Proton Beam Therapy for Cancer Treatment in India

The package of proton beam therapy (PBT) in India starts from $45,000 for patient from SAARC countries and $65,000 for international patients.

The X-rays Vs The Protons

By and large Radiation Therapies have been associated with curing mostly all types of cancers. The cancer cells are destroyed by high-energy waves to eradicate the cancer-causing cells using radiation; however, the leakages could kill the healthy cells surrounding the targeted area.

Its Radiation is yet targeted

Proton Beam Radiation Therapy, is a breakthrough and more advanced than all other radiation therapies, especially when a higher radiation dose is required for a more accurate outcome. is administered to the targeted areas in form of concentrated radiation, which hits the tumor/cancer cells from different directions.

  • PBT is a painless therapy and precise.
  • It’s less time-consuming. It’s the preparation and positioning that takes a long time for a more accurate outcome.
  • Based on the size/shape of the tumor the doctors can aim better target radiation.
  • It can be used to treat even noncancerous/benign tumors in the case of children and adults.

Types and Techniques of Proton Beam Therapy

The PBT or proton radiotherapy or even termed as particle therapy and what type of PBT treatment or the technique required, in a particular situation is based on:

  • Assessment
  • Suitability
  • Technique

The case first undergoes an assessment- the tests to be conducted are ascertained, where it’s checked for suitability in context to the dosage and then the technique is determined.

This advanced form of radiation uses protons instead of conventional X-rays, in which the exit dose may spill and impact adversely on the healthy cells. However, PBT has the flexibility to regulate either a high energy beam dose or a low energy beam dose, as per the depth of the tumor so that a suitable amount of radiation could be delivered to different parts of the tumor which could be at vital or very delicate parts of the body.

Below are the types of tumors where PBT is the best available option for treatment:

  • Neuro cancer
  • Head & Neck Cancer
  • GI Cancer
  • Urology Cancer
  • Thoracic Cancer
  • Gynec Cancer
  • Paediatric Cancer

After identifying the area of treatment, PBT may be:
Passive beam scattering: a method of vulnerability detection without direct interaction. The data is captured through a target computer.

Dynamic spot scanning system: also known as “pencil beam” which is magnetically scanned across the target cross-section.

In PBT the high energy beam, which has the flexibility to be regulated, and works with precision, destroys the order of the DNA which eventually destroys the tumor cells.

The Tripple-D Reaction:

  • Disrupts the DNA cells.
  • Disables the growth of the tumor.
  • Doesn’t allow it to grow new cells or repair.

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How does proton beam therapy work?

The implementation of the PBT session is now automated and the majority of hospitals and the doctor’s fraternity use the beam angle selection using Bayesian optimization.

In some cases, the Bayesian optimization is combined with ECHO (Expedited Constrained Hierarchical Optimization).

Before the final session, there is a responsible planning process that plays a very vital role.

This planning may take a few weeks to carry out an impeccable procedure. This includes:

  • A sound diagnosis– the exact target area has to be determined with a team of experts, understanding the history and the influencing factors.
  • Reports– the target area is finally determined based on the CT scans, CBCT, MRI reports and the involvement, size, shape and adjoining tissues, cells and organs are studied and confirmed.
  • Mapping– much before the treatment finally begins there is a treatment planning process known as ‘simulation’ to rule out any uncertainty during the course of treatment and for a smooth and predictable plan of action. This may take more than an hour. In some cases, MRI & PET scans may be done on the day of the simulation as well.
  • Positioning– It is highly critical to have the body correctly positioned. The reports are the basis of marking the body to aim for the exact administration of the proton beam. Depending on the severity these marks may or may not be permanent.
  • Immobilization devices– are created by the radiation team to maintain the same position during each session. Precautions are taken to create immobility which may not interfere with the basic functioning of other organs, like a breath-through mask if the head or neck is being treated.
  • Dosage determination with a goal– PBT stands apart due to its adjustable high-energy dosage administration feature.
    How deep should the beam travel, and how much radiation has to be delivered is ascertained by programmed computers (proton treatment planning software) used by the dosimetrists and the radiation oncologists aiming to kill the cancer cells with the least damage to the healthy tissue. This technical planning may take a week or more.
  • Quality control– The quality control team ensures that the entire system, technical planning, dose administration, patient reports, and all the members of the team correspond well from the start to end; and may have further relevance post-treatment as well. The team checks and eliminates the defects in the entire planning and execution of the treatment.

Benefits of Proton Beam Therapy

The fundamental advantage of a PBT over other conventional radiotherapy methods is- precision which improves the quality of life during and post-treatment.

