Proton beam therapy is a type of radiotherapy that uses a beam of high energy protons, which are small parts of atoms, rather than high energy x-rays (called “photons”) to treat specific types of cancer.
Proton beam therapy enables a dose of high energy protons to be precisely targeted at a tumour, reducing the damage to surrounding healthy tissues and vital organs which is an advantage in certain groups of patients or where the cancer is close to a critical part of the body such as the spinal cord.
Proton beam therapy is only suitable for certain types of cancer, such as highly complex brain, head and neck cancers and sarcomas as it does not lead to better outcomes for many cancer cases than using high energy x-rays, which is still considered the most appropriate and effective treatment for the majority of cancers.
Like high energy x-ray radiotherapy, proton beam therapy is painless, but patients may experience side effects similar to those experienced from other forms of radiotherapy.
Two NHS centres will provide high energy proton beam therapy in the UK, The Christie NHS Foundation Trust (Manchester) and University College London Hospital (UCLH) NHS Foundation Trust.
The Christie NHS proton beam therapy centre opened in Autumn 2018, and the first patient was treated in December 2018.
The second NHS centre is currently being built at University College London Hospitals with treatment due to begin in 2020. When complete the two centres will each treat up to 750 patients every year.
Since April 2008, eligible patients who required proton beam therapy have been able to access treatment abroad. Some patients will still need to travel abroad for treatment until both NHS proton beam therapy centres are fully operational.
A proton beam therapy centre has also been operating in the UK delivering low energy proton therapy specifically for NHS patients with eye tumours at The Clatterbridge Cancer Centre NHS Foundation Trust in Merseyside.
How proton beam therapy works
Health Education England have developed a film in partnership with NHS England explaining how proton beam therapy works and what impact two state of the art centres in the UK will have on the service that the NHS provides:
A national panel of clinical experts reviews individual cases. If a patient’s consultant feels that proton beam therapy might be a suitable treatment for one of their patients, they submit a form to a panel of clinical experts. The panel will then decide whether the case is suitable for proton beam therapy in line with NHS England clinical commissioning policies and if so, confirm back to the patient’s doctor whether a referral can be made to either the NHS centre at The Christie or, until both NHS proton beam therapy centres are fully up-and-running, one of the NHS commissioned overseas centres in Germany, the USA or Switzerland.
Prior to starting proton beam therapy, eligible patients will need to attend an assessment and planning visit at the centre they have been referred to with treatment starting approximately 2 weeks later. Treatment is typically over five days for 6 weeks with each daily treatment taking up to an hour. Each proton beam therapy centre will provide more detailed information about what to expect during treatment.
Accommodation will be available for patients and carers coming from outside the immediate vicinity of proton beam therapy centre at The Christie (estimated at one hours’ travel time), but individual circumstances will be taken into consideration. You may be able to claim a refund of reasonable travel costs under the Healthcare Travel Costs Scheme (HTCS). Details explaining who’s eligible for the scheme and how to make a claim can be found on the NHS Choices website.
Accommodation and travel will be provided for patients referred to a commissioned overseas proton beam therapy centre. The leaflets below give information about what patients and their families should expect when they have been referred for proton beam therapy abroad. The policy also gives information about precisely what the NHS funds in relation to travel and accommodation in this case.
- Guide for families with children receiving Proton Beam Therapy abroad
- A guide for adult patients receiving Proton Beam Therapy abroad
- Clinical commissioning policy – funding policy for travel and accommodation proton overseas programme
Developing the UK proton beam therapy service
The government committed £250 million capital investment for both NHS proton beam therapy centres. This includes the buildings and PBT cyclotron and gantries, providing 6 NHS treatment rooms (3 at each centre).
Both Trusts have more information about the new proton beam therapy centres on their websites. This includes information on the clinical facilities, their location and, for UCLH, progress on construction.
NHS England proton beam therapy policies, standard operating procedure and service specification
Links to all of NHS England’s clinical commissioning policies on proton beam therapy, and a link to the proton beam therpy service specification can be found below:
- Proton beam radiotherapy (high energy) for paediatric cancer treatment – NHS overseas programme
- Proton beam radiotherapy (high energy) for skull base tumour treatment – NHS overseas programme (Adult)
- Proton beam radiotherapy (high energy) for teenage and young adult cancer treatment – NHS overseas programme
- Proton beam therapy for cancer of the prostate
- Process for applying for proton beam therapy and subsequent treatment centre allocation
- Proton beam therapy NHS service (all ages)
- Proton beam therapy service – overseas programme (adult and children)
- Proton Beam Therapy for Adult Lymphoma
- Proton Beam Therapy for Head and Neck Cancer in Adults
- Proton Beam Therapy for Hepatocellular Carcinoma
- Proton Beam Therapy for Oesophageal Cancer in Adults
- Proton Beam Therapy for Children, Teenagers and Young Adults in the treatment of malignant and nonmalignant tumours