Targeted Treatment for Gastrointestinal Cancers
Gastrointestinal tract cancer, or GI cancer, may occur in a number of places throughout the digestive tract, including the esophagus, stomach, pancreas, bile duct, liver, colon, rectum and anus. These types of cancer often require aggressive treatment, including combinations of surgery, chemotherapy and radiation.
From diagnosis and treatment to navigation and support, Scripps offers comprehensive cancer care. Learn how proton therapy further extends our full range of services.
About proton therapy for gastrointestinal cancers
The GI tract is made up of and surrounded by intricate and sensitive tissues and organs, which makes treating gastrointestinal tumors with radiation especially challenging. Radiation must be delivered with high precision and the utmost care to maximize the dosage to cancerous cells while minimizing harmful exposure beyond the tumor, because:
- Radiation to healthy tissues around GI tumors can affect the small intestines, stomach, bowel and kidneys, as well as the heart, lungs and spinal cord. These structures are very sensitive to radiation even at low doses, and damage to them can cause significant side effects.
- If the cancer comes back after radiation therapy, further treatment options may be limited. A second round of radiation treatment is often not possible due to the higher risk of injury to these vital organs and tissues.
Benefits of proton therapy for GI cancer
With any radiation technique, the potential for serious complications can be high in some cases. This can lead to a difficult choice between giving:
- a less-than-optimal dose to the tumor (which reduces the chance of remission); or
- an ideal dose to the tumor with a higher risk of radiation to healthy tissues.
Proton therapy is a highly precise form of radiation treatment that enables us to target tumors within these intricate areas. Protons deposit their maximum treatment energy directly in the tumor, so radiation exposure to healthy tissues is greatly reduced.
- Intensity-Modulated Proton Therapy (IMPT) — which is only available in California at the Scripps Proton Therapy Center — allows doctors to more selectively place high-dose radiation within the tumor, while simultaneously reducing the dose to surrounding critical organs. This can potentially result in rates of higher rates of remission, even with some of the most difficult tumor types, and lower the risk of side effects from the radiation treatment.
- Many studies have shown an increased rate of secondary cancer in surrounding areas years after patients receive radiation therapy. Research has shown that because proton therapy lowers the dose to normal tissue, this could lower the risk of secondary cancer due to radiation.
- Combined treatments of surgery, chemotherapy and radiation have become the standard of treatment for a great majority of gastrointestinal cancers. Proton therapy reduces radiation-related toxicity, which increases the likelihood that patients can complete treatment with fewer interruptions or delays due to short-term side effects.
- When compared with conventional passively scattered protons, Scripps Proton Therapy Center’s intensity-modulated pencil-beam scanning technique (IMPT) can treat more complex tumor shapes, vary the dosage within the tumor and reduce the amount of radiation to surrounding tissues. The radiation dose from pencil-beam scanning that extends beyond the target tumor has been shown to be substantially less than passively scattered protons and intensity-modulated X-ray therapy (IMRT).
- Proton therapy is often the best way to treat recurring tumors in areas that have previously been treated with radiation therapy. Treating previously radiated areas is challenging and very risky. The healthy tissues around the recurrent tumor do not “forget” the previous radiation dose, and any added dose continues to increase the risk of normal tissue injury. Proton therapy enables doctors to better concentrate the dose to the target and limit it elsewhere, allowing re-treatment with radiation in selected patients.
When you are living with cancer, you may need more than expert medical treatment. Our cancer specialists are here to help you and your family every step of the way, from scheduling appointments and answering questions to finding support services and other resources.
We offer a wide variety of services to help speed your recovery, including:
- Home health care services
- Nutrition services through Scripps Center for Weight Management and Scripps Center for Integrative Medicine
- Psychological and emotional care
- Complementary cancer care provided through Scripps Center for Integrative Medicine
Proton therapy is a highly precise form of external radiation therapy that can be used for tumor control in select patients. All cancer treatments have advantages and disadvantages. Be sure to discuss these, as well as your treatment options, with your cancer specialist.
Evidence Supporting Proton Therapy for Gastrointestinal Cancer
- Intensity-modulated proton therapy further reduces normal tissue exposure during definitive therapy for locally advanced distal esophagus
- Four-dimensional computed tomography-based treatment planning for intensity-modulated radiation therapy and proton therapy for distal esophageal cancer
- High-dose proton beam radiotherapy of hepatocellular carcinoma: preliminary results of a phase II trial
Pancreatic and Bile Duct Cancer:
- Proton offers reduced normal-tissue exposure for patients receiving post-operative radiotherapy for resected pancreatic head cancer