h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Recently, radio-oncologists have a new tool to treat pituitary and other skull base tumors, proton radiation. Unlike normal (x-ray) radiation therapy, proton radiation does not ionize a path completely through the body. The protons do most of their ionization within a centimeter of the target zone. While there is some amount of tissue damage done along the entry path, there is NO radiation exiting past the target area. And the amount of tissue damage along the entry is very minimal as the protons release most of their ionizing radiation near the target zone as the particles come to a stop.

I went through this treatment in the winter of '06-'07 for a suprasellar sphenoid chordoma that was located adjacent to my pituitary gland. The tumor was pressing on the optic nerves. Traditional radiation was not an option as it would have severely damaged the surrounding tissues leading to much more extreme hypopituitarism and most likely, blindness. As it is, now, my only lasting effect is some amount of gonadotrophin defeciency, treatable by testosterone replacement. During treatment, the only noticeable effect that I experienced was two spots of localized hair loss... that was it. (I wasn't typical but side effects from proton radiation do tend to be much less severe than for typical radiotherapy.)

Sounds good

As far as I know the main problem with proton therapy is making the things - while x-rays and electrons are relatively easy to produce using more or less the same machine, protons need a particle accelerator to get them up to speed.

The largest downside to proton therapy is, of course, the cost. The fear is that proton therapy will be prescribed for cases that do not warrant the high cost. For example, prostate tumors are very successfully treated with traditional radiotherapy. The cases tend to be men past the age when fertility is an issue. There are no tissues around the prostate that need to be as protected as those in the skull or in the chest. Yet many of the patients I saw during my treatments were obviously prostate patients.

The need to "push" this technology is obvious. Without enough paying patients, these things won't be built. But to treat patients who can be treated just as successfully for a fraction of the price is concerning.

Don't get me wrong... if price isn't an issue, always go for the protons. But that extra amount spent will come out as higher premiums and health insurance costs.