Cancer is a significant health concern in India, and its prevalence has been increasing in recent years. According to the National Cancer Registry Program (NCRP) of India, the estimated number of cancer cases in India in 2020 was 13.9 lakhs (1.39 million), with a prevalence of 163 cases per 100,000 population. The most common types of cancer in India are breast, cervical, oral, and lung cancers. Other types of cancer, such as prostate, colorectal, and stomach cancer, are also prevalent in India. Proton Beam Therapy in India is widely taken in use to treat patients.
The incidence of cancer varies across different regions and states of India, with higher rates reported in urban areas compared to rural areas. Additionally, certain lifestyle factors such as tobacco use, alcohol consumption, unhealthy diet, physical inactivity, and environmental factors, such as air pollution, are known to contribute to the development of cancer.
Early detection and timely treatment of cancer can significantly improve the chances of survival and quality of life for patients. Therefore, it is essential to increase awareness about the risk factors of cancer and promote regular cancer screening and early diagnosis in India.
Here is the year-wise prevalence of cancer in India, according to the National Cancer Registry Programme (NCRP) reports:
- 2011: 121 per 100,000 population
- 2014: 130 per 100,000 population
- 2015: 106 per 100,000 population
- 2016: 112 per 100,000 population
- 2017: 115 per 100,000 population
- 2018: 126 per 100,000 population
- 2019: 130 per 100,000 population
- 2020: 163 per 100,000 population
- 2021: 179 per 100,000 population
As you can see, the prevalence of cancer has been steadily increasing in India over the years. This could be attributed to various factors such as aging population, lifestyle changes, and environmental factors.
What is Proton Beam Therapy?
Proton beam therapy is a type of radiation therapy used to treat cancer. It uses high-energy protons to kill cancer cells and is considered a more targeted form of radiation therapy than traditional radiation therapy. Proton therapy is a relatively new and expensive treatment option in India and may not be suitable for all types of cancer. It is essential to consult with a qualified oncologist to determine if proton therapy is the right treatment option for your specific type of cancer. Get know about proton cancer therapy in India.
There are a few hospitals that offer proton beam therapy in India for cancer treatment. Some of these hospitals are:
Apollo Proton Cancer Centre, Chennai: This is the first proton therapy center in South Asia and is equipped with state-of-the-art proton therapy equipment. It offers proton therapy for various types of cancer, including brain tumors, prostate cancer, and pediatric cancers.
Max Hospital, Delhi: This hospital offers proton therapy for a range of cancers, including head and neck cancer, breast cancer, and lung cancer.
Tata Memorial Hospital, Mumbai: This is a leading cancer treatment hospital in India and offers proton therapy for select cases of cancer.
HCG Cancer Centre, Bangalore: This hospital offers proton therapy for various types of cancer, including pediatric cancers, brain tumors, and prostate cancer.
Types of Cancer Treated with Proton Beam Therapy
Several scientists are working on the fact that which types of cancer can be treated with proton beam therapy. At Penn Medicine’s Roberts Proton Therapy Center, our radiation oncologists are always looking for new applications for proton therapy to treat cancer and benign (noncancerous) tumours. Tumours that are in or close to vital organs like the brain, heart, or lungs as well as tumours that have not spread (i.e., are not metastatic) can all benefit from proton therapy. At present, the types of cancers best treated with proton therapy include:
- Brain cancer and spinal tumors Breast cancer
- Cervical cancer
- Gastrointestinal (GI) cancers
- Head and neck cancer
- Kidney cancer Lung cancer
- Lymphoma Mesothelioma Pediatric cancers
- Prostate cancer
- Throat (oropharyngeal) cancer
Types of Proton Therapy
Passive scattering beam delivery
Passive scattering is a delivery technique in which scattering and range-shifting materials spread the proton beam. The therapy was delivered by passive scattering in the first commercially available proton delivery systems. In scattering proton treatment, scattering devices spread out the proton beam, which is then shaped by placing objects like collimators and compensators in the beam’s path. Using milling machines, the collimators were created specifically for the patient. The target volume receives a homogenous dosage from passive scattering. Passive scattering hence offers less control over dosage distributions close to the target. To deliver pencil beam scanning, numerous scattering therapy systems have been upgraded over time.
