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What is proton therapy?

Proton therapy is an extremely precise form of radiation treatment. Most radiation treatments use X-rays, but proton therapy uses protons, which are tiny particles from the center of an atom. Compared to a beam of X-rays, a proton beam can better concentrate the radiation directly in the target, conforming more closely to the shape and depth of a tumor and avoiding normal, healthy tissues. Another unique feature is that after treating the target, protons come to a complete stop, meaning they deliver no radiation dose to areas beyond the target and up to 60% less radiation to healthy tissue around the tumor. Because proton beams can reduce or eliminate radiation to sensitive normal healthy tissues and organs, proton therapy may reduce some of the side effects that can occur as a result of radiation treatments as well as potential long-term side effects and risks that can occur months or years after radiation treatment.

How do I know if it is right for me?

The best way to determine if proton therapy is a good treatment option for you is to meet one of our radiation oncologists in consultation or be seen in one of our multi-disciplinary clinics. During a consultation visit, your doctor will work with you to develop an overall plan of care, discuss all radiation treatment options, including proton therapy, discuss the details of treatment, including the potential risks and side effects, and answer questions. Proton therapy is only one of Winship at Emory’s cancer treatment tools. Our multidisciplinary team will look at your case, compare the benefits and risks of different treatment options, and then recommend what may work best for you.

What is the difference between proton therapy and standard x-ray radiation?

Proton therapy uses protons, positively charged subatomic particles that are heavy, whereas standard x-ray radiation uses photons or x-rays with no mass and no charge. Whereas proton therapy deposits a small dose of radiation on way to target with greater dose in the diseased cells, x-ray radiation deposits the entry dose of radiation close to the skin, with the remaining dose on the diseased cells. Finally, protons stop releasing energy at the tumor (there is no “exit dose” of radiation), while x-ray radiation releases energy along the entire path they travel, potentially exposing healthy tissues and organs to unnecessary radiation.

What is pencil-beam technology?

All of our treatment rooms use the most advanced pencil beam scanning technology (also known as Intensity Modulated Proton Therapy or IMPT). A narrow stream of protons is steered by a magnet to “paint” the radiation to match the size, shape, and depth of the target, increasing intensity and dose layer by layer within the tumor. This allows for maximum flexibility in treatment planning and sparing of healthy tissues and surrounding organs.

How many people have been treated by proton therapy?

Over 220,000 patients have been treated with proton therapy worldwide.

Do I need a referral from a physician to be treated at the proton center?

No, you are able to self-refer. We will require you to provide information about your doctor’s offices so we can collect the necessary medical records to review prior to your visit with us.

How quickly can I have a consultation? Is there a waiting list?

The average time from inquiry to consultation is about seven business days. This may vary based on disease site, clinical urgency, and ability for center to collect necessary medical records prior to appointment.

What if I am not an Emory patient?

As the only proton therapy center in the state of Georgia, we serve as a specialized resource for patients across the region. If you are already under the care of other specialists outside of Emory, we will partner with them in your treatment, whether they’re across town or across the world.

Will my insurance cover the treatment?

We will work with you to provide a clear understanding of your insurance benefits and potential financial responsibilities with treatment. Emory Proton Therapy Center is contracted with many private insurance plans as well as Medicare. If coverage is denied, a physician from the insurance company will usually contact your physician at the proton center to discuss the insurance company’s policy on proton therapy. Depending on the company, the peer-to-peer review may also provide your physician with an opportunity to explain why proton therapy is recommended in your care. If treatment is still denied, our insurance team will work closely with you to file appeals.

What if I do not live within driving distance?

There is a wide variety of lodging options designed to meet a range of price points and amenity requirements. Our goal is to help our patients find lodging that supports their care. We have partnered with several nearby hotels to offer patients discounted nightly rates. Out-of-town patients may also be interested in short term rentals. If assistance is needed in assessing options, a member of our Patient Experience team will assist.

Can I continue to drive and/or work throughout treatment?

Most patients have no restrictions on their daily activity during radiation therapy. Many patients come independently for treatment each day.

What are the side effects of treatment?

All treatments have potential side effects and risks. The potential side effects of treatment depend on the type of tumor and where it is in the body. If proton therapy is a good option for treatment, it is because the side effects are likely to be fewer and/or the risks lower than other treatment options. Potential side effects and risks of treatment are discussed during consultation.

Will I feel anything during the treatment?

Like other types of radiation treatments, proton therapy is invisible and painless.

Is proton therapy experimental?

No, proton therapy is not experimental. Proton therapy has been approved by the U.S. Food and Drug Administration since 1990 and has been used in the United States for more than 50 years.

Do I have to stay overnight?

Proton therapy is an outpatient treatment performed in the Emory Proton Therapy Center. You do not stay overnight.

Why are X-ray images taken daily?

Each patient has low-dose X-ray images obtained at the treatment machine to ensure you are positioned correctly before treatment. Your physician reviews this imaging each day. This is called “image-guided” radiation therapy and is standard when delivering precise radiation like proton therapy.

Does it matter which room I am treated in?

All four of the gantry treatment rooms are functionally identical. During the course of treatment, you may occasionally receive treatment in a different treatment room to help adhere to the day’s treatment schedule, or if there is downtime in your regular treatment room. If you are normally receiving treatment in the fixed-beam room, your treatment cannot automatically be changed to one of the gantry rooms.

How long is a treatment course?

Proton treatment sessions are typically delivered daily, Monday through Friday. The total duration of treatment depends on your diagnosis and other factors, and may vary between three to eight weeks, with the average being six weeks of treatment. The number of treatments recommended for your diagnosis is discussed in consultation with your treating physician.

How long is treatment each day?

Most patients spend about 30 minutes in the treatment room each day. Most of that time is spent getting set up for treatment and ensuring everything is aligned properly before the treatment is delivered. The actual treatment is typically delivered in a few minutes.

What about my other appointments?

Many patients receive concurrent treatments or may have other medical procedures during their course of proton therapy. Our team will coordinate with your other medical providers so that you can receive all necessary treatments.

What is the success rate?

The chance of controlling the disease or cure depends on many factors including the type of tumor, how advanced the disease is, and the use and success of other treatments. Clinical experience and published results of proton therapy in the treatment of many different conditions have shown results at least as good as those achieved with other radiation techniques but with potentially fewer side effects or risks. In some tumors, results with proton therapy are among the best reported. Expectations from treatment will be discussed as part of the consultation process.

What if I do not live nearby?

If you live too far away to commute for treatment, our team will work with you to identify local housing options.