointestinal cancers, such as pancreatic cancer. Compelling evidence suggests proton therapy may lead to improved outcomes and less risk of damage to nearby organs, like the small intestine, kidneys, spinal cord, and stomach.
• Recurrent gastrointestinal cancers: Proton therapy is a safe treatment option for patients with recurring cancer in certain organs previously treated with radiation.

We continue studying the use of proton therapy for various gastrointestinal cancers through clinical trials, exploring new and safer ways to treat patients with these cancers.

Our radiation oncologists are focused on treating you, working with a multidisciplinary team of specialists to create a comprehensive treatment plan that will work best for your needs. Talk to one of our experts today to see if proton therapy may be an option for you.

• Cervical cancer
• Endometrial cancer
• Vulvar cancer

Cancers of the head and neck and skull base are difficult to treat, depending upon the proximity of the tumor to the many essential organs in the region. For patients who need radiation therapy, it’s important that we avoid the eyes, jawbone, teeth, and saliva-making glands as much as possible. At MedStar Georgetown, our proton therapy system with HYPERSCAN allows us to significantly reduce low-to-medium dose radiation to these areas because there is no exit dose—the highest levels of radiation are deposited directly to the tumor site. As a result, proton therapy may decrease the risk of side effects and/or allow higher doses of radiation.

Current indications for proton therapy for head, neck and skull base tumors, and the benefits of proton treatment, include:

• Oropharynx cancers: Studies show that compared to intensity-modulated radiation treatment, proton therapy for oropharynx tumors results in reduced rates of feeding tube usage and less impairment to taste and appetite. Other advantages of proton therapy in treating these cancers may be less weight loss, dry mouth and fatigue, and a quicker return to work.
• Nasopharynx cancers: As a result of less radiation exposure to healthy tissue, including nerves to the eyes and portions of the brain involved in memory, proton therapy may reduce side effects, such as visual problems, cognitive issues, as well as dry mouth and dental problems in patients with cancer in the pharynx.
• Paranasal sinus cancers: Proton therapy is the standard of care for treating paranasal sinus cancers, as studies show it lowers the risk of tumor recurrence, compared to treatment with conventional radiation. It may also decrease the risk of visual and cognitive problems due to less radiation dose to the brain.
• Hypopharynx cancers: In select patients with cancers of the hypopharynx, proton therapy may allow sparing of tissue that is involved with swallowing and voice. Paraganglioma and schwannoma: Proton radiation can be used to treat these tumors with decreased radiation exposure to healthy tissue nearby.
• Salivary tumors: Proton therapy reduces the radiation dose to the uninvolved areas of the head and neck, making it an excellent option for treating salivary tumors. In select cases, proton therapy may allow higher doses of radiation to be applied to areas at highest risk of microscopic or known residual cancer.
• Skull base tumors: Because proton therapy is highly precise, leaving no exit dose, it allows for optimal dosage to increase the chance of cure in skull base tumors. It is often considered the standard of care for these tumors.
• Skin cancers: Since proton therapy does not deposit dose beyond the target, it may be useful for certain skin cancers that are near critical areas, including the scalp, over the cheek, or in other regions. Recurrent tumors: Proton therapy allows for curative doses while sparing normal tissues that have previously been irradiated, with promising results.

At MedStar Georgetown our subspecialists in both head and neck radiation oncology and otolaryngology have extensive experience in dealing with complicated cases, and also know how to best optimize the balance between tumor cure and side effects. Furthermore, we are all integrated together with an expert team including neuroradiologists, all under one roof.

If you have head and neck cancer, a team of multidisciplinary specialists will review your case and customize a treatment plan that will be most effective for your unique diagnosis, needs, and preferences. Call us today to learn if you may benefit from proton therapy.

Many patients with lung cancer that cannot undergo surgery are treated with radiation therapy, usually in combination with chemotherapy. Although standard radiation treatments are often effective, nearby healthy organs, such as the esophagus, heart, and uninvolved lung can be exposed to radiation. This can increase the risk of treatment-related complications, such as difficulty swallowing, lung inflammation, and heart problems later in life.

Proton therapy may be a good option for patients with locally advanced lung cancers and thoracic tumors because it allows a radiation oncologist to deliver targeted radiation to the precise size, shape, and depth of the tumor. Unlike traditional radiation which gives off radiation beyond the tumor, proton therapy deposits the radiation directly in the tumor and then stops—there is no exit dose. As a result, the heart and other critical organs receive less exposure to harmful radiation.

Whether or not you are a candidate for proton therapy depends on several factors, including your tumor’s size, location, proximity to nearby organs, and overall treatment goals. Proton therapy may be especially advantageous in for patients who have:

• Cancer on the left side
• Large tumors, or tumors that cannot safely be treated with other types of radiation
• Additional heart or lung problems
• Genetic mutations linked to cancer
• A long life expectancy ahead of them
• Recurrent cancer

Proton therapy is generally accepted as part of the standard of care treatment for many pediatric cancers. In addition to providing the most advanced form of radiation therapy for adults, this type of therapy is beneficial for children, in particular, for several reasons.

