As the only National Cancer Institute-Designated Comprehensive Cancer Center in Georgia, Winship is a leader in the treatments for sarcoma, conducting innovative research and clinical trials that are transforming how these cancers are identified, treated, and survived.
The radiation oncologists at Emory Proton Therapy Center work with the multidisciplinary Sarcoma cancer team at Winship, which includes experts in sarcoma surgical oncology, orthopedicopaedic oncology, thoracic surgery, sarcoma medical oncology, radiology, sarcoma pathology, supportive oncology, dieticians, social workers, physical therapy, and cancer rehabilitation. Your radiation oncologist will work closely with these other specialists to customize your sarcoma treatment plan and coordinate your care. We can also partner and coordinate with a patient’s existing care team, whether they are across town or around the world.
What Is Proton Therapy for Sarcoma?
Proton therapy is a type of radiation treatment that uses a beam of particles called protons to target tumors. Unlike traditional X-ray radiation, proton therapy is designed to deliver most of its radiation dose directly to the tumor and then stop.
This physical property, known as the Bragg peak, allows radiation oncologists to precisely target tumors. In some cases, this may reduce radiation exposure to nearby healthy tissue compared to conventional radiation therapy.
For sarcoma patients, this can be especially important. Sarcomas often develop near critical structures such as the spinal cord, kidneys, nerves, blood vessels, and reproductive organs. Proton therapy may help limit radiation to these surrounding areas, depending on the individual treatment plan.
Because proton beams can be sensitive to changes in body position and anatomy, your care team carefully plans each treatment to ensure accuracy and consistency.
Proton therapy is not appropriate for every patient. Your care team will determine the most appropriate treatment based on your specific condition.
Why Is Proton Therapy Used for Sarcoma?
Sarcomas can present unique treatment challenges. These tumors are often located deep in the body and may be close to critical structures such as organs, nerves, and blood vessels. In some cases, delivering radiation with conventional X-ray therapy can expose nearby healthy tissue to higher levels of radiation.
Proton therapy offers a different approach. Because proton beams can be controlled to stop at a specific depth, treatment plans may be designed to limit radiation exposure beyond the tumor. This can be particularly important when tumors are located near sensitive anatomy.
Treatment planning flexibility: Proton therapy may allow radiation oncologists to deliver effective doses to the tumor while reducing exposure to surrounding tissues, depending on the individual case.
Considerations for limb sarcomas: For tumors in the arms or legs, treatment planning may take into account surgical reconstruction and surrounding soft tissue. In some cases, reducing radiation exposure to these areas may be relevant for healing and function.
Bone and organ considerations: When tumors are near bone or internal organs, proton therapy may help limit radiation exposure to these structures. This may be relevant when considering potential side effects such as fracture risk or organ-related symptoms, depending on the treatment plan.
Long-term considerations: Reducing radiation exposure to healthy tissue is one factor that may be considered when evaluating potential long-term effects of treatment.
Researchers are also continuing to study how radiation exposure to bone marrow and immune cells may affect the body during treatment.
Your physician and care team will evaluate all appropriate treatment options and recommend the best approach based on your specific diagnosis.
Proton Therapy for Sarcoma
A sarcoma diagnosis can be one of the biggest challenges you and your family will ever face. Our team is dedicated to helping you meet that challenge through compassionate care using the most advanced treatments for sarcoma available. Proton therapy may be a more precise radiation option for treatment of your sarcoma to help protect the function of important nearby organs, as well as reducing the risk of developing a future cancer. Our cancer specialists will work with you to develop a personalized treatment plan which aims for fewer side effects and improved quality of life.
What We Treat
- Retroperitoneal sarcomas
- Abdominal sarcomas
- Pelvic sarcomas
- Bone sarcomas
- Chordomas
- Chondrosarcoma
- Ewing’s sarcoma
- Rhabdomyosarcoma
- Liposarcoma
- Leiomyosarcoma
- Osteosarcoma
- Desmoid tumors
- Sarcoma metastases (lymph nodes, lung, liver, or adrenal)
- Re-irradiation
Benefits of Proton Therapy
Sarcomas may occur anywhere in the body. Potential benefits of proton therapy depend on the type of sarcoma and location in the body. Click below to see the benefits for proton therapy for each body site.
Benefits for Head & Neck Sarcomas
- Reduced risk of painful sores in the mouth (mucositis) during treatment.
- Reduced risk of dental decay after radiation.
- Reduced risk of problems swallowing (dysphagia or aspiration) during or after therapy.
- Reduced risk of hoarseness during treatment.
- Reduced risk of dry mouth (xerostomia) after radiation.
- Reduced risk of hearing loss after radiation. This is relevant for tumors near the cochlea, such as those in the nasopharynx, paranasal sinuses, or skull base.
