UK breast cancer patients undergo proton beam therapy in world’s first NHS study

Proton beam therapy was used to treat breast cancer patients in the world’s first NHS study to determine its promise as an alternative to radiotherapy.

Standard radiotherapy is very effective and has few side effects for most of the 30,000 breast cancer patients treated each year, says Professor Charlotte Coles, consultant oncologist at Addenbrookes Hospital.

But for a minority of about 500 patients each year, radiation therapy can cause at least 2% or more of life-long heart problems, which occur in less than 1% of recipients.

You will be given the opportunity to join this group Parable – The new NHS study, led by Professor Coles, is set to enroll 192 patients at 22 UK sites – to establish whether proton beam therapy could be a ‘best option’.

Proton beam therapy, which uses charged particles instead of X-rays, targets tumors more precisely, and researchers believe it will allow doctors to deliver radiation therapy where it’s needed, reducing radiation delivered to the heart and not increasing early risk. Side effects such as skin redness and changes in the appearance of the breast.

It is currently only available to NHS cancer patients at two centers in London and Manchester and is significantly more expensive than standard radiotherapy. Primarily used to treat children with brain tumors, there have been no large trials in breast cancer patients until now.

Those enrolled in the study will receive standard radiation therapy or proton beam therapy and will record their experiences using questionnaires so researchers can assess side effects, including skin reactions, pain and breast swelling.

The study will measure the amount of radiation delivered to the heart as an early predictor of potential heart problems, avoiding the need for long follow-ups of years before results are available.

“Using this early prognosis will allow us to identify the potential benefits of using proton beam therapy for heart health over the long term, rather than decades,” said Professor Judith Bliss from the Cancer Research Institute.

Kim Jones, 44, from Ely, Cambridgeshire, was diagnosed with cancer last February after noticing thickening of the skin and painful stitches in her chest.

At Addenbrooke’s, she underwent chemotherapy, a mastectomy and a lymph node dissection. Jones was accepted into the paradigm study and began proton beam therapy at Christie NHS Foundation Trust in Manchester on October 24.

“When I was told that I was accepted for the trial, I was so lucky to have the opportunity to receive this treatment,” Kim said. “Clinical trials are incredibly important because they are the best way to assess which treatments work best.”

Radiation therapy carries a very small risk of causing heart problems later and is usually because patients have breast tissue and lymph nodes located close to the heart or they already have an increased risk of developing heart problems.

However, the average dose of radiation therapy the heart can receive can be estimated and, along with age and other medical histories, this information is used to predict a small lifetime risk of heart problems.

Although proton beam therapy has been used to treat breast cancer in other countries, the number of participants in these studies was small, and there are no studies directly comparing proton beam therapy with standard radiation therapy.

Professor Coles said: “Although only a very small group are affected by the increased risk of heart problems later in life, it can still be a serious problem.

“Most patients treated with radiation therapy have decades of healthy lives, and we must do everything we can to prevent treatment-related future heart problems.”