• Children are less likely to develop a secondary cancer later in life when treated with proton therapy as it treats tumors while minimizing damage to healthy surrounding cells.
• Proton therapy lowers a child’s exposure to radiation, avoiding unnecessary radiation exposure and resulting in less growth impairment as they develop.
• Proton therapy causes fewer side effects compared to traditional radiation, allowing children to continue their everyday life with less disruption during the treatment process.

Proton therapy, or other advanced radiation therapies, may be a treatment option for men with prostate cancer. Proton therapy delivers radiation precisely to the prostate with minimal exit dose, which means that nearby organs may receive less radiation exposure. At MedStar Georgetown University Hospital, patients have access to the fastest and most advanced form of proton therapy available, using HYPERSCAN with pencil beam scanning to precisely target a tumor’s exact size, shape, and depth.

Here, a multidisciplinary team of cancer experts, including experienced radiation oncologists, will work together to determine an individualized treatment plan for your specific cancer based on several factors, including your age, cancer stage, symptoms, and overall health.

Historically, giving radiation to a previously treated area was not an option, leaving patients with recurrent cancers little hope. Today, re-irradiation can be an effective and safe treatment option when delivered by an experienced team. Our multidisciplinary team at MedStar Georgetown is highly skilled in administering proton therapy to treat patients for recurrent cancers of the breast, esophagus, brain, lung, prostate, pancreas, and neck/head.

Unlike conventional radiation, proton beams stop at the tumor site and do not continue to travel through the rest of the body, significantly limiting the radiation dose to nearby healthy tissues. As a result, proton therapy offers the following advantages for re-irradiation:

• Reduces radiation exposure to surrounding healthy tissues
• Leaves virtually no exit dose, as little to no radiation continues past the tumor
• Lowers the risk of radiation-induced secondary cancers
• May result in fewer side effects and better quality of life

• Extremity sarcoma
• Retroperitoneal sarcoma

We were the first in the world to offer the Mevion S250i with HYPERSCAN™ technology, which is the fastest and most precise proton system available today. We remain the only Proton Therapy Center in Washington, D.C. treating patients with this advanced system, using pencil beam scanning (PBS) to deliver intensity-modulated proton therapy (IMPT) to treat tumors layer-by-layer. With pinpoint accuracy, HYPERSCAN can deposit its cancer-fighting dose directly into the tumor and then stop, leaving virtually no exit dose. This allows for better dose distribution and fewer side effects.

In addition, our proton therapy system integrates advanced imaging systems, including Surface Guided Radiation Therapy (SGRT) which ensures the highest level of precision while treating many types of cancer, including breast cancer. The advanced imaging technique allows us to continuously track a patient’s position and motion, thereby increasing patient safety and comfort while increasing treatment accuracy.

No two cancers are the same, and it’s important to seek care from someone with experience in treating yours. Many of our radiation oncologists have extensive experience with proton therapy and focus exclusively on treating certain types of cancers, including breast, prostate, and lung cancers, as well as those affecting gastrointestinal organs and the head or neck. This disease-specific emphasis ensures we have the depth and breadth of experience necessary to lead to the best outcomes for you and your particular cancer. In addition, our board-certified radiation oncologists have experience treating all ages, including using proton therapy to treat the adolescents and young adult population. Our experts also conduct weekly case conferences to comb through the details of each patient undergoing proton therapy. This thorough review process allows us to uphold the highest quality of care and safety for every individual patient.

Our patients benefit from the collective input of different specialists who work together to develop comprehensive treatment plans that consider all possible options. Our radiation oncologists work closely with surgeons, medical oncologists, and others, meeting in multidisciplinary tumor boards to design individualized care plans that integrate the physical, emotional, financial, and spiritual aspects of cancer treatment—all within the same facility.

As the first point of contact for many, Cheryl Savage, our department administrator, shares her knowledge of the various treatment options so patients can get answers to questions before they even meet with their physician team. With a background in radiation therapy, Cheryl helps cancer patients navigate diagnosis, treatment, and life outside of the hospital, providing seamless coordination with the various members of your care team.

Our research engine, Georgetown Lombardi Comprehensive Cancer Center, is the only comprehensive cancer center in the Washington D.C., region designated by the National Cancer Institute (NCI), offering breakthrough therapies and the latest in cancer treatments. Our oncologists and researchers continue to find better ways to prevent, diagnose, and treat cancer, including studying innovative ways to use proton therapy and other forms of radiation in clinical trials.

View available trials in proton therapy.