By Dr. Shannon MacDonald
Hearing the words “You have breast cancer” is hard enough. Having access to one of the most effective treatments for the disease should be easy.
When caught in its earliest stages, the five-year relative survival rate is 99%, according to the National Breast Cancer Foundation Inc. Advances in early detection and treatment methods have significantly increased breast cancer survival rates in recent years. One of those advances is proton therapy, which is proving to be a critical part of the treatment plan for patients diagnosed with all types of cancer.
While proton therapy is still relatively new to the scene, we’re discovering more about its benefits every year. It’s a type of radiation therapy that uses high-energy protons to treat cancer with the precision of a painter’s brush. This targeted treatment allows radiation to be delivered directly to the tumor while minimizing damage to surrounding healthy tissue, which means fewer side effects for patients as compared to traditional forms of radiation.
One of the major challenges in treating breast cancer with conventional radiation is the unavoidable exposure of nearby organs, particularly in patients receiving treatment on the left side of the chest. Long-term effects of this exposure can include heart disease, lung complications and increased risk of secondary cancers.
Proton therapy significantly reduces these risks. A study published in JAMA Oncology in 2022 found that patients treated with proton therapy experienced fewer side effects and better preservation of heart and lung function compared to those who received traditional radiation.
As we see an increasing number of women under 50 being diagnosed with breast cancer, proton therapy can also be extremely helpful in these cases. Younger women tend to have denser breast tissue, and proton therapy has been shown to be particularly effective for treating tumors located deep within the body.
According to the National Association of Proton Therapy, breast cancer patients are among the top three most enrolled in proton therapy.
Proton therapy is an option for treating most types of breast cancer, including:
- Estrogen positive or negative
- Progesterone positive or negative
- HER2 positive or negative
- Triple negative
- Triple positive
One of the frustrations with proton therapy is not in its effectiveness, but the cost. It’s generally more expensive per treatment than conventional photon radiation. However, treatment for cancer is never a quick fix, so patients should consider the full picture when it comes to the cost. The increased upfront price of proton therapy may be offset by reduced side effects and improved quality of life for some patients, leading to lower overall long-term health care costs. In recent years, insurers also have recognized the benefits of proton therapy and are more receptive to covering the cost of treatments.
A current clinical trial is being conducted at the Baptist Health Miami Cancer Institute, breaking down the comparison of costs when it comes to cancer treatments.
“If proton therapy can keep more patients functional and out of the hospital, it may lower the total cost of care, thereby justifying more consistent support for proton therapy,” said Dr. Robert H. Press, a radiation oncologist with Baptist. “Additionally, mitigating financial toxicity is crucial, as many cancer patients face higher costs due to treatment side effects and often cannot work during treatment.”
The reduced side effects of proton therapy have been well documented in clinical trials. A 2020 study in JAMA Oncology analyzed data from nearly 1,500 adults with 11 types of cancer, including breast cancer. Almost 400 of those participants received proton therapy, while the rest received traditional radiation. Within 90 days of starting treatment, only 12% of the patients in the proton therapy group experienced a severe side effect, compared to the 28% of those who received traditional radiation. According to the study, proton therapy also appeared to be as effective as traditional radiation therapy in treating cancer and preserving life.
While proton therapy is becoming one of the leading treatments for cancer, access remains extremely limited.
Though the number of proton centers has increased from three to 46 over the years I’ve practiced radiation oncology, regional access remains a primary barrier to receiving this treatment. Most proton centers are in larger metropolitan areas and are affiliated with large hospital systems or major universities.
In Florida, there are six proton centers: two in Miami, one in Delray Beach, one in Orlando and two in Jacksonville. That means residents of Southwest Floridia – including Naples, Fort Myers, Cape Coral and Port Charlotte – face a two- to three-hour drive each way to access a treatment that could save their lives and allow them to live without debilitating side effects.
However, through competitive engineering and technological advancements, access to proton therapy is gradually improving. Southwest Florida Proton in Estero is an excellent example of bringing state-of-the-art proton technology to a community.
By the end of 2025, residents of Southwest Florida will have easy access to proton therapy. Engineers at Southwest Florida Proton are currently installing the final components of the IBA ProteusONE, widely regarded as the most modern and sophisticated proton machine available anywhere in the world. Testing and calibration will continue for the next few months.
With breast cancer being the most common cancer in women in the United States, excluding skin cancers, the new center will immediately prioritize patients with breast cancer, as well as those with prostate cancer and localized skull base or brain tumors.
Southwest Florida Proton will allow local patients to save on any travel costs they may have had to endure in the past, giving them immediate access to some of the most effective and groundbreaking cancer treatments available.
About the Author
Dr. Shannon MacDonald is the medical director of Southwest Florida Proton and a pioneer in the field of proton therapy.