- Reduced risk of hormone imbalances (endocrine dysfunction) which can particularly affect growth and development in children and young adults. This is relevant for tumors near the pituitary and hypothalamus, such as those in the nasopharynx, paranasal sinuses, or skull base.
- Reduced radiation to the bone marrow and circulating lymphocytes, which may help support the function of the immune system in taking on cancer.
- Reduced risk of developing a future second tumor or cancer, which is most relevant in younger patients, those with a good prognosis and a long life expectancy, and those patients who may have genetic conditions putting them at higher risk for developing other cancers.
Benefits for Chest Sarcomas
- Reduced risk of inflammation of the heart (pericarditis) and future heart problems like hardening of the arteries (atherosclerosis), stiffening of the heart muscle (fibrosis, cardiomyopathy), and heart attacks.
- Reduced risk of inflammation of the lungs (radiation pneumonitis) and problems with lung function (lung fibrosis).
- Reduced risk of difficulty or pain with swallowing (dysphagia or odynophagia) or chronic narrowing of the esophagus (stricture).
- Reduced radiation to the bone marrow and circulating lymphocytes, which may help support the function of the immune system in taking on fighting cancer.
- Reduced risk of low blood counts (anemia, neutropenia) which may support the body’s tolerance of chemotherapy.
- Reduced risk of developing a future second tumor or cancer, which is most relevant in younger patients, those with a good prognosis and a long life expectancy, and those patients who may have genetic conditions putting them at higher risk for developing other cancers.
Benefits for Retroperitoneal, Abdominal or Pelvic Sarcomas
- Reduced risk of inflammation of the heart (pericarditis) and future heart problems like hardening of the arteries (atherosclerosis), stiffening of the heart muscle (fibrosis, cardiomyopathy), and heart attacks.
- Reduced risk of new or worsening problems with liver function (radiation induced liver dysfunction). This is relevant for patients with large liver tumors and/or small remaining size of normal liver, for those with poor liver function (liver cirrhosis), or those who have had prior radiation treatments including prior liver radioembolization.
- Reduced risk of nausea and diarrhea.
- Reduced risk of new or worsening kidney function.
- Reduced risk of frequent urination or stinging or burning with urination during treatment, or of chronic urinary problems after treatment.
- Reduced risk of diarrhea and rectal soreness (proctitis) during treatment and of chronic rectal problems after treatments such as rectal bleeding or ulceration.
- Reduced radiation to the bone marrow, spleen, and circulating lymphocytes, which may help support the function of the immune system in fighting cancer.
- Reduced risk of low blood counts (anemia, neutropenia) which may support the body’s tolerance of chemotherapy.
- Reduced risk of developing a future second tumor or cancer, which is most relevant in younger patients, those with a good prognosis and a long life expectancy, and those patients who may have genetic conditions putting them at higher risk for developing other cancers.
Benefits for Skull Base or Spine Sarcomas
- Improved ability to treat radiation- resistant sarcomas near the brainstem or spinal cord with a high dose of radiation necessary for these tumors.
- Reduced risk of inflammation of the heart (pericarditis) and future heart problems like hardening of the arteries (atherosclerosis), stiffening of the heart muscle (fibrosis, cardiomyopathy), and heart attacks. This is relevant for tumors near the heart, for example in the thoracic spine.
- Reduced risk of inflammation of the lungs (radiation pneumonitis) and lung function (lung fibrosis). This is relevant for tumors near the lungs, for example in the thoracic spine.
- Reduced risk of nausea and diarrhea. This is relevant for tumors near the bowels, for example in the lumbar or sacral spine.
- Reduced radiation to the bone marrow and circulating lymphocytes, which may help support the function of the immune system in taking on fighting cancer.
- Reduced risk of low blood counts (anemia, neutropenia) which may support the body’s tolerance of chemotherapy.
- Reduced risk of developing a future second tumor or cancer, which is most relevant in younger patients, those with a good prognosis and a long life expectancy, and those patients who may have genetic conditions putting them at higher risk for developing other cancers.
Schedule a Consultation
What To Expect From Proton Therapy
The first step in your care is a consultation. During consultation, we review your medical history, perform a physical exam, decide if any additional tests are needed, discuss all radiation options that may be appropriate for your treatment plancare, make recommendations, and answer questions.
To plan your treatment, you will undergo a “simulation” or planning session. During this visit our radiation therapists will help position you the way you will be treated each day. A CT scan will be done to create a picture of you in the treatment position to design your radiation plan. Some patients also undergo an MRI during this visit to help identify the target for treatment. It normally takes 10 days for the team to design the proton treatment plan and perform the quality assurance checks before treatment begins.