Pencil beam scanning beam delivery
Pencil beam scanning is a more recent and adaptable delivery technique that employs a beam that sweeps laterally over the target to provide the required dose while closely mimicking the shape of the tumour. This conformal delivery is accomplished without the use of apertures or compensators by magnetically scanning small proton beamlets to shape the dose. Multiple beams are delivered from various angles, and magnets in the treatment nozzle direct the proton beam as the dose is applied layer by layer to conform to the target volume. Delivery of protons via pencil beam scanning allows for the most precise type of proton delivery: intensity-modulated proton therapy (IMPT). IMPT is to proton therapy what IMRT is to conventional photon therapy—treatment that more closely conforms to the tumor while avoiding surrounding structures.
Benefits of Proton Radiation for Cancer
Proton therapy is more precise than other types of radiation therapy. Our radiation oncologists can design radiation beams that exactly fit the shape and depth of the tumor. The proton beams deliver most of their energy only in the targeted tissue.
Less damage to healthy tissue:
Proton treatment can minimize the radiation dose to healthy surrounding tissues by 50 to 70 percent. Decreased radiation means minimum tissue damage to critical areas near tumors and reduced risk of later complications due to radiation.
Possibility for higher radiation dose:
The decreased risk of damage to surrounding tissue means our radiation team can increase the radiation dose to the tumor. Additionally, a higher dose can be more effective in destroying cancer cells.
Fewer, milder side effects:
In the latest studies, patients stated that fewer side effects such as pain, difficulty swallowing, difficulty breathing, nausea and diarrhea. Also, reducing side effects helps you feel better so you can complete your course of treatment without delays.
Ability to treat recurrent cancer:
People who have conventional radiation for cancer treatment may not be able to have radiation again if the cancer comes back (recurrent cancer). That’s because healthy tissue near tumors can be irreversibly damaged by too much radiation. Proton therapy can be an option because of the reduced radiation exposure to nearby tissue.
Proton Beam Therapy vs Other Treatments
Because proton therapy is a type of radiation therapy it has a lot of similarities to other forms of radiation therapy. However, the two most prominent differences between proton therapy and other radiation treatments are the beam types used and the precision they offer. Traditional radiation therapy remains a powerful cancer treatment option. There are many reasons a provider may recommend one treatment over the other.
During several trials it is justified the comparison between proton beam therapy compared to other treatments.
There is a Phase II Randomized Controlled Trial that compared photons versus protons for Glioblastoma and concluded that patients at risk of severe lymphopenia could benefit from proton therapy. Using data from the National Cancer Database for nine types of tumors: head and neck, gastrointestinal, gynecological, lymphoma, lung, prostate, breast, and bone/soft tumors, the Stanford University team investigated primary cancers with external beam irradiation. We assessed the risk of second cancer after treatment. Tissue and brain/central nervous system. The study included a total of 450,373 patients and concluded that proton therapy was associated with a reduced risk of developing second cancers.
Proton Therapy Vs X-Ray
Megavoltage X-ray therapy has less “skin protection potential” than proton therapy, and x-ray exposure to the skin and very shallow depths is lower than proton therapy. One study estimates that passively scattered proton fields produce slightly higher skin-incident doses (~75%) compared to therapeutic megavolt photon (MeV) beams (~60%) . The dose of x-ray radiation is gradually reduced, causing unnecessary damage to deep body tissue and damage to the skin and superficial tissue on the side of the beam’s entrance. X-ray’s advantage of less skin damage at entry is partially offset by skin damage at exit.
X-ray treatments are usually delivered in multiple doses from opposite sides, so each section of skin is exposed to both incoming and outgoing X-rays. With proton therapy, skin exposure is high at the point of entry, but tissue on the other side of the tumor is not irradiated. Therefore, X-ray therapy is slightly less damaging to the skin and superficial tissues, and proton therapy is less damaging to deep tissue before and after the target.
