Proton Therapy for Breast Cancer (Proton Beam Radiation)

Proton beam radiation is a type of external beam radiation that uses positively charged particles called protons to destroy cancer cells. Like other types of radiation, proton therapy works by damaging the DNA inside cancer cells. This makes it harder for cancer cells to divide and grow.

Proton therapy is considered more precise than traditional external beam radiation.

Traditional external radiation uses high-energy X-ray beams to destroy cancer cells. X-rays hit the tumor treatment site, but then can continue through the body, potentially affecting tissues in the path of the radiation. Because the breasts are close to the heart and lungs, these organs may receive some radiation. Newer radiation techniques for breast cancer, including having people receive radiation in a facedown position or having them hold their breath, may help minimize the amount of radiation that hits healthy tissue.

Unlike X-rays, once protons hit the targeted treatment area, they stop. This potentially reduces the risk of the radiation hitting other tissues and organs and minimizes side effects. However, when proton therapy is used to treat breast cancer, protons may travel a range of distances because of the shape of the breast and chest wall.

There are other important differences between proton therapy and traditional external radiation:

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  Proton therapy is much more expensive than traditional external radiation and is not covered by all health insurance plans.

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  Proton therapy is not as widely available as traditional external beam radiation. While many large teaching and research facilities offer proton therapy, it’s not commonly available at smaller, community hospitals. According to the National Association for Proton Therapy, there are 44 proton centers in the United States and more than half of them are east of the Mississippi River.

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  While research on proton therapy for breast cancer is ongoing, no large studies have shown that proton therapy is better than traditional external beam radiation in reducing recurrence rates or improving survival, or that it offers better cosmetic results or causes fewer severe side effects. In fact, studies have shown that proton therapy causes more severe skin side effects, as well as more long-term side effects.

At this time, proton therapy is not commonly recommended to treat breast cancer outside of a clinical trial and there are no formal guidelines recommending proton therapy for breast cancer. Some centers may offer proton therapy off-trial.

Receiving proton therapy is very similar to receiving traditional external radiation. There is a planning session and then people usually receive treatments five days a week for several weeks.

Some doctors think proton therapy may cause fewer and less severe side effects than traditional external beam radiation, but more research is needed. But that doesn’t mean there are no side effects. The most common side effects of proton therapy are similar to traditional external radiation side effects:

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  fatigue

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  skin redness in the treated area

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  tenderness or pain in the treated area

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  hair loss in the treated area

Before proton therapy is routinely recommended to treat breast cancer, experts agree that more research is needed to figure out:

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  if proton therapy is more effective than traditional radiation therapy

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  how the benefits and side effects of proton therapy compare with traditional radiation therapy

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  the people who might benefit the most from proton therapy

The cost of proton therapy will vary according to your health insurance and where you live and receive care.  Medicare may cover proton therapy to treat breast cancer if it’s the most appropriate treatment, meaning other types of radiation therapy aren’t an option.  To learn more about out-of-pocket costs for proton therapy, contact your health insurance company.