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"In the case of breast cancer, proton therapy allows for a dose reduction to the surrounding healthy tissues, especially the heart and lungs." MUDr. Andrea Pásztorová
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The Highest Chance Of Being Cured

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The Highest Chance Of Being Cured

Breast Cancer Treatment

The aim of modern cancer treatment is to provide patients with the maximum chance of cure while minimizing treatment-related side effects. This can be achieved with proton therapy.

If irradiation has been recommended to you, it is important that you choose the most gentle method. Proton therapy is able to significantly reduce the risk of the occurrence of cardiac infarction, cardiac complaints, the risk of development of pulmonary fibrosis, or secondary tumors caused by radiation.

Proton therapy is a precise and gentle breast cancer treatment method with minimal side effects. Proton therapy enables precise targeting of the proton beam at the target area (breast, thoracic wall, sentinel lymph nodes), thus minimizing exposure of surrounding tissues and organs to radiation. 

Proton therapy is especially beneficial for: 

  • tumors located in the left breast;
  • patients who have already undergone a round of radiation for the other breast;
  • bilateral findings;
  • patients with associated heart disease.

 

One substantial reason to choose proton radiotherapy for breast cancer would be radiation induced heart disease (RIHD).

Currently, it is possible to cure a large proportion of women with breast cancer, so it is our goal that their life after treatment is without further restrictions and health complications. Proton radiotherapy performed by means of the deep inspiration breath-hold technique is clearly the most suitable and the gentlest radiation technology, and no other technology can achieve the same irradiation parameters.

 

Benefits Of Proton Therapy

Proton therapy:

  • minimizes the risk of adverse effects on the heart, lungs and spinal cord;
  • guarantees precise coverage of the irradiated area;
  • reduces the risk of the development of secondary tumors;
  • reduces the risk of complications after treatment;
  • offers patient-friendly, effective, and painless treatment.

International treatment protocols recommend that proton therapy always be considered as first-line treatment.

How To Choose The Optimal Treatment

Have you detected a lump in your breast, and you don’t know where to turn? Have you been told by your physician that you have breast cancer? If you have been diagnosed with breast cancer and radiation therapy is part of your treatment, ask for proton therapy.

We are here to help you.

 

Protonová léčba je ze zákona hrazena zdravotními pojišťovnami

 

How To Choose The Most Suitable Treatment For Breast Cancer

In order to select the optimal treatment, it is imperative to get comprehensive and comprehensible information. Ask not only about the most advanced treatment methods but also treatment-related side effects. They may significantly affect the quality of your life during and after treatment.

If radiation is considered as part of your treatment, inquire about all the options available. Our physicians have many years of experience in radiotherapy. Moreover, they are experienced in both standard (photon) and proton radiation therapy; therefore, they will be able to answer all your questions pertaining to your decision on your treatment.

  • Think about the options you have.
  • You don’t have to decide immediately.
  • The treatment you choose has a fundamental influence on the quality of life not only during but also after treatment.

Keep in mind that your decision will significantly affect your future life. Our physicians are prepared to answer all of your questions related to PROTON THERAPY; therefore, do not hesitate to contact us immediately.

 

I Know My Chances Of Healing And Treatment Options

  • What treatment has my attending physician recommended?
  • Has the physician informed me about the risks and complications associated with currently used treatments?
  • Has the physician informed me about proton therapy?
  • Has the physician informed me about the risks and complications associated with standard radiation methods?

You can send your medical documentation for assessment of the suitability of proton therapy by e-mail to pacient@ptc.cz. Alternatively, you can contact our treatment coordinators, who are prepared to answer all of your questions related to proton therapy. You can call them at +420 222 999 031.

 

dsc-0422.jpg (832 KB)

 

The only thing you need to do is to come to us in time. We are ready to help you.

Proton Therapy Reduces Damage To The Heart
More

One substantial reason to choose proton radiotherapy for breast cancer would be radiation induced heart disease (RIHD). Heart disease caused by radiation is one of the most serious and best-documented very late effects of radiation. Therefore, in the treatment of breast cancer when radiation is recommended, experts seek to minimize the radiation dose to the heart. Thanks to the proton beam, we are able to significantly reduce the risk of the occurrence of cardiac infarction, cardiac complaints, or the risk of development of pulmonary fibrosis.