Doctors decide whether to have surgery or proton therapy (or radiation therapy) based on the type, stage, and location of the tumor. Surgery may be better (such as cutaneous melanoma), radiation may be better (such as skull base chondrosarcoma), or it may be equivalent (such as prostate cancer). In some cases, these may be used together (such as rectal cancer or early-stage breast cancer).
|Uses beams of energetic protons||Uses photons to irradiate diseased tissues|
|Fewer serious side effects||More serious side-effects|
|Slow effects on survival control||Slow effects on survival control|
The advantage of external proton therapy lies in its dose difference with external x-rays and brachytherapy when the use of radiotherapy is already indicated and does not directly compete with surgery. For prostate cancer, the most common indication for proton therapy, no clinical studies have directly compared proton therapy to surgery, brachytherapy, or other treatments, demonstrating the clinical benefits of proton therapy. In fact, the largest study to date showed that IMRT was associated with reduced gastrointestinal disease compared to proton therapy. proton cancer therapy in India.
Risks of Proton Therapy
Proton therapy can cause side effects if cancer cells are killed or if the proton beam’s energy damages healthy tissue near the tumor. Because proton therapy gives doctors better control over where the highest energy concentration is delivered, it is believed to be less damaging to healthy tissue and have fewer side effects than conventional radiation therapy. Nonetheless, proton therapy releases some of its energy into healthy tissue.
The side effects you experience depend on which part of your body is being treated and the dose of proton therapy you are receiving.
In general, the most common side effects of proton therapy are:
- Hair removal on treated body parts
- Redness of the skin around the treated area on the body
- Pain in the part of the body that was treated
Costs of Proton Beam Therapy
The cost of proton beam therapy varies depending on several factors, including the location of the treatment facility, the type of cancer being treated, the stage of cancer, and the number of treatment sessions required. In general, proton beam therapy is more expensive than traditional radiation therapy due to the higher cost of the equipment.
The cost of proton beam therapy can range from $30,000 to $150,000 or more per patient, depending on the factors mentioned above in the United States. There are cases wherein health insurance may cover the cost of proton beam therapy, but patients may still be responsible for co-payments, deductibles, and other out-of-pocket expenses.
It is important to note that proton beam therapy may not be the most appropriate treatment option for all types of cancer, and patients should consult with their healthcare providers to determine the best course of treatment for their individual needs.
A 2007 study raised concerns about the efficacy of proton therapy for proton cancer therapy in India. However, this situation could change significantly with the advent of new developments in technology such as improved scanning techniques and more precise dose delivery (“pencil beam scanning”). Not for everyone. Notably, some other treatments offer better overall benefits in treating prostate cancer. In 2018, single-chamber particle therapy systems will cost $40 million, and multi-chamber systems will cost up to $200 million.
With insurance, in major Indian cancer hospitals across several cities, the proton therapy treatment costs around Rs. 25,00,000 ($32,700). Without insurance, the proton beam treatment cost can range somewhat up to $120,000. However, actual expenses may vary based on several factors, including the tumor’s size and location and the length of therapy.
How long does proton therapy take?
The treatment time for proton beam irradiation is about 15 to 30 minutes after entering the treatment room. The duration depends on the area to be treated and the number of treatments. It also depends on how well the team can identify the tumor site from her X-ray or CT scan during the positioning process.
Factors affecting treatment time include:
- Treatments performed from various portal angles. Ask if they will come through the portal or if the portal will revolve around you.
- Target different areas that require different radiation fields. For example, one treatment may target the tumor itself, while another may target surrounding tissues or lymph nodes.
- Wait for the proton beam to move from one treatment room to the next. In centers with multiple treatment rooms, you may have to wait several minutes as the proton beam is magnetically guided from one room to the next.
What are the locations of proton therapy centers globally?
The Proton Treatment Centre at Apollo Hospitals in Chennai is Southeast Asia’s first proton cancer centre, identifying priority research and development areas and conducting basic and applied research. There are over 89 particle therapy centres globally as of August 2020, with at least 41 more under construction. There will be 34 functioning proton therapy centres in the United States by August 2020. More than 154,203 patients had been treated worldwide as of the end of 2015.
