Country policy and information note: medical treatment and ...

On Target: Proton Beam Therapy Improves Quality Of Life Post-cancer

Avery Berg was diagnosed with brain cancer just a few weeks before her 11th birthday.

It seemed like an inopportune time for Avery Berg to get sick: just a few weeks before her 11th birthday and with more than a month left of summer vacation before she would be starting sixth grade. But when her headaches and nausea turned to double vision, what seemed like a minor inconvenience turned into a serious concern. After an August 2016 emergency room visit, an MRI and a flurry of exploratory procedures, her family would learn that her symptoms pointed to something far more sinister than the common flu.

Avery's symptoms were caused by a malignant tumor in her brain, and biopsy results showed it was an extremely rare cancer called atypical teratoid rhabdoid tumor, or AT/RT, and most often seen in children age 3 or younger.

Surgery was mandatory, but the tumor would first have to be reduced in size through a combination of radiation and chemotherapy. Avery's parents, Kristie and Joe, explored a number of treatment options, eventually deciding on a protocol that included proton beam radiation therapy at Seattle Cancer Care Alliance.

Conventional radiation vs. Proton beam therapy

Around half of cancer patients receive some kind of radiation therapy, in which a machine delivers high-energy radiation to shrink tumors and kill cancer cells. While standard X-ray radiation therapy is generally viewed as an effective cancer treatment, normal, non-cancerous cells can also be damaged in the process. Early on in treatment, radiation patients experience side effects such as fatigue, hair loss and skin irritation. Months or years after radiation treatment is finished patients can still suffer from internal scarring, memory loss or damage to nearby organs.

While in the hospital, Avery received a visit from Seahawks quarterback Russell Wilson.

Proton beam radiation therapy is different. A newer, more targeted approach to killing cancer, proton therapy is a next-generation radiation treatment that deposits the greatest amount of radiation right into the tumor and then stops, allowing patients to receive high doses with less risk of damage to nearby healthy tissue. Research shows proton therapy can minimize short- and long-term side effects, and help maintain patients' quality of life.

"We expect proton radiation to be as effective as standard X-ray radiation, but with fewer side effects," says Dr. Ralph Ermoian, a pediatric radiation oncologist at SCCA Proton Therapy Center and Avery's radiation oncologist, "particularly long-term side effects."

SCCA's Proton Therapy Center in Seattle is one of about 20 proton centers in the United States, and the only proton center in the Northwest.

Avery's treatment protocol

Avery's treatment plan called for four weeks of standard proton radiation treatment to her head, spine and pockets of fluid that had built up around the tumor, followed by two weeks of proton beam therapy targeted at the tumor itself.

"We choose proton radiation therapy for treating children with brain tumors because it works equally well against tumors, but with less radiation to healthy brain, pituitary gland, thyroid gland and other tissues," says Dr. Ermoian. "This is expected to make a difference in the long term, which is what all of us plan for when we treat patients with curable brain tumors, whether they are children or adults."

Avery's protocol also included six months of chemotherapy, with surgery to remove the growth occurring two months into the chemotherapy regimen.

While Avery's surgeries and chemotherapy were done at Seattle Children's Hospital, she received radiation — including the proton therapy — at SCCA Proton Therapy Center. She and her mom made the trip five days a week for the 45-minute sessions, during which Avery would don a specially fitted mask and lie still on a platform while radiation was directed at the tumor.

During her treatment, Avery worked hard to stay on track in school. While she was able to continue to attend classes during her radiation treatment, she missed a considerable amount of school during chemotherapy. Still, she kept up with homework and has since advanced to seventh grade with the rest of her peers.

Several of Avery's friend's shaved their heads when the radiation treatment caused her hair to start falling out.

Avery and her family were buoyed by the support of friends, family and their community throughout Avery's treatment process. Several of Avery's friends shaved their heads in solidarity when the radiation treatment caused her hair to start falling out. Classmates folded paper cranes and joined the Run of Hope charity race for pediatric brain tumor research. Friends brought meals and church members sent prayers.

"You have done more than I can ever articulate or thank you for," Kristie wrote in an open letter on her blog to everyone who supported the family throughout Avery's treatment. "Without you, I wouldn't still be standing."

The success of treatment

Midway through radiation treatment, Avery's family was encouraged to learn that the tumor had shrunk significantly. Avery continued with the remaining radiation sessions and was scanned again. While this MRI showed little change in the tumor's size beyond the initial reduction, doctors were nevertheless encouraged.

"They said it looked different," said Kristie. "It was similar in size, but it looked deadened."

The scar left from a successful surgery to remove the tumor.

Only after radiation and chemo were finished and doctors were able to surgically remove the tumor did Avery and her parents receive the news they had been waiting for: not only was the surgeon able to remove the entire tumor, but he told Avery's parents that the tumor was nearly completely killed by the treatment.

