Proton Therapy for Prostate Cancer: Why and What Orthopaedic Surgeons Need to Know About It

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Most orthopaedic surgeons are unfamiliar with proton therapy or the difference between proton radiation and photon (X-ray) radiation. After they perform a total hip replacement or metallic hip implant, their patient cannot have proton therapy for prostate cancer because the protons must pass exclusively through the hips and are blocked by metal. Proton therapy is a sophisticated and expensive technology with growing demand and limited supply. In proton therapy, heavy protons are accelerated to almost the speed of light in a synchrotron (particle accelerator) down a magnetic beam the length of a football field to radiate cancers. Proton therapy is a remarkably safe and effective treatment for prostate cancer, the most common cancer in men, although treatment superiority has yet to be proved in randomized studies. There are currently only 10 proton centers in the United States.. (Journal of Surgical Orthopaedic Advances 24(2):91–98, 2015) Key words: Bragg peak, particle accelerator, prostate cancer, proton radiation, proton therapy, protons, synchrotron

J. Ollie Edmunds, MD, and Andrew K. Lee, MD, MPH