Proton Therapy for Esophageal Cancer

Treating esophageal cancer with an adequate dose of radiation can be difficult because of the close proximity of the esophagus to critical structures, such as the heart, lungs and spinal cord. Because protons deposit their highest dose of radiation at the tumor or area of concern, proton therapy can be an excellent choice for treating patients with esophageal cancer.

Proton therapy offers patients and their doctors a unique option for effectively treating esophageal cancer while reducing radiation exposure to surrounding organs and tissues. The MD Anderson Proton Therapy Center is one of the few centers of its kind treating esophageal cancer with proton technology.

What is the course of treatment for esophageal cancer patients typically like?

The standard of care for esophageal cancer is chemotherapy and radiation together followed by surgical evaluation. The course of radiation is five days a week, for five and half weeks. Patients will return 6-8 weeks later with repeat scans and scope to ensure there is no progression of the disease before they are evaluated by the surgeon.

What are the benefits of esophageal cancer patients being treated with protons?

The heart and lung, including the liver, is spared from doses of radiation that is scattered by X-ray radiation. Protons have little to no exit dose, so the dose of radiation stays confined to the tumor and the surrounding normal organs like the heart, lung, and liver, are preferentially spared, thereby reducing potential side effects.

What side effects are avoided? 

Side effects from radiation come from stray radiation hitting normal organs. For the heart, the blood vessels and the cardiac muscles have microinjury from radiation which can have long-term consequences at the time of surgery or even after years of completing radiation.

Lungs can be inflamed or scarred which can cause loss of breathing capacity. The liver, depending on the health of the liver, could be impacted by destroying healthy liver cells that are vital for detoxifying the blood and food that are being digested. 

How does esophageal cancer usually develop?

There are several causes for esophageal cancer, but the most common is due to chronic reflux disease, leading to adenocarcinoma. Other common causes are from smoking, alcohol, or ingestion of hot liquids, that with repeated injury to the lining of the esophagus over time can lead to a cancer called squamous cell carcinoma. 

MD Anderson is currently doing research to make advances for future treatment. Patient participation in clinical trials or research study help improve cancer care for our patients in the future.