Moving forward

Today, a little more than a year after she was diagnosed, Avery is back at Explorer Middle School in West Seattle, enjoying classes (especially science and drama), and partaking in her new favorite foods discovered during a post-treatment trip to Italy: gnocchi and truffles.

She's through with active treatment, and now enters into an "after treatment" protocol, which involves MRIs every three months for the next two years, followed by scans every six months for five years and then yearly after that. Doctors will watch the small cyst that remains where the tumor once grew, but Avery is considered to be NED, or "no evidence of disease."

"She's doing better than anyone expected," said Kristie. "We're taking it one day at a time at this point, and not waking up and thinking about cancer nonstop."

Avery and her family at the 2016 Run of Hope. Team Awesome Avery raised $70,000 for Seattle Children's Hospital.

Avery and her family participated in their second Run of Hope event in September, with Team Awesome Avery raising $70,000 for Seattle Children's Hospital. In December, the family heads to New York City to see the musical Hamilton on Broadway, thanks to the Make-A-Wish® Alaska and Washington..

Although Avery is busy immersing herself in life as a seventh grader, she's grateful for the treatment she received at Seattle Children's and SCCA Proton Therapy Center — and especially for proton beam radiation therapy.

"It makes me feel grateful that this is available for people in the same situation as me," said Avery. "It really did save me."

Avery Berg's mother, Kristie Berg, documented Avery's diagnosis and treatment of AT/RT – including proton beam radiation, chemotherapy and surgery — on her blog, Step by Step with Awesome Avery. You can read about the family's journey here: http://nevergivingupheart.Blogspot.Com/

Your Good Health: No Evidence To Support Proton Beam Therapy

To date, there is no evidence that proton beam therapy for prostate cancer leads to better outcomes than IMRT, so I do not recommend it.

Dr. Keith Roach

Dear Dr. Roach: My husband had surgery the first time he was diagnosed with prostate cancer. Five years later, he had a recurrence. We investigated his options and decided to go with the proton therapy. I am surprised you did not suggest this treatment in your recent column about prostate cancer. He had no further recurrences and recommended it to others who had good experiences and outcomes.

J.G.

In that column, the man with prostate cancer could not get any more radiation. Because he had already had two courses of treatment and his physician was concerned that he would get permanent damage to the colon, a different type of treatment was needed.

Proton beam therapy is a type of radiation treatment different from the current standard of care for radiation (called intensity-modulated radiation therapy), which is localized precisely every day prior to giving the radiation treatment. In theory, proton beam treatment has less toxicity, and although one study showed less toxicity to the genitourinary system from proton treatment, the only study I know that looked directly at toxicity to the colon found that IMRT had less toxicity than proton beam.

To date, there is no evidence that proton beam leads to better outcomes than IMRT, so I do not recommend it. I defer picking the exact type of radiation to the radiation oncologist.

Dear Dr. Roach: Is there a way to get rid of calluses on the feet once they have developed? Can seeing a podiatrist provide benefit?

A callus is a localized thickening of the skin, and it is caused by repeated pressure. In the foot, these commonly occur as a result of weakness in the ligaments supporting the arch, causing the metatarsal bone to cause excess friction and then a callus — most commonly on the second metatarsal bone in the foot.

Fixing the underlying problem isn't really an option in most, although the podiatrist may use an orthotic to help support the arch. They can certainly treat the callus, usually with cutting the superficial layer of callus and using a medicine to soften the underlying skin, which can then be removed with a pumice or file. Of course, getting properly fitted shoes is essential.

Dear Dr. Roach: Why is the adult dosage of the COVID vaccine the same for all adults regardless of their weight? I am 73 and weigh 101 pounds. I was sick after my third booster — chills, a fever, muscle aches, exhaustion, a sore arm and a headache. My 200-pound, 70-year-old brother who got the same bivalent booster had no side effects. Could the difference in side effects have anything to do with weight?

D.Z.

Many medicines are based on weight, because the medicine needs a certain concentration in the blood (and sometimes in other organs) to be effective. Too much concentration can be toxic, while too little won't be effective.

That's not the case for vaccines. The goal is to "teach" enough immune cells what the potential invader looks like (like the virus that causes COVID-19) so that the body can fight it off and keep the person from getting sick at all, getting very sick (more often in the case of COVID-19) or dying. The number of immune cells in adults is largely independent of a person's weight.

A recent study in Spain confirmed that side effects are not more likely in smaller people. However, needle size needs to be considered, since the vaccine should go directly into the muscle, and different people do need different sizes.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.Cornell.Edu

Proton Beam Therapy Equipment Market Research Firm Explained New Regions Growth 2023

The MarketWatch News Department was not involved in the creation of this content.