Proton Therapy Reduces Damage To The Lungs
More

Very late effects of breast cancer radiation treatment may be manifested in the tissue of the lungs. According to years of experience, irradiation of larger regions of the lungs is unequivocally linked to the development of pulmonary fibrosis, which consists of changes in the pulmonary tissue. Pulmonary fibrosis can be linked to repeated incidences of pneumonia and chronic cough. Additionally, proton therapy mitigates the risk of the development of secondary tumors.

Proton therapy is also suitable for patients who have already undergone a round of radiation for the other breast, for bilateral findings, and is also recommended for patients with associated heart disease.

Proton Therapy In Combination With Controlled Breathing
More

As respiratory movements may impair the correct and precise execution of proton irradiation, in the treatment of breast cancer we also use the method of controlled breathing. This is achieved by the Dyn'R. The Dyn'R is a special spirometer which not only serves to monitor the breath, as is the case with a conventional spirometer, but also allows triggering of the radiation (radiation beam) only when inhaled to a certain breath level. The controlled breathing method has been chosen because it is important that the irradiated area of the body and the target volume of the tumor are irradiated the same way during each fraction. Since this irradiated volume varies depending on breathing, we need to ensure that the patient's body is always in the same position. This is best done by holding their breath at a certain level. To determine this level, the patient first undergoes a controlled breathing training (Dyn'R training).

The controlled breathing training is done lying down on the back after being connected to the spirometer, using an antibacterial filter and a mouthpiece. The patient´s nose is held closed by a pin so that all exhaled air flows through their mouth. The patient also wears special glasses, where they see the breathing pattern to follow. The training is conducted by an experienced assistant and the patient has nothing to worry about.

 

dynr.png (511 KB)

How Proton Therapy Works
How Proton Therapy Works
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What Is Proton Therapy?

Proton therapy is an effective, accurate and gentle cancer treatment method with minimal side effects. Thanks to the precise targeting of the proton beam directly to the tumor, the occurrence of side effects is significantly reduced. This gives proton therapy patients a chance to enjoy a quality life even after cancer treatment without an increased risk of late toxicity, which can appear several years after irradiation (10, 15 or even 20 years).

 

Proton Therapy Provides A High Chance Of Being Cured
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Modern, Effective And Safe Oncological Treatment

The goal of modern oncological treatment is to ensure the maximum chance of recovery for patients while minimising adverse effects related to the treatment. Currently, this can be achieved by proton therapy. Unlike conventional radiotherapy, which uses photons for tumor cell irradiation and destruction, proton therapy is more advanced and uses protons. These particles give proton therapy its many advantages. The biggest advantage, compared to conventional radiotherapy, is its accuracy and its ability to protect healthy tissues.

The commonly used photon beam goes through the body and emits a significant portion of its energy in the regions in front of and behind the tumor. Protons have a certain physical property called the Bragg peak, which means they emit significantly lower amounts of energy on their way to the tumor, thus minimising their impact on healthy tissues behind the tumor.

 

How We Treat You
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Few patients are aware of the complexity of the technology hidden below the Proton Therapy Center, which ultimately allows us to treat cancer gently. Protons, the positively charged elementary nuclei of the hydrogen atom, are accelerated in the cyclotron to approximately half the speed of light. This provides them with energy to destroy tumours up to 30 centimetres deep. Then the protons are directed via a strong magnetic field into a very narrow beam and transferred to the tumour with high precision. As protons impact tumour tissue, they release energy, ionise, and damage the DNA of the affected cell. When the protons damage the tumour repeatedly, the cancer cells stop dividing or immediately die.

 

How We Can Irradiate Tumors With Millimeter Accuracy

Pencil Beam Scanning (PBS) marks the exact distribution of the proton beam dose and is currently the absolute peak in proton therapy technology. PBS irradiates the target area with millimeter accuracy with minimal damage to surrounding healthy tissues and organs. With this irradiation method, the thin (pencil) beam is directed to the appropriate point of the target volume by means of a magnetic field. Highly precise control of this magnetic field achieves gradual irradiation of the entire tumor site.

