Effective Treatment of Cancer through Advanced Proton Therapy

Proton Therapy is an advanced form of radiation therapy that highly targets tumor cells. Dr. Edward Soffen, a radiation oncologist at ProCure Proton Therapy Center in New Jersey, talks about proton therapy, and how it is effective at treating both prostate and breast cancers.

Dr. Soffen treats patients at the ProCure Proton Therapy Center in Somerset, NJ, and through Princeton Radiation Oncology. He is a leading expert in the treatment of cancers of the genitourinary tract, particularly prostate cancer. He offers extensive experience in all forms of radiation therapy for prostate cancer, including not only proton therapy but also high dose and low dose rate brachytherapy (radiation implant). He was one of the researchers involved in a pivotal study establishing the use an absorbable hydrogel spacer to further improve the safety of radiation treatment for prostate cancer.


Neal Howard: Hello and welcome to Health Professional Radio, thank you so much for joining us today. I’m your host Neal Howard. Our guest is Dr. Edward Soffen. He’s an oncologist and he’s joining us on the program today to talk about “proton therapy.” Welcome to the program Dr. Soffen.

Dr. Edward Soffen: Hi, thank you very much and I’m looking forward to this discussion.

N: Thank you for taking the time as I said. Now I said that you’re an oncologist and I know that covers a lot of area so why don’t you pinpoint it down for our listeners? What type of oncologist are you?

S: Right. I’m a radiation oncologist which means that I use high energy ionizing radiation to treat patients who have cancer. There are a few benign conditions that we treat but for the most part, we treat patients with malignancies. We use x-ray therapy, electron beam and proton beam irradiation which is really what I’m excited to talk about today.

N: Where are you practicing?

S: Well I practice in Central New Jersey in a number of facilities in several hospitals and our proton facility is in Somerset, New Jersey. So there’s sort of a swath of area in central New Jersey where I practice.

N: Now I’ve mentioned at the outset of our conversation that we were going to be discussing proton therapy. What exactly is proton therapy?

S: Right. Proton therapy is an advanced form of radiation therapy that very highly targets tumor cell. What I mean by that is, a proton is a particle that is generated in a cyclotron and the particle which has a certain mass will go in a certain distance right into the tumor and it will stop. It’s sort of like a smart bomb that goes in and detonates when it gets in the tumor so it gives all of its energy right where we want it and there’s no exit radiation. So what’s nice about this as opposed to conventional x-ray therapy is that x-rays go in one side of the body and out the other and it irradiates the tumor in the center but it treats sort of a whole tract of normal tissue. The proton goes in, detonates and gives off all of its energy. And basically, the proton when it releases the energy, it can destroy the DNA of the tumor cell so that it can no longer reproduce and it dies when it goes through a cell division. So that’s basically irradiation in a nutshell but protons specifically are extremely advanced targeting forms of high-energy particles into tumor cells.

N: So obviously, this affects, I guess the preservation of some vital organs that may not necessarily be affected by a tumor but because the tumor’s size or maybe that shotgun effect of conventional radiation, some healthy tissue may have to be removed. Is that something that you see being a thing of the past with this therapy?
S: Well that is exactly the benefit of the protons, is that because we irradiate less normal tissue, there is a significantly lower risk of side effects of treatment, patients get through the treatment much more easily. There are fewer long-term side effects in terms of there’s less damage to the normal healthy tissue. Some tumors are in places where it doesn’t matter if you cause some damage to the surrounding tissue but there are other tumors that are in critical places where damage to the normal tissue can lead to long-term lasting side effects that requires surgical repair or things like that. So one of the real benefits is less tissue, normal tissue getting irradiated, fewer complications, fewer side-effects, easier to get through treatment.

N: Are we talking effectiveness across the board when it comes to tumors that normally are treated through radiation, I mean breast cancer, brain cancer? What types of cancers are most affected by this type of therapy?

