The lungs are located near several of the most sensitive and critical organs and tissues, including the heart, esophagus and spinal cord. Only about 20 percent of lung tumors can be treated with surgery; the rest typically require high doses of radiation or a combination of radiation and other treatments.
Targeted treatment for tumors of the lung can mean a greater chance of remission, less risk of radiation to surrounding areas, and potentially fewer side effects than X-ray radiation.
From diagnosis and treatment to navigation and support, Scripps offers comprehensive cancer care. Learn how proton therapy further complements these services.
The clinical and scientific teams have more than 90 years of combined experience treating patients with proton therapy. Learn more about the experts at the center.
Ideally, radiation therapy for lung cancer will:
- Target the tumor only
- Protect your healthy lung tissue
- Protect your heart, esophagus and spinal cord
- Maintain your quality of life during treatment
- Reduce side effects of treatment
Lung tumors can be especially difficult to target with radiation therapy, because:
- Radiation to healthy tissues around a diseased lung can affect healthy lung, heart, esophagus and spinal cord tissues. These structures are very sensitive to radiation even at low dosages, and damage to them can have significant side effects that can impair your quality of life.
- Many people with lung cancer have underlying lung or heart disease. Radiation to healthy lung or heart tissue around the lung tumor can make these conditions worse.
- If cancer comes back after radiation therapy, treatment options may be limited. Retreating cancer with X-ray radiation in or near the same area is challenging and potentially very risky. The dose of radiation required to effectively treat the tumor may be too toxic for surrounding healthy tissues, but a lower dose may not be enough to kill the cancer cells.
With any cancer radiation treatment, 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 a remission); or
- an ideal dose to the tumor with a higher risk of radiation to healthy tissues.
Proton therapy is an extremely precise form of radiation treatment that can target lung tumors within these sensitive areas. Because proton beams can be carefully controlled, and protons deposit their maximum energy directly in the tumor, radiation exposure of sensitive healthy tissues in and around the lungs can be reduced. Proton therapy may be particularly beneficial for patients with compromised lung function or cardiovascular disease.
- Proven therapy. Research shows that proton therapy is as effective as X-ray radiation in treating non-small-cell lung cancer, and can reduce side effects such as inflammation of the lungs and esophagus. Studies show some lung cancer patients can receive higher therapeutic doses with fewer radiation side effects.
- Reduced radiation to surrounding tissues. Intensity-Modulated Proton Therapy (IMPT) or pencil-beam scanning, available in California only at the Scripps Proton Therapy Center, allows doctors to more selectively place high-dose radiation on your tumor, while simultaneously reducing the dose to your surrounding critical organs.
- More targeted treatment through pencil-beam scanning. 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).
- Reduced risk of side effects. Research shows that higher doses of proton radiation could be delivered to lung tumors with a lower risk of esophagitis and pneumonitis.
- Reduced exposure to normal lung and bone marrow tissue. Research demonstrates that proton therapy can offer reduced normal lung and bone marrow exposure when compared with conventional photon (X-ray) therapy. Reducing radiation to bone marrow may reduce treatment-related fatigue as well.
- Reduced risk of second cancers. Many studies have shown an increased rate of secondary cancer in surrounding areas in patients who receive X-ray radiation therapy. Because lung cancer proton therapy lowers the dose to normal tissue, studies predict a lower risk of secondary cancer.
Because proton therapy can better concentrate its radiation dose to the target and limit it elsewhere, it is ideally suited for treating areas that have previously received X-ray radiation therapy. Treating previously irradiated areas is challenging and very risky with any radiation therapy. Tissues around the recurrent tumor don’t “forget” the previous radiation dose, and any added dose continues to increase the risk of normal tissue injury. By reducing the radiation dose given to these previously treated tissues, protons can help to reduce (but not eliminate) some of the risks associated with re-irradiation.
When you are living with lung cancer, you may need more than expert medical treatment. Our staff is 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 support services for patients recovering from lung cancer treatment, including:
- Support groups
- 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.
- Early findings on toxicity of proton beam therapy with concurrent chemotherapy for non-small-cell lung cancer
- Proton radiation therapy offers reduced normal lung and bone marrow exposure for patients receiving dose-escalated radiation therapy for unresectable stage iii non-small-cell lung cancer: a dosimetric study
- Proton therapy with concurrent chemotherapy for non-small-cell lung cancer: technique and early results
- An in-silico comparison of proton beam and IMRT for postoperative radiotherapy in completely resected stage IIIA non-small cell lung cancer
- Dose-volume comparison of proton radiotherapy and stereotactic body radiotherapy for non-small cell lung cancer
- High-dose hypofractionated proton beam radiation therapy is safe and effective for central and peripheral early-stage non-small cell lung cancer: results of a 12-year experience at loma linda university medical center