What to Expect During Treatment

Proton Therapy

Fighting cancer is challenging. To help you prepare for the fight, here is a brief outline of what you can expect during treatment with proton therapy. The details of some of the steps may differ depending on your particular case.

Step 1: The Consultation

First, you'll meet with your doctor, a radiation oncologist, to discuss your treatment. Based on your specific case, your radiation oncologist will tell you what type of radiation therapy he or she recommends, whether it will be given alone or in conjunction with other treatment methods, what the specific goals of treatment are, and what side effects you may experience. You can talk to your radiation oncologist about your treatment options and make a decision together. The consultation is an excellent opportunity for you to ask your radiation oncologist whatever questions. The consultation is an excellent opportunity for you to ask the doctor whatever questions you may have. Click here for a list of some common questions you may want to ask.

Step 2: Imaging

In order to design your treatment plan, your treatment team will take images to reveal the exact location of the tumor, including its size and position relative to the surrounding tissues and organs. This is typically done with a CT scan.

Depending on the general location of the tumor and other factors, additional types of scans may be taken, such as an MRI, a PET scan, or an ultrasound scan. With the help of these scans or images, your clinical team can see details of the tumor from a variety of angles.Depending on your treatment needs, a custom body-mold (or mask if your head is being treated) will be made, and tiny skin marks may be used to help ensure you’re in exactly the same position for each treatment session.

Step 3: Treatment Planning

With the completed scans, your clinical team will use sophisticated treatment planning software to develop a three dimensional “picture” of the area where you will receive treatment. They’ll determine the amount of radiation to be delivered, the appropriate angles from which to deliver it, and the number of sessions needed to deliver the prescribed treatment. They’ll also take into account many other factors—including the type of cancer being treated, its location and size, your medical history, and your lab test results—to create a plan uniquely designed for you.

Step 4: Treatment Begins

Proton therapy is typically provided in a number of sessions, called “fractions,” ranging from 5 to 35, usually with one session per treatment day.

Before each treatment session, your radiation therapist (RT) will help position you on the treatment table, also called a “couch.” Your therapist may use the machine’s imaging system to take a new image of the tumor in that day’s treatment position to verify the correct target. Adjustments to your position may then be made to precisely match the position that was planned for you.

Your therapist will be in constant contact with you through cameras and microphones in the treatment room. The gantry will rotate to the angles determined by your treatment plan. The pencil beam scanning system delivers the proton beam layer-by-layer, spot-by-spot, like a 3D printer. This helps deliver accurate treatment while minimizing radiation exposure to surrounding healthy tissue. You will not see or feel the proton beam.

Step 5: Post-Treatment and Follow-Ups

You may experience some side effects from radiotherapy. If you do, they might not begin until after several sessions because the effects of radiation treatment are cumulative. Talk to your oncologist before and during treatment if you have any questions or experience discomfort. Learn more about possible side effects.

After you complete your treatment, your radiation oncologist and healthcare team will monitor your progress with a series of follow-up visits. These visits can include a physical examination, blood screening, additional imaging, and other tests that may be needed. Your follow-up appointments are also a good opportunity for you and your caregivers to ask any questions about your progress, or inquire about the status of your overall health.