Clinical experts at the National Cancer Centre Singapore collaborate to plan and deliver tailored cancer treatments for patients.
ADVANCES in cancer treatment have led to more precise, personalised therapies, offering hope for patients with tumours located near delicate or vital organs.
“Proton therapy, a form of radiation treatment delivers high precision with potentially fewer side effects to healthy tissues,” said National Cancer Centre Singapore radiation oncology division deputy chairman and senior consultant Dr Soong Yoke Lim.
What makes proton therapy different
Unlike traditional X-ray radiotherapy, which emits radiation along its entire path, proton beams can be manipulated to deposit the majority of their energy at a specific depth.
This precision enables oncologists to target tumours more effectively while preserving nearby healthy tissue.
“This unique physical property helps minimise radiation to critical structures such as the brainstem, spinal cord or optic nerves,” explains Dr Soong.
“That means fewer side effects for patients and lower risk of long-term complications.”
Conditions treated with proton therapy
In Singapore, proton therapy is currently used to treat cancers including:
> brain tumours;
> head and neck cancers;
> liver cancer;
> bone and soft tissue cancers;
> prostate cancer;
> lymphoma;
> childhood cancers.
Clinical research is ongoing to assess its benefits for a broader range of cancers.
How it works
According to Dr Soong, proton therapy damages cancer cells’ DNA, preventing them from growing or repairing.
Over time, the cancerous cells die, causing the tumour to shrink.
Its efficacy depends on factors, including tumour type, size, location and the patient’s overall health.
Treatment planning involves high-resolution imaging to pinpoint the tumour site.
Patients are fitted with custom immobilisation devices for consistent positioning during sessions.
Collaborative efforts
Proton therapy is not a one-size-fits-all solution. Each case is evaluated by a multidisciplinary team of oncologists to determine the best course of action.
“Cancer care is increasingly collaborative,” Dr Soong points out.
“By combining our expertise, oncologists will advise patients on a suitable treatment plan.”
Reduced radiation exposure may result in fewer side effects such as fatigue, dry mouth or damage to organs near the tumour site.
For many patients, quality of life during and after treatment matters as much as survival, notes Dr Soong.
“Minimising side effects helps patients recover faster and maintain their day-to-day functioning,” he adds.
Proton therapy in paediatric oncology
A major concern in treating childhood cancer with radiotherapy is the potential long-term side effects.
Dr Soong notes that children are more vulnerable due to the sensitivity of their developing tissues and organs.
With more potential years ahead of them, they also face a greater risk of experiencing later complications from radiation exposure.
Proton therapy can mitigate the risk of these late side effects by lowering overall radiation exposure to the body.
This approach can reduce the risk of long-term complications, which can help affect aspects of a child’s development and quality of life.
A scientific review of proton therapy in childhood head and neck cancers found that this method significantly reduced side effects such as hearing loss, vision problems and neurocognitive impairments, while maintaining effective tumour control, making it a promising option for paediatric patients.
In the Malaysian context
Cancer is a growing concern in Malaysia, becoming the third leading cause of death in 2022.
Between 2017 and 2021, the most frequently diagnosed cancers were breast, colorectal, lung, lymphoma, liver, prostate, leukaemia, nasopharyngeal, uterine corpus and ovarian cancers.
Data from the Malaysia National Cancer Registry indicates that the lifetime risk of developing cancer before age 75 has increased to one in eight for both men and women.
“Increasing rates of cancer worldwide highlight the importance of early detection, public awareness and access to evolving treatment options,” says Dr Soong.
While proton therapy may not be necessary for all patients, it offers an option for those with tumours near sensitive organs or at risk of long-term complications.
Ultimately, treatment decisions have to be made in consultation with qualified healthcare professionals.
With careful planning and collaboration, proton therapy has the potential to offer a more refined approach to cancer care.
