Prostate cancer has a wide range of severity, outcomes, and risk factors, but improvements in radiation treatment technology have been critical to better outcomes for prostate patients in recent years.
“Less invasive forms of surgery, such as robotic prostatectomy and proton therapy, have been instrumental in improving patient outcomes by reducing post-treatment complications,” said Naren Ramakrishna, M.D., Ph.D, director of neurologic and pediatric radiation oncology at Orlando Health UF Health Cancer Center.
“The development of innovative and individualized treatment strategies are critical to optimize tumor control, while minimizing the impact on daily living and preserving functions which may be compromised by tumor or treatment including urinary control, sexual function, and other genitourinary functions.”
Embracing proton therapy
Since the early 1900s, X-rays have predominantly been used to treat cancer, but doctors now have another option.
“Protons are fundamentally different than X-rays/photons,” Dr. Ramakrishna explained. “They are charged particles, produced using complex devices, such as superconducting synchrocyclotrons. They deposit the majority of their dose in a sharp peak within the tumor, and essentially no dose beyond the tumor.
“This means that proton therapy allows for sparing of adjacent normal tissue in ways that may not be possible with X-ray-based technology. For selected patients, this can mean decreased side effects from less dose to uninvolved normal tissue.”
Another benefit is the lower overall dose deposited by proton therapy to uninvolved tissue can also reduce the risk of radiation-induced cancers.
A promising future
The technology for proton therapy continues to improve using technology like pencil beam scanning, which allows proton doses to be “painted” in layers in a tumor and form even more precise shapes and distributions, according to Dr. Ramakrishna.
“There’s also great interest in combining advanced radiation delivery with individualized therapy approaches, which take into account the abnormal genes and proteins expressed in a patient’s tumor,” he said. “Improved imaging modalities also have resulted in more sensitive detection of metastases, and have been used for better targeting of tumors with surgery and radiation. Multiple treatment modalities, such as surgery, radiation, drug therapy, gene therapy, and cancer immunotherapy, may be combined in the future to deliver improved outcomes.”
Dr. Ramakrishna noted that morbidity and mortality from prostate cancer have a significant impact on society, and are challenging for men’s health.
“Better outcomes in the foreseeable future will require approaches that combine improved technology, such as proton therapy, with our growing understanding of the biology of prostate cancer in the localized and metastatic setting.”
Cindy Riley, [email protected]