Apr 22, 2023 (The Expresswire) -- 92 Pages Report: Latest Report of Proton Beam Therapy Equipment Market 2023

Global "Proton Beam Therapy Equipment Market" report is a detailed Share ofLatest Report Year 2023 Forecast 2030of the most significant developments in the market, information, and statistics is provided in the market research report. Global Proton Beam Therapy Equipment Market Research Report 2023 provides Size, Share, Growth, and Forecast with exclusive vital statistics, data, information, trends, and competitive landscape details in this niche sector. Proton Beam Therapy Equipment Market research report offers updates on Major Global Key Players(BA, Varian, Hitachi, Mevion, Sumitomo, ProNova),Businesses may make decisions that support their financial goals and objectives by analyzing the industry's financial performance. Proton Beam Therapy Equipment Market Industry research report evaluates different aspects of the industry by understanding the latest trends, market demands, and consumer behavior, businesses can make informed decisions that drive growth and profitability. Ask for A Sample Report

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The market analysis entails a section solely dedicated for major players in the Global Proton Beam Therapy Equipment Market wherein our analysts provide an insight to the financial statements of all the major players along with its key developments product benchmarking and SWOT analysis. The company profile section also includes a business overview and financial information. The companies that are provided in this section can be customized according to the client's requirements.

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Detailed TOC of Global Proton Beam Therapy Equipment Market Report 2023