S: Right. So we start from the head and work our way down, brain tumors are very attractively treated with protons because we do want to spare as much normal brain tissue as possible – the optic nerve, acoustic nerve, the brainstem, these are all critical areas of the brain that we don’t want to damage and protons can go right into the tumor and stop. So benign and malignant brain tumors, a lot of head and neck cancers, cancers of the nasopharynx, the oropharynx, we can spare the mouth, we can spare the salivary glands to a greater degree. We treat lung cancer, particularly in patients who don’t have good lung function. We can treat esophageal cancer, other gastrointestinal cancers. We treat breast cancer, particularly on the left side, so left-sided breast cancer, when conventional radiation is used sometimes, the heart and the lung get some radiation dose and we’re looking at women who are going to live for decades, we don’t want them to get heart disease as a result of the therapy that they had for their breast cancer. So it seems that protons do dramatically reduce the lung and the heart dose to virtually nothing. We treat a lot of men with prostate cancer because the bladder and the rectum are right adjacent to the prostate and we can significantly spare the normal bladder and rectal function with protons. A whole slew of cancers that can be treated and very specifically, pediatric cancers. When we treat children who have cancer, we really need to spare as much normal tissue as possible – their heart, their lungs, their reproductive organs. So virtually, every child who has a malignancy except for, let’s say leukemia, we would offer proton therapy too.

N: Well let’s talk about when you became a part of Procure proton therapy. Is this the only center that offers this type of therapy there in the tri-state area in New York and Jersey and Connecticut?

S: There’s no Proton Therapy Center in New York yet. We were the first in New Jersey, there’s the second one also in New Jersey. There are only about 25 operating proton facilities in the country. So it’s an average of one center for every two states. We were the first in the tri-state area. We have a capacity of over a hundred patients a day. We use something called “Pencil-beam Scanning” which is a way of painting little spots of protons throughout the tumor. It allows us to carve out very specific geometric areas where we treat so we can wrap the dose around critical structures like the spinal cord or the brainstem. We can actually treat all around that area without treating the brainstem. So it’s this pencil-beam scanning which is highly, highly refined way of parking the protons exactly where you want it and around critical structures. There’s a facility in Pennsylvania, none in New York, so really, for the tri-state area, I think Procure is the spot to look for if you’re thinking that protons might be an advantage.

N: Well in wrapping up, let’s talk about the patient experience outside of the successful treatment there at Procure Proton Therapy Center.

S: Well, we have a truly loving staff. We say it’s high-tech but it’s also high-touch. We have a concierge service which helps patients internationally and from other areas of the country who come. We help them get housing, transportation, schooling for their children. It’s really like a five-star hotel when it comes to the non-professional services. We have counseling and social work, we have nutrition, everything that you would find in a tertiary cancer center is in under our roof at Procure. Our therapists are outstanding, we have a fantastic nursing staff and honestly, some of the best physicians in the country. We have an internationally renowned proton therapy expert who helps us treat the children and really just about every type of cancer service that you can find, we’ll provide, as well as non-professional services, like I said transportation, housing, tickets to a show, things like that. We have a very sophisticated concierge service to help people navigate through the number of weeks that they’re going to be transported out of their normal environment if they come from Connecticut. They may be staying during the week but going home over the weekend. International patients will be coming and staying for 6 to 8 weeks. Children or siblings of patients may need schooling or tutoring and we provide all of that.

N: Well where can we go and learn some more about Procure Proton Therapy Center there in Somerset, New Jersey?

S: I think if you go to our website, procurenewjersey.com or you can call, I believe the number is 732-357-2600. One of our intake nurses will discuss the issues with you. We also have something called “Welcome Wednesday” with patients who want to come to speak to a physician, we talk in several groups on Wednesdays. We also have our graduation day, so patients or future patients can come in and talk to people who have just gone through the treatment and find out how their experience was. So there are lots of options you can start just by going to the website.

N: Well thank you so much, lots of great information.

S: Thank you. I’m really delighted to get the word out. I think proton therapy is something that is underutilized because people just don’t know about it. And Neal, I look forward to talking to you again so take care and be well.

N: You too. You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this show are available at healthprofessionalradio.com.au and also at hpr.fm. You can subscribe to our podcast on iTunes, listen in and download at SoundCloud and be sure and visit our Affiliate Page at healthprofessionalradio.com.au and also at hpr.fm.

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