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. UCLH will gradually ramp up PBT activity during 2021. 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 and travel will be provided for patients referred to a commissioned overseas proton beam therapy centre. For paediatric and Teenage & Young Adult patients (up to 24 years old) this will be for the patient and a maximum of two carers, for Adult patients aged 25 and over this will be for the patient and one carer. Travel includes costs from the patient’s home address to the airport, transfers from destination airport to patient accommodation and daily travel for treatment. Overseas car hire is available and patients/carers travelling to Europe may take their own car and can reclaim fuel costs (Please see full NHS England policy below).
Patients and families will be held financially responsible for any damage to or additional cleaning costs for their accommodation incurred due to misuse.
From the 1 January 2021, all patients and carers travelling overseas for treatment, including Europe, must ensure they have a passport valid for at least six months and travel insurance for all members of the travelling party including the patient. For those travelling to the USA an ESTA or VISA will also be required. It is recommended that travellers check the latest UK Government travel advice before travelling.
- 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 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 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 Lung Cancer (Adults)
- Proton Beam Therapy for Oesophageal Cancer in Adults