1 Proton Beam Therapy Equipment Report Overview

1.1 Proton Beam Therapy Equipment Research Scope

1.2 Market Segment by Type

1.2.1 Global Proton Beam Therapy Equipment Market Size Growth Rate by Type, 2018 VS 2023 VS 2030

1.3 Market Segment by Application

1.3.1 Global Proton Beam Therapy Equipment Market Size Growth Rate by Application, 2018 VS 2023 VS 2030

1.4 Study Objectives

1.5 Years Considered

2 Global Market Production

2.1 Global Proton Beam Therapy Equipment Production Capacity (2018-2030)

2.2 Global Proton Beam Therapy Equipment Production by Region: 2018 VS 2023 VS 2030

2.3 Global Proton Beam Therapy Equipment Production by Region

2.3.1 Global Proton Beam Therapy Equipment Historic Production by Region (2018-2023)

2.3.2 Global Proton Beam Therapy Equipment Forecasted Production by Region (2023-2030)

2.4 Market Dynamics

2.4.1 Proton Beam Therapy Equipment Industry Trends

2.4.2 Proton Beam Therapy Equipment Market Drivers

2.4.3 Proton Beam Therapy Equipment Market Challenges

2.4.4 Proton Beam Therapy Equipment Market Restraints

3 Global Proton Beam Therapy Equipment Sales

3.1 Global Proton Beam Therapy Equipment Sales Estimates and Forecasts 2018-2030

3.2 Global Proton Beam Therapy Equipment Revenue Estimates and Forecasts 2018-2030

3.3 Global Proton Beam Therapy Equipment Revenue by Region: 2018 VS 2023 VS 2030

3.4 Global Top Proton Beam Therapy Equipment Regions by Sales

3.4.1 Global Top Proton Beam Therapy Equipment Regions by Sales (2018-2023)

3.4.2 Global Top Proton Beam Therapy Equipment Regions by Sales (2023-2030)

3.5 Global Top Proton Beam Therapy Equipment Regions by Revenue

3.5.1 Global Top Proton Beam Therapy Equipment Regions by Revenue (2018-2023)

3.5.2 Global Top Proton Beam Therapy Equipment Regions by Revenue (2023-2030)

4 Competition by Manufacturers

4.1 Global Proton Beam Therapy Equipment Production Capacity by Manufacturers

4.2 Global Proton Beam Therapy Equipment Sales by Manufacturers

4.2.1 Global Top Proton Beam Therapy Equipment Manufacturers by Sales (2018-2023)

4.2.2 Global Top Proton Beam Therapy Equipment Manufacturers Market Share by Sales (2018-2023)

4.2.3 Global Top 10 and Top 5 Companies by Proton Beam Therapy Equipment Sales in 2023

4.3 Global Proton Beam Therapy Equipment Revenue by Manufacturers

4.3.1 Global Top Proton Beam Therapy Equipment Manufacturers by Revenue (2018-2023)

4.3.2 Global Top Proton Beam Therapy Equipment Manufacturers Market Share by Revenue (2018-2023)

4.3.3 Global Top 10 and Top 5 Companies by Proton Beam Therapy Equipment Revenue in 2023

4.4 Global Proton Beam Therapy Equipment Sales Price by Manufacturers

4.5 Analysis of Competitive Landscape

4.5.1 Manufacturers Market Concentration Ratio (CR5 and HHI)

4.5.2 Global Proton Beam Therapy Equipment Market Share by Company Type (Tier 1, Tier 2, and Tier 3)

4.5.3 Global Proton Beam Therapy Equipment Manufacturers Geographical Distribution

4.6 Mergers and Acquisitions, Expansion Plans

5 Estimates and Forecasts by Type

5.1 Global Proton Beam Therapy Equipment Sales by Type

5.1.1 Global Proton Beam Therapy Equipment Historical Sales by Type (2018-2023)

5.1.2 Global Proton Beam Therapy Equipment Forecasted Sales by Type (2023-2030)

5.1.3 Global Proton Beam Therapy Equipment Sales Market Share by Type (2018-2030)

5.2 Global Proton Beam Therapy Equipment Revenue by Type

5.2.1 Global Proton Beam Therapy Equipment Historical Revenue by Type (2018-2023)

5.2.2 Global Proton Beam Therapy Equipment Forecasted Revenue by Type (2023-2030)

5.2.3 Global Proton Beam Therapy Equipment Revenue Market Share by Type (2018-2030)

5.3 Global Proton Beam Therapy Equipment Price by Type

5.3.1 Global Proton Beam Therapy Equipment Price by Type (2018-2023)

5.3.2 Global Proton Beam Therapy Equipment Price Forecast by Type (2023-2030)

6 Proton Beam Therapy Equipment Market Size by Application

6.1 Global Proton Beam Therapy Equipment Sales by Application

6.1.1 Global Proton Beam Therapy Equipment Historical Sales by Application (2018-2023)

6.1.2 Global Proton Beam Therapy Equipment Forecasted Sales by Application (2023-2030)

6.1.3 Global Proton Beam Therapy Equipment Sales Market Share by Application (2018-2030)

6.2 Global Proton Beam Therapy Equipment Revenue by Application

6.2.1 Global Proton Beam Therapy Equipment Historical Revenue by Application (2018-2023)

6.2.2 Global Proton Beam Therapy Equipment Forecasted Revenue by Application (2023-2030)

6.2.3 Global Proton Beam Therapy Equipment Revenue Market Share by Application (2018-2030)

6.3 Global Proton Beam Therapy Equipment Price by Application

6.3.1 Global Proton Beam Therapy Equipment Price by Application (2018-2023)

6.3.2 Global Proton Beam Therapy Equipment Price Forecast by Application (2023-2030)

7 North America

7.1 North America Proton Beam Therapy Equipment Sales Breakdown by Company

7.2 North America Proton Beam Therapy Equipment Market Size by Type

7.3 North America Proton Beam Therapy Equipment Market Size by Application

7.4 North America Proton Beam Therapy Equipment Market Size by Country

8 Europe

8.1 Europe Proton Beam Therapy Equipment Sales Breakdown by Company

8.2 Europe Proton Beam Therapy Equipment Market Size by Type

8.3 Europe Proton Beam Therapy Equipment Market Size by Application

8.4 Europe Proton Beam Therapy Equipment Market Size by Country

9 Asia Pacific

9.1 Asia Pacific Proton Beam Therapy Equipment Sales Breakdown by Company

9.2 Asia Pacific Proton Beam Therapy Equipment Market Size by Type

9.3 Asia Pacific Proton Beam Therapy Equipment Market Size by Application

9.4 Asia Pacific Proton Beam Therapy Equipment Market Size by Region

10 Latin America

10.1 Latin America Proton Beam Therapy Equipment Sales Breakdown by Company

10.2 Latin America Proton Beam Therapy Equipment Market Size by Type

10.3 Latin America Proton Beam Therapy Equipment Market Size by Application

10.4 Latin America Proton Beam Therapy Equipment Market Size by Country

11 Middle East and Africa

11.1 Middle East and Africa Proton Beam Therapy Equipment Sales Breakdown by Company

11.2 Middle East and Africa Proton Beam Therapy Equipment Market Size by Type

11.3 Middle East and Africa Proton Beam Therapy Equipment Market Size by Application

11.4 Middle East and Africa Proton Beam Therapy Equipment Market Size by Country

12 Company Profiles

13 Value Chain and Sales Channels Analysis

13.1 Proton Beam Therapy Equipment Value Chain Analysis

13.2 Proton Beam Therapy Equipment Key Raw Materials

13.2.1 Key Raw Materials

13.2.2 Raw Materials Key Suppliers

13.3 Proton Beam Therapy Equipment Production Mode and Process

13.4 Proton Beam Therapy Equipment Sales and Marketing

13.4.1 Proton Beam Therapy Equipment Sales Channels

13.4.2 Proton Beam Therapy Equipment Distributors

13.5 Proton Beam Therapy Equipment Customers

14 Key Findings

15 Appendix

15.1 Research Methodology

15.1.1 Methodology/Research Approach

15.1.2 Data Source

15.2 Author Details

15.3 Disclaimer

Continued….

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