The size and cost of the requisite cyclotron or synchrotron equipment is one barrier to widespread use of the proton in cancer treatment. Several corporate teams are developing fairly modest accelerator devices to give proton treatment to patients. There are numerous countries that are adapting different different cenetrs for proton beam therapy.
Locations For Proton Beam Therapy
Australia- Construction on “SAHMRI 2”, the second building for the South Australian Health and Medical Research Institute, will begin in July 2020. ProTom International will install its Radiance 330 proton treatment system, which is the same system utilised at Massachusetts General Hospital, to supply the proton therapy unit. When fully operational, it will be able to treat 600-700 patients each year, with around half of these being adolescents and young people.
Israel- In January 2020, it was announced that a proton therapy centre would be built at the Tel Aviv Sourasky Medical Center’s Ichilov Hospital. The construction of the facility was entirely sponsored by donations. There will be two therapy rooms.
Spain- The Amancio Ortega Foundation has agreed to provide 280 million euros to the Spanish government and numerous autonomous communities in October 2021 in order to establish 10 proton accelerators in the public health system.
United Kingdom- The British government announced in 2013 that £250 million had been budgeted for the establishment of two advanced radiotherapy centres: The Christie NHS Foundation Trust (the Christie Hospital) in Manchester, which opened in 2018; and University College London Hospitals NHS Foundation Trust, which will open in 2021.
What are the locations of proton therapy centers in India?
Apollo Proton Cancer Centre (APCC) in Chennai, Tamil Nadu, a unit under Apollo Hospitals, is a Cancer specialty hospital. APCC is the only cancer hospital in India with Joint Commission International accreditation. Apollo Hospital in Chennai is the only centre in South and West Asia that provides proton beam therapy. The hospital has treated up to 900 patients, and around 47% of cases were brain tumours. Additionally, prostate, ovaries, breast, lungs, bones, and soft tissues cancer patients have also seen promising results through this therapy.
Patient Experience During and After the Proton Beam Therapy
- The dosage and whether you are also receiving chemotherapy are two more factors that may influence how you feel following treatment.
- Fatigue is a common side effect, especially when a vast area is being treated, as are temporary hair loss and skin reactions in the radiation’s direct path.
- Radiation therapy may have unfavourable outcomes. These issues could arise as a result of the therapy or as a result of radiation damage to neighbouring healthy cells.
- The frequency and severity of adverse effects will vary depending on the type of radiation used, the amount administered, and the body location being treated. Inform your doctor and/or nurse so that they can assist you in
- Radiation can have both immediate and delayed negative effects. Early side effects occur during or immediately following therapy. They usually go after a few weeks. Fatigue and skin problems are two common early side effects.
- Skin that is sensitive, red, itchy, or swollen may occur in the treatment area. Other changes include dryness, stinging, peeling, and blistering.
How to Choose a Hospital for Proton Beam Therapy in India?
Proton radiation therapy facilities in India have a reputation for being pleasant and patient-centered. One of the greatest proton treatment hospitals in India can be found, and these institutions are staffed by the best doctors in India. Choosing a decent hospital for treatment may be difficult for an international patient. It is critical to understand the proton beam therapy cost in India while keeping in mind:
- Quality certificates and accreditations
- Hospital and transportation facility location
- Team of doctors and surgeons
- Advanced diagnostic and therapeutic equipment
- International patient assistance
In order to conclude the article, it can be said that proton beam therapy in India are widely used to treat patients suffering from different types of cancer. It was found that proton beam therapy may cause fewer side effects than other forms of radiation therapy. But, proton beam therapy is not widely available, as it requires specialized equipment and expertise to administer the treatment. This therapy can be highly effective for treating certain types of cancer, such as prostate cancer, brain tumors, and certain pediatric cancers. Also, there is limited long-term evidence on the effectiveness of proton beam therapy compared to other forms of radiation therapy. Besides all these, it has both side effects and benefits and the therapy will be applicable to the patients depending upon the patient’s severity as well. In general, it can be said that: