Treatments

Pediatric proton therapy

Since proton therapy is targeted, it can be particularly effective in treating children, who are more sensitive to the effects of radiation. The precision of protons means children have a reduced chance of radiation side effects such as growth and developmental problems, as well as secondary tumors later in life. Fred Hutchinson Cancer Center - Proton Therapy has radiation oncologists who specializes in proton therapy treatment for children.

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Explaining proton therapy to your child

To alleviate your child's fears before treatment, it may help to have a tour of the center to see the radiation technologists and equipment. You can also download the kid-friendly presentation about the whole process.

When your child asks questions about cancer or treatment, be honest. Use age-appropriate terms and encourage your child to share his or her feelings. And remember that you're not alone: doctors, nurses, child-life therapists, and other members of the treatment team are here to reassure you and your child before, during, and after proton therapy.

With all kids, bring the conversation to their level, but also ask questions. Ask them what they understand, what they want to know and don't over-think your answers. Often your first instinct to answer is what they want and then let them ask follow-up questions. They often understand a lot more than we think and if you are not open with them, their imagination can come up with far worse things than reality.

Parents should also keep in mind that children might not ask questions that are on their mind. Children, like adults, find it difficult to ask questions when worried about the possible answer. We advise parents to facilitate questions by providing a welcoming and encouraging atmosphere for their child. And as with all stressful situations, your child might ask the same question many times simply because he or she may feel the need for repeated opportunities to discuss emotional concerns.

child proton
Advantages of proton therapy treatments over conventional X-ray radiation

Proton therapy is generally preferred for treating solid tumors in children because it delivers less radiation to healthy tissue, which helps prevent serious complications and causes fewer short- and long-term side effects. The following diagram shows the difference in radiation dose between protons and the most sophisticated form of X-ray radiation in treating a common pediatric cancer, medulloblastoma. Proton therapy delivers less radiation to the heart, lungs and abdomen for pediatric patients with medulloblastoma. Less radiation to these critical organs reduces the likelihood that patients will experience adverse effects years after treatment.

Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.
Pediatric brain and spinal scan

A number of complications can result with the use of X-ray radiation therapy for pediatric brain cancer. Because the hypothalamus is close to the site of radiation, the neurohormones produced in that organ can be affected. These neurohormones stimulate the secretion of growth and thyroid hormones, which are particularly important in a growing child.

Research has shown that proton therapy may significantly reduce the likelihood and/or amount of developmental abnormalities, growth delays, reductions in IQ, and other complications that often occur with standard X-ray radiation.

Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body.
Pediatric brain scan top
Pediatric brain scan side

Protons are preferred in many pediatric cancers, including:

  • Anaplastic astrocytoma 
  • Atypical teratoid/Rhabdoid tumor
  • Chordoma
  • Craniopharyngioma 
  • Desmoid tumor 
  • Ependymoma 
  • Ewing’s Sarcoma 
  • Gliomas, including optic pathway/hypothalamic glioma, oligodendroglioma, oligoastrocytoma
  • Glioblastoma
  • Intracranial germ cell tumors (germinoma)
  • Juvenile angiofibromas 
  • Lymphoma 
  • Medulloblastoma 
  • Meningioma
  • Nasopharyngeal carcinoma 
  • Neuroblastoma 
  • Osteosarcoma 
  • Pineoblastoma 
  • Retinoblastoma 
  • Rhabdomyosarcoma 
Lymphoma Cancer that begins in the cells of the immune system. There are two basic categories of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphomas. Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer. Neuroblastoma Cancer that forms from immature nerve cells. Usually begins in the adrenal glands but may begin in the abdomen, chest or nerve tissue near the spine. Most often occurs in children younger than age 5. A type of cancer that forms from immature nerve cells. It usually begins in the adrenal glands but may also begin in the abdomen, chest, or in nerve tissue near the spine. Neuroblastoma most often occurs in children younger than 5 years of age. It is thought to begin before birth. It is usually found when the tumor begins to grow and cause signs or symptoms.

Studies show that using proton therapy to control pediatric tumors provides excellent results while reducing damage to healthy tissue and reducing the likelihood of cancers occurring at other sites in the body.

Orbital rhabdomyosarcoma (RMS) is a type of tumor that occurs in the socket (or orbit) that houses the eye. This cancer is curable 85% of the time. While the studies on treating this cancer with proton therapy are small in size, the results show great promise. In a study done at Massachusetts General Hospital, proton therapy delivered less radiation to normal tissue than X-rays, and, six years later, patients experienced fewer side effects.

Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.
Advantages of proton therapy treatments over conventional X-ray radiation

Proton therapy is generally preferred for treating solid tumors in children because it delivers less radiation to healthy tissue.

Anesthesia

This is advised for anyone who would not be able to hold still during treatments. Anesthesiologists from Seattle Children’s use medicines to block pain and make your child less aware during treatment. The doctors have special training in giving anesthesia to children.

Treatments with proton therapy are extremely precise. For this reason, the patient must be positioned in exactly the same place each time. To help with this, the team creates immobilization devices such as bean bags and masks. However, young children have a hard time lying still even with the devices. Anesthesia helps children remain still during treatment.

Anesthesia Drugs or other substances that cause a loss of feeling or awareness. This keeps patients from feeling pain during surgery or other procedures. A loss of feeling or awareness caused by drugs or other substances. Anesthesia keeps patients from feeling pain during surgery or other procedures. Local anesthesia is a loss of feeling in one small area of the body, such as the mouth. Regional anesthesia is a loss of feeling in a part of the body, such as an arm or leg. General anesthesia is a loss of feeling and a complete loss of awareness that feels like a very deep sleep.
Anesthesia

Depending on your child’s age, he or she may have to undergo anesthesia in order to conduct treatments.

Child life specialists

Dealing with your child’s cancer diagnosis is a very challenging time for your entire family, but you’re not alone. The skilled and caring expertise of a child life specialist - a pediatric health care professional who works with children and families in hospitals and other settings - can help you and your child understand what is happening. We have a child life specialist on staff, and our partner Seattle Children’s also offers counseling. A child life specialist can:

Explain a diagnosis or treatment in words your child or teen can understand

  • Create a coping plan your child can use during the treatments
  • Offer support during and after treatments
  • Use play to help your child understand medical procedures and express feelings
  • Work with medical staff to assess your child's unique needs
  • Give you information about child development and the effects of health care
  • Teach techniques to help your child cope and relax
  • Offer support to help families cope with death or loss in partnership with the Journey Program
  • We've worked with our child life specialist to create this coloring book, which can help your child understand what to expect when receiving care at our center. 
Child life specialists

At Fred Hutch – Proton Therapy your family will have access to a child life specialist.