To illustrate how PBS works, imagine the task of colouring in a circle on a piece of paper with a pencil. As you fill in the circle, you will focus on making sure that you do not cross the borders. PBS also focuses on staying within the borders of the area being treated. That is why side effects with proton therapy are minimal.

Why Choose Proton Therapy?

Advantages Of Proton Therapy Over Conventional Radiotherapy

  • Dose to the heart is lowered by 99%
  • Dose to the lungs is lowered up to 81%
  • Allows a dose reduction to the contralateral breast by 96%
  • Significantly reduces exposure of the spinal cord to radiation
  • Offers the option of undergoing a second round of radiation, should there be a relapse and the need for further radiation treatment

Photon radiotherapy treatment for breast cancer, especially the left breast, may deliver unwanted irradiation to the heart, lungs and spinal cord. These organs are very sensitive to radiation and their damage can have significant side effects. Thanks to the proton beam and the reduction of unwanted radiation to healthy organs, we are able to significantly reduce the risk of the occurrence of cardiac infarction, cardiac complaints, or the risk of development of pulmonary fibrosis.

 

breastcomparison.png (91 KB)

 

Based on worldwide experience and long-term results in treated patients, it is clear that patients after proton treatment have a higher quality of life compared to those who have undergone conventional (photon) radiotherapy.

Our physicians’ experience, our technology, excellent results, and professional attitude give you the maximum chance of being cured.

 

Did you know that the advantages of proton irradiation are based on physical principles and properties of protons?

Protons target the tumor directly, which allows us to protect healthy tissues and organs from adverse effects.

Unlike conventional radiotherapy, which uses photons for tumor cell irradiation and destruction, proton therapy is more advanced and uses protons.

The commonly used photon beam goes through the body and emits a significant portion of its energy in the regions in front of and behind the tumor. Protons have a certain physical property called the Bragg peak, which means they emit significantly lower amounts of energy on their way to the tumor, thus minimising their impact on healthy tissues behind the tumor. The greatest advantage of proton therapy is that, unlike common radiotherapy, it is precise and able to protect healthy tissues.

How Proton Therapy Is Conducted

The Prague Proton Therapy Center was the first in the world to develop unique and innovative processes, combining proton radiation, deep inspiration breath hold, and body surface detection by the Vision RT system. Thanks to these procedures, our center is a global leader in the treatment of breast cancer.

Proton radiotherapy significantly reduces the radiation load on the heart during radiation of left breast cancer. PTC can present excellent results and achievements of proton radiotherapy on the basis of long-term monitoring.

 

Initial Assessment

In order for our medical team to assess a patient for suitability, we require some medical information from you. Your treatment coordinator will inform you of exactly what information we require. Usually, we will also request to see scans, such as an MRI, CT or PET scan. This information can be requested from the hospital or clinic and is often given to the patient on a CD. We can provide you with login details to upload the CD to our secure server. Alternatively, you can mail it to us.

Any information you already have about your diagnosis and previous treatments is very helpful and it is a good idea to provide us with as much information as possible in your initial enquiry. Your case will then be reviewed by our medical team at the daily indication board meeting. Your treatment coordinator will get back to you with the outcome, or possibly a request for more information if the oncologists require it to make their final decision.

You do not need to travel to Prague for the assessment.

 

Treatment planning

When you come to Prague for treatment, you will first have a consultation to discuss the side effects and outcomes of treatment in your specific case, as well as the concrete treatment plan. The doctor also explains what to expect during and after the treatment. Finally, all of your questions are answered.

The first stage of treatment involves the diagnostic scans here at the Proton Therapy Center (MRI and/or CT, preparation of the fixation device, etc.). Precise treatment planning is crucial for treatment success. Therefore, a team of clinical physicists and physicians prepares a radiation plan tailored to each patient according to which proton therapy will take place. The irradiation plan also determines from which directions and with what intensity the proton beam will irradiate the tumor. This process is very complex and it typically takes one week to finalise before treatment can commence.

