2. The Furture has Arrived


This shows the critical difference between protons, which stop at the target, and x-rays, which keep going.




A pencil beam is a narrow beam of protons. Note how the greatest amount of energy (shown in red) is released at the final burst, with no exit—the exquisite feature of proton therapy that sets it apart from x-rays. I include the formula even though I don’t understand it, just to show the complex calculations required to know when and where the burst will take place. The end result directs the protons to within one or two millimeter precision (half the width of a quarter coin). As you can see, I like this image so much I have decided to use it as a logo for my websites.



This bous photo (not in the book) shows the same phenomenon.











DaVinci represents the state of the art in robotic surgery, which involves making five small incisions in the abdomen for the tubes through which the robotic equipment operates. The doctor views an enlarged three-dimensional image in the monitor while using a joy stick to control the scalpels and other tools. Robotics may reduce incidents of bleeding and infection. Suggesting this kind of surgery for me, my surgeon showed me a very vivid video of an actual operation. That alone was enough to discourage me.


Clinac® iX x-ray System by Varian: With over 5,000 installed sites worldwide, this powerful workhorse treats thousands of patients around the world every day. Designed to deliver a wide range of imaging and patient treatment options, the Clinac system offers advanced features to facilitate state-of-the-art treatments including IMRT, IGRT, VMAT, RapidArc and stereotactic radiosurgery.


The previous two illustrations portray alternatives to proton therapy. I offer these in the spirit of being inclusive, even though I don't advocate these treatments.


In the illustration, note how much more radiation healthy tissues receive with IMRT than proton therapy (especially notice the yellow area). Proton therapy can be given from each side. Perhaps it doesn’t matter to irradiate all of that tissue, but why chance it? I prefer less rather than more.





This bonus photo shows IMRT (x-rays) in greater detail, color coding the amount of exposure to radiation.







Cancer cells are more unstable than healthy ones. The protons damage and destabilize the DNA through a process of ionization (stealing their electrons), from which the cancer does not fully recover. Suppose both cancerous and healthy cells start at ten, reaching six after proton therapy. The healthy cells bounce back to a ten but the cancer cells only to a nine. After the next treatment, the healthy cells recover again to a ten, but the cancer only to eight. After the next treatment, the healthy cells go back to ten but the cancer only to seven. And so it goes until the cancer reaches a level from which it cannot recover or reproduce. The healthy tissue, on the other hand, returns to normal.


This survey records how many people report no impact by their cancer treatment. The higher the bar on the graph, the better. The highest dark blue bars indicate proton therapy. Note they don't reach 100%, which means not everyone totally avoids impact with proton therapy, just fewer people with the other modalities.




You may also be interested in our list of proton centers around the United States, found at:

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