Depending on the type of tumor and stage, proton therapy may be delivered over one to three weeks, six weeks, or eight weeks of therapy. Typically, radiation is given once daily during the weekdays, Monday through Friday. For those receiving five treatments or fewer, proton therapy may be delivered every other day. While some situations are treated with radiation alone, proton therapy is often integrated with surgery, chemotherapy, immunotherapy, or other cancer treatments as part of a comprehensive plan of care.
Like other types of radiation, proton therapy treatments are invisible and painless. Most sarcoma tumor treatments average 30 minutes each day in the treatment room. If your tumor is located in the abdomen, it may move significantly while breathing. During your radiation planning process, your team will identify the most appropriate methods to manage tumor motion, if necessary.
Patients are seen by the radiation oncology physician team weekly during treatment to monitor progress, answer questions, address concerns, and manage any side effects from treatment. Your radiation oncologist will discuss a plan to assess response to treatment and for long-term follow-up after therapy.
Proton Therapy vs. Conventional Radiation Therapy for Sarcoma
Conventional X-ray radiation therapy, including techniques such as IMRT, is an effective treatment for many sarcomas. The most appropriate approach depends on the tumor type, location, and individual patient factors.
For tumors located near critical structures or in younger patients, radiation planning may focus on minimizing exposure to surrounding healthy tissue. Proton therapy offers a different physical approach, as proton beams can be designed to stop at a specific depth (the Bragg peak), which may help limit radiation beyond the tumor.
Key differences between proton therapy and conventional radiation for sarcoma include the following:
Dose beyond the tumor: Conventional radiation delivers dose along its full path, including beyond the tumor. Proton therapy can be planned to reduce radiation beyond the target area.
Radiation to surrounding tissue: Proton therapy may reduce the volume of healthy tissue receiving low levels of radiation, depending on the treatment plan.
Dose to the tumor: In some cases, proton therapy may support treatment planning that delivers appropriate radiation doses to tumors located near sensitive structures.
Side effect considerations: Reducing radiation exposure to nearby tissues may be associated with differences in side effects, depending on the individual case.
Long-term considerations: The amount of healthy tissue exposed to radiation is one factor considered when evaluating potential long-term effects. Not every sarcoma patient will benefit from proton therapy. Your care team will evaluate all relevant factors to determine the most appropriate treatment approach.
Frequently Asked Questions
Does proton therapy work for sarcoma?
Proton therapy is used in the treatment of many types of sarcoma. Your care team will determine whether it is appropriate based on your specific diagnosis.
What is the most effective treatment for sarcoma?
Treatment typically involves a combination of surgery, radiation therapy, and, in some cases, chemotherapy. The best approach depends on the sarcoma type, stage, and individual patient factors.
Is proton therapy better than conventional radiation?
Both proton therapy and conventional radiation therapy are effective treatment options. Proton therapy differs in how radiation is delivered and may be considered when minimizing radiation to nearby structures is a priority.
How long does proton therapy take?
Treatment length varies by case but typically ranges from one to eight weeks, with daily sessions on weekdays.
Can sarcoma come back after radiation therapy?
Recurrence is possible with any sarcoma treatment. Patients are monitored closely after treatment with follow-up imaging and clinical evaluations.
Studies on Proton Therapy in Sarcoma
Our team has identified these studies as examples of the clinical benefits of proton therapy in sarcoma.
Patient Stories
“I’ve been through it, and I can’t say enough about the amazing care I received. The team who handled my treatments was absolutely wonderful, making a difficult time so much easier to navigate.”
My experience at Emory was incredible—it was as easy as drinking water! The therapy sessions only took about 5 to 10 minutes, and right after, I’d go for a 4-mile walk every single day. I had no side effects whatsoever—I can’t even tell that I had the treatment. Emory truly saved my life, and I couldn’t be more grateful.
Stephen, a 36-year old father from Columbus, Georgia, is one of the almost 2000 patients who have been treated at the Emory Proton Therapy Center since it opened in December 2018. He completed six weeks of proton therapy to treat a brain tumor.
“I went through 37 treatments for prostate cancer at the Emory Proton Center two years ago. The care I received from their team of professionals was amazing. I was willing to travel from South Carolina for treatment, and I’m so thankful I did. I started this fight in 2017 and today my PSA is still undetectable. Truly amazing folks.”
Proton therapy gave Zack his best shot at treating a spinal tumor that had come back. Zack was one of the first patients treated at the Emory Proton Therapy Center after it opened in 2018. The treatments, every weekday for six weeks, took less than one hour of his day and gave Zack the greatest odds of a long life with his wife and children.
Tony was diagnosed with prostate cancer in 2019 and sought care from experts at Emory Proton Therapy Center. He’s confident that the advanced radiation therapy gave him the best cancer treatment possible and says the comfort and care he got from Winship doctors and staff were unmatched. “There were many great solutions here in Atlanta, but the best to me was Emory Proton Therapy Center,” says Tony.