 

Protonové centrum Praha

 

The treatment is outpatient, and you come to the Proton Therapy Center for radiation and regular check-ups during treatment. One visit takes about 60 minutes while the radiation is a matter of a few minutes. Prior to each radiation session, we carefully check your position using X-ray scans and carry out certain other checks necessary to commence irradiating. At least once a week, you undergo check-ups with the physician who will go through the treatment progress with you and check your condition.

Individual treatment doses are given each day, Monday to Friday. Treatment cannot be interrupted except for serious health reasons.

 

We Use The Pencil Beam Scanning Technology

Pencil Beam Scanning (PBS) marks the exact distribution of the proton beam dose and is currently the absolute peak in proton therapy technology. PBS irradiates the target area with millimeter accuracy with minimal damage to surrounding healthy tissues and organs.

 

Protonová terapie

 

The Controlled Breathing Method

As respiratory movements may impair the correct and precise execution of proton irradiation, in the treatment of breast cancer we also use the method of controlled breathing. Patients whose tumor position changes due to respiratory movements are irradiated using a controlled breathing method. For this, we use the Dyn'R.

The controlled breathing method has been chosen because it is important that the irradiated area of the body and the target volume of the tumor are irradiated the same way during each fraction. Since this irradiated volume varies depending on breathing, we need to ensure that the patient's body is always in the same position. This is best done by holding their breath at a certain level. To determine this level, the patient first undergoes a controlled breathing training (Dyn'R training).

The controlled breathing training is done lying down on the back after being connected to the spirometer, using an antibacterial filter and a mouthpiece. The patient´s nose is held closed by a pin so that all exhaled air flows through their mouth. The patient also wears special glasses, where they see the breathing pattern to follow. The training is conducted by an experienced assistant and the patient has nothing to worry about.

 

dynr.png (511 KB)

 

The treatment is outpatient and, in most cases, lasts from 16 to 33 business days, according to the regime determined by the physician on the basis of the initial assessment and other diagnostic tests.

 

The World Prefers Protons

Proton therapy is an increasingly recognized and preferred method in the world. The results of the world's proton centers and the Prague Proton Therapy Center clearly confirm that proton therapy opens up completely new possibilities for the treatment of cancer.

Proton therapy is not a new method. Since 1991, the first exclusively clinical (not academic) workplace located at Loma Linda University, California, USA has treated many tens of thousands of cancer patients using proton therapy. Proton therapy is a technologically mature treatment proven by almost three decades of clinical operation. 

Despite many years of proton radiotherapy being used for the treatment of selected types of cancer, some healthcare professionals are still of the opinion that the higher radiation doses used in standard (photon) radiotherapy to which healthy tissues are exposed do not justify the use of proton beam therapy.

A team of physicians from MGH in Boston focused on patients with breast cancer. The study concludes that proton radiotherapy of breast cancer especially in patients with necessary radiation of sentinel lymph nodes has a low toxicity while maintaining the same control over cancer as previously published photon radiotherapy data. Proton therapy for breast cancer clearly reduces the risk of side effects.

The study is available in the Journal of Clinical Oncology.

About Breast Cancer

Breast carcinoma is the most common cancer among women and the second leading cause of death by cancer. Approximately 7,000 new cases are diagnosed annually in the Czech Republic. Around 75% of those women suffer from stage I or II cancer at the time of diagnosis, with a long life expectancy.

 

breast-graph.png (42 KB)

 

If the disease is detected at an early stage, treatment is usually more successful, with fewer complications, and a lower risk of developing adverse effects. Breast cancer occurs not only in women, it can also occur in men. Thanks to early diagnostics and new technology, the chance of a successful cure is rising.

Multiple therapies are often combined in breast cancer treatment. The therapies include surgery, chemotherapy, hormonal therapy, biological therapy and radiotherapy.

Radiotherapy has an irreplaceable place in the comprehensive treatment of breast cancer. Our physicians have many years of experience in radiotherapy. Moreover, they are experienced in both standard (photon) and proton radiation therapy; therefore, they will be able to answer all your questions pertaining to your decision on your treatment.

The Prague Proton Therapy Center was the first center in the world to develop unique and innovative breast cancer treatment procedures minimising undesirable exposure of the heart, coronary arteries, the lungs, and the contralateral breast to radiation.