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 highly 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. This 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. It does not lead to better outcomes for most cancer cases compared to using modern high energy x-rays, which is still considered the most appropriate and effective treatment for the majority of cancers.

As Proton Beam Therapy is a new and highly specialised type of radiotherapy, the NHS also carries out clinical trials to explore its future potential in treating other cancers and build the evidence around its safe and effective use.

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 provide high energy proton beam therapy in the UK. The centre at The Christie NHS Foundation Trust (Manchester) opened in December 2018 and the second NHS centre at University College London Hospital (UCLH) NHS Foundation Trust opened in December 2021. The two centres work together as an integrated National service.

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

This film from 2019 explains how proton beam therapy works and the impact of these two state of the art centres in England:

Patient information

If a patient’s consultant considers that proton beam therapy might be a suitable treatment for one of their patients, they will submit an online form and pass their details securely to the relevant treatment centre.

An expert team at the treatment centre will then decide whether the case is suitable for proton beam therapy and in line with NHS England clinical commissioning policies. If accepted, they will confirm the outcome of the decision to the patient’s referring doctor and team and explain what will happen next.

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 2-3 weeks later. Treatment is typically over five days a week 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 provided for patients referred to an NHS commissioned proton beam therapy centre. Eligibility for financial support for travel is the same as for any NHS radiotherapy treatment and may be discussed once a patient has been accepted for an assessment visit by the proton centre. If the patient is eligible for Hospital Transport, it will be the responsibility of the referring trust to organise hospital transport to the accommodation site and for the return journey on completion of the initial assessment visit and the course of PBT. The PBT centre is only able to arrange transport, where eligible, between the accommodation site and the PBT centre during the initial assessment visit and the course of PBT.

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 and their location.

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 therapy service specification can be found below:

• Proton beam therapy for breast cancer (all ages)
• Proton beam therapy for children, teenagers and young adults in the treatment of malignant and non-malignant tumours
• Proton beam therapy for craniospinal irradiation in adults
• Proton beam radiotherapy (high energy) for skull base tumour treatment – NHS overseas programme (adult)
• 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 for adult lymphoma
• Proton beam therapy for head and neck cancer in adults
• Proton beam therapy for hepatocellular carcinoma
• Proton beam therapy for lung cancer (adults)
• Proton beam therapy for oesophageal cancer in adults