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Cancers that can be treated with proton therapy

Esophageal Cancer Treatment with Proton Therapy

This diversity in tumor type brings with it a wide range of suitable esophageal cancer treatments that may include surgery, chemotherapy, radiation, or a combination thereof, depending on the specific classification and aggressiveness of the tumor.
Radiation therapy is used to destroy cancer cells and prevent their regrowth. When treating esophageal tumors, it is especially important to treat the tumor and kill cancer cells while preserving the surrounding healthy tissue. Proton therapy can be an excellent tool that doctors use to achieve this balance.

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Signs / Symptoms

Patients may not experience symptoms until the cancer has progressed. Some of the most common symptoms associated with esophageal cancer are listed below.

  • Difficulty or pain when swallowing

  • weight loss

  • Pain in the chest behind the breastbone

  • Cough

  • hoarseness

  • Indigestion and heartburn

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Diagnosis

Imaging and other studies used for diagnosis and staging may include:

  • Esophagogastroduodenoscopy (EGD)

  • Endoscopic ultrasonography (EUS)

  • Contrast computed tomography (CT) of the abdomen and chest

  • Contrast-enhanced pelvic CT scan if clinically indicated

  • Positron emission tomography (PET) scan

  • bronchoscopy

  • Laparoscopy and thoracoscopy

  • barium swallow

  • Laboratory / Molecular Studies

  • Blood analysis

  • Biopsy

  • Tumor sample material tested for specific genes, proteins and antibodies (formerly HER2 test)

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Treatment

Treatment for esophageal cancer depends on many things, including the stage of the cancer and the overall health of the patient. Typically, a combination of modalities is used that includes radiation, chemotherapy, and surgery.

 

It is located very close to many sensitive and critical structures such as the esophagus, heart, lungs, and spinal cord. This position makes it very difficult for physicians to obtain the prescribed dose of radiation needed to treat cancerous cells while minimizing harmful exposure to tissue outside the treatment area.

 

Proton therapy may be an especially good option for treating esophageal cancer. Protons accumulate the highest radiation dose in the target (tumor) region and stop. This means that there is no exit dose.

The precision of proton therapy allows doctors to limit and prevent exposure to harmful radiation to surrounding healthy tissue and structures while delivering an ideal dose to the tumor. With pen beam scanning, the radiation can precisely match the target area of the esophagus.

Recent studies have reported that patients with esophageal cancer have improved overall survival rates if treated with chemotherapy and radiation prior to surgery.*

Proton therapy has also been associated with a reduction in postoperative complications and reduced hospital stays.**

*Based on CROSS study published August 5, 2015 in Lancet Oncology

**Simone CB et al, "Clinical outcomes and toxicities of proton radiotherapy for gastrointestinal neoplasm: a systematic review." J Gastrointest Oncol. 2016 Aug: 7(4): 644-64.

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