Proton therapy is a type of radiation therapy that uses protons instead of X-rays. New research suggests it might effectively treat esophageal cancer with less risk of damaging nearby organs.

The American Cancer Society estimates that about 21,560 people in the United States will receive esophageal cancer diagnoses in 2023. Despite the survival rate of esophageal cancer increasing fourfold in the past 50–60 years, only about 20% of people live at least 5 years after their diagnosis.

Esophageal cancer can be hard to treat because of the location of your esophagus, which is near your lungs and heart. Surgery and radiation therapy can have a high risk of damaging these organs. Organ damage becomes more likely at higher dosages of radiation.

A small 2022 study suggested that proton therapy might reduce heart and lung toxicity. And it may be equally as effective as traditional radiation therapy.

Let’s take a deeper look at the potential benefits and risks of proton therapy.

Proton therapy is a type of radiation therapy that’s under investigation for treating esophageal cancer.

Traditional radiation therapy uses X-rays to destroy cancer cells. X-rays can also cause damage to nearby healthy tissue. Your heart and lungs are at particular risk of damage when treating esophageal cancer due to their proximity.

Proton therapy uses beams of protons to destroy cancer cells instead of X-rays. Proton therapy can potentially expose healthy tissue to less radiation while effectively treating the cancer.

There’s still little research comparing the outcomes of people who undergo proton therapy for esophageal cancer with those who don’t. But researchers are hopeful that it could help improve the outlook of esophageal cancer.

Traditional radiation therapy causes high complication rates when used to treat esophageal cancer. The main benefit of proton therapy is that it exposes your healthy cells, especially those in your heart and lungs, to less radiation while potentially offering the same effectiveness.

In a small 2023 study, researchers found that proton therapy could be safe and effective for treating cancer that has spread to lymph nodes after surgery. They also found that it could be safe and effective even when conventional radiation therapy is difficult to provide with chemotherapy.

The researchers found that half the people in their study lived at least 22 months, significantly longer than expected with traditional treatment. For reference, in a 2021 study from the Netherlands, researchers found that half the people with local or regional recurrence of esophageal cancer lived less than 7.4 months.

Proton therapy technology is expensive, and few centers have purchased the necessary equipment.

Despite the higher cost, relatively little research is available examining the survival rates of people who have received proton therapy compared with people who have received traditional radiation therapy.

Although proton therapy may cause less toxicity than traditional radiation therapy, it may still cause complications, some of which could potentially be life threatening, such as:

Research examining the outcomes of using proton therapy for treating esophageal cancer is still in the early stages. Some studies have found promising results.

In the small 2023 study mentioned above, researchers found 4 out of 11 people who received proton therapy for recurrent esophageal cancer had died, according to an average follow-up period of 20.2 months. Half the people lived at least 22.4 months, and nobody developed any serious complications. Two years following the procedure, 27% were alive.

In a small 2022 study, researchers looked at the combined use of proton therapy and chemotherapy for 17 people with esophageal cancer. The 3-year overall survival rate was 55%, meaning those people were still alive 3 years after the treatment.

Doctors use radiation therapy to treat almost all stages of esophageal cancer. Proton therapy still isn’t widely available since only a few treatment centers have the necessary equipment.

Proton therapy may make a good alternative to traditional radiation therapy for people who can afford and access the procedure.

Who should avoid it?

Conditions that may make you ineligible for radiation therapy include:

Doctors use seven standard treatments for esophageal cancer:

Researchers are continuing to look at newer treatments for esophageal cancer that might be more effective than current treatments. One new treatment researchers are looking at is combining immunotherapy with targeted therapy drugs.

Here are some frequently asked questions people have about proton therapy for esophageal cancer.

Can proton therapy cure esophageal cancer?

Esophageal cancer is currently rarely curable. But when a doctor detects it early, this may increase the chance of curing it. Proton therapy may help improve the chances of survival.

What is the best treatment for esophageal cancer?

The best treatment for esophageal cancer depends on how far your cancer spreads. Treatment usually consists of some combination of chemotherapy, radiation therapy, and surgery.

Immunotherapy and targeted therapy are promising new treatments that doctors may combine with other treatments to increase survival rates.

Proton therapy is a type of radiation therapy that uses beams of protons instead of X-rays. Research suggests that it exposes healthy tissue to less radiation and may help reduce toxicity to the heart or lungs.

There’s still little research comparing the effectiveness of proton therapy with traditional radiation therapy for people with esophageal cancer. Researchers hope it may help improve the survival rates of esophageal cancer in the future.