  • Less side scatter-PBT works directly on the targeted area, with an adjustable energy input and comparatively much-reduced damage to the neighboring healthy cells. The healthy tissues and critical organs are spared.
  • It’s painless and more non-invasive.
  • Better dose distribution-Its best suited for tumors diagnosed close to closely organized tissues. This is in the case of irregularly shaped lesions near very delicate and critical areas only protons are suited.
  • More skin-sparing comparatively.
  • Better stopping factors– in case of recurrent tumors and patients who have already been exposed to radiation.
  • Extremely suitable for pediatric use/for children who are otherwise more prone to regular x-ray radiation.
  • The higher cure rate with better cancer control.
  • Well tolerated– by all age groups.

Cost of Proton Beam Therapy in India

The package of proton beam therapy (PBT) in India starts from $45,000 for patient from SAARC countries and $65,000 for international patients.

The package includes all treatments and investigations related to proton, airport pickup and drop and translator.

The cost attached to this therapy contributes to the leaner availability of this therapy, however, the total cost involved in case of the traditional radiation therapy is sometimes more than the PBT considering the post-care cost and towards the treatment in case of resurfacing of the cancerous cells.

The cost as per session

The PBT treatment is considered the best radiation option if cancer has not travelled to other/various parts of the body. It, therefore, targets a specific location. Once the cancer site is ascertained, based on the severity of the cancer cells, more than one session is recommended. Sometimes 4-5 sessions spread over 6-7 weeks.

The treatment is considered successful if the cancer doesn’t resurface within 5 years.

Possible side-effects

As the PBT treatment is known for its painless administration, there may be some side effects that may surface depending on the severity, the tumour site, the patient’s medical track record, and the expertise of the radiation team.

The good news, however, still makes it stand apart for being painless and for ruling out discomfort.

Some very common side effects that have been seen may take a while to appear are the delayed side effects, while there is no outline to ascertain if they appear in a few months or even a few years.

Patients may experience

  • Temporary hair loss and bearable fatigue (mostly considered as immediate side effects and they go in just a few weeks).
  • Skin sensitivity which results in redness, irritability, and puffiness. PBT usually is considered skin-sparing otherwise.
  • The severity may sometimes get deeper to blistering and peeling off the skin.
  • Oral involvement- of mouth and in swallowing, which further leads to indigestion.
  • Constipation, nausea accompanied by severe headaches.
  • Changes or some alterations in the brain, spinal cord, lungs, kidneys, colon and rectal area.
  • Infertility- depending on the tumour site.

Caution: Apart from these treatment-based side effects, the radiation process itself sometimes triggers cancerous growth. This can be ruled out only by a detailed examination, an efficient oncologist and regular follow-ups.

How can Lyfboat assist you getting Proton Beam Therapy in India?

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Lyfboat is a free advisory platform; we do not charge any fees from patients. In fact, we negotiate the price that Indian hospitals offer. In some cases we are able to reduce the cost by negotiating upto 20% of what Hospitals generally offer. We advise the best treatment from the top hospital/surgeon at best price.

Frequently Asked Question about Proton beam Therapy

Q. Is it safe for kids?
The PBT treatment is best suited to children of all age groups considering its painless nature, less time consuming and better cure rate.

Q. How long it may last?
The PBT is delivered in less than 30 minutes, however, the preparation time takes 1-2 weeks as it involves accurate positioning.

Q. Is PBT covered by insurance?
Medicare services do cover PBT treatment, however, the coverage depends on case to case and place to place.

Q. What to expect before coming for PBT treatment?
The technical processing time does take time, do not hurry. Its accurate pre-treatment planning and positioning which would ascertain a higher cure rate. Regular and timely follow-ups cannot be ruled out.

Q. How to decide on a PBT centre?
A place that has a global footprint and is trusted to provide information and tools to research treatment options, prices and gets trusted opinions all in one go. The initial right choice about the place offering such options plays a very critical role if at the treatment is hassle-free and worth the money spent.

Q. What if the physician does not recommend PBT or may not even has it on his list of options?
PBT is the most refined form of radiation known for precision. There may not be a reason not to suggest PBT as an option. In all likelihood, they may not have access to this treatment. However, not considering may only result in not choosing the best just because it wasn’t advised at a certain place. A place that is well equipped and educated to know all the services and tools regarding a specific line of treatment may only be trusted.

Q. How many treatment sessions are required?
The type of cancer and its severity ascertains the number of these treatment sessions.
By and large, the PBT team administers the proton therapy in 1-5 proton beam treatments.

Q. When to expect the side effects to start showing up?
There is no specific time for the side effects to show up. Sometimes it surfaces in a few months or a few years. The risk involved in the side effects of a PBT treatment over the conventional treatment is less, however, may be permanent in nature.

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Dr. Surbhi Suden is one of the founders of Lyfboat and a doctor with a renowned name in the Medical tourism industry. She has been working with international patients since 2008 and is a deeply committed professional with a long term vision of transforming the current healthcare scenarios.
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