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What is Hadron Therapy and how does it work?

The therapy  used is called hadron therapy, and it has an accuracy of two-tenths of a  millimeter.
In this way, the therapy focuses ONLY on the tissue affected by cancer and reduces it, session after session, until healed.
The technology that enables this short and focused treatment is called Synchrotron.  Synchrotron is an innovative tool to treat those tumors which are  resistant to conventional radiotherapy and is partly created in Italy.
The project comes from studies made by the CERN, in Geneva, and by the National Institute of Nuclear Physics, in which Italian scientists and researchers took part with great commitment and success.
Your specific  case will be analysed by specialist doctors. As the first thing, the  body is immobilized before getting treated. The therapy is made of a  variable amount of sessions, from 10 to 20, and each session lasts from 5 to 15 minutes.

Rapid technological progress in recent years has led to an evolution in all areas of medicine and has significantly influenced radiation oncology. Today, a new frontier in radiation therapy is represented by the hadrontherapy, which is the use of protons and atomic nuclei (ions) called hadrons (from the Greek hadrós, strong) that are subjected to a strong nuclear force.
The advantages of hadrontherapy compared to traditional radiotherapy are:
  1. The release of energy (and thus the destruction of cells) is done selectively, targeting only cancer cells. The damage incurred in the body on initial penetration is relatively small and  significant release of energy is confined only to the vicinity where  the cancer is located (a phenomenon referred to as the Bragg Peak). This maximizes the destruction of cancerous tissues while minimizing collateral effects on healthy tissues
  2. The beam of hadronic particles remains collimated as it penetrates the biological material. The high collimation of the beams of hadrons further minimizes damage to healthy tissues
  3. The energy release mechanism for hadrontherapy causes a large amount of breaks on the chemical links present in biological macromolecules, especially DNA. The latter has the ability to repair itself,  but if the number of broken links is excesive it loses its function of  self-reparation and the cells remain inactive and die. In conventional  radiotherapy the DNA damage is modest; on the contrary, in the hadrontherapy with carbon ions the number of breaks allows the destruction even of tumors resistant to conventional therapy.
Together these three benefits result in a significant destructive effect on biological tissues, for which reason the target (tumor) must be positioned  with a degree of  accuracy which is much greater than that associated with conventional radiotherapy.

Effective application of hadrontherapy requires the following:
  • a proton and / or ion accelerator (such as the circular accelerator or synchrotron) producing a number of particle beams
  • a system for transporting the beam in the treatment room
  • a procedure for precisely positioning the patient for treatment
  • complete control of the energy to be released i.e. the dose
  • a three-dimensional customized patient treatment system obtained by integrating diagnostic imaging results (CT, MRI, PET).
It is important to note that since hadrontherapy is a relatively recent addition to the modern oncological treatment panorama, a number of indications are still in the experimental stage.
The National Centre of Oncological Hadrontherapy (CNAO), located in Pavia, is the first Centre of Hadrontherapy in Italy provided with a beam able to irradiate patients with protons or carbon ions for the treatment of radioresistant tumors.

The Synchrotron: what it is and how it works

CNAO’s ‘High Technology’ components consist of a set of accelerators and transport lines of particle beams. The beams are generated by sources that produce carbon ions and protons. The most important accelerator machine is the Synchrotron. The synchrotron at CNAO is  a prototype resulting from the research in high energy physics made  possible through the collaboration of the Istituto Nazionale di Fisica  Nucleare (INFN), CERN(Switzerland), GSI (Germany), LPSC (France) and of the University of Pavia University (Italy). It is based mostly on Italian technology.
The synchrotron is a “donut” 80 meters long  with a diameter of 25 meters. In two areas inside the circumference the  beams of particles are created in devices called “sources”, which contain plasma formed by the gas atoms that have lost their electrons. Using magnetic fields and radio frequency pulses, these atoms are extracted and the protons and carbon ions are selected. In this way “packages” composed of beams -each one containing billions of particles- are formed.

These packages are pre- accelerated and sent to the  synchrotron where, initially, they travel at about 30,000 kilometers per  second. Subsequently they are accelerated to kinetic energies of 250 MeV for protons and 480 MeV for carbon ions (the MeV, equivalent to one million electron volts, is the unit of energy used in nuclear and atomic scale phenomena).
The particle beam is accelerated in the synchrotron and travels about  30,000 kilometers in a half second to reach the desired energy. The  beams are then sent to one of the three treatment rooms. Above this  station there is a magnet of 150 tons which bends 90 degrees the  particle beam and directs it from above to the person to be healed.
The beam that strikes the cells of the tumor is like a “brush” that moves in a manner similar to that of electrons in a TV and acts with a precision of 200 micrometers (two tenths of a millimeter).
This accuracy is achieved by means of:
  • Constant monitoring of the patient to follow any movements of the body (breathing, for example) that can change the location of the tumor, using infrared cameras to measure movement in a three-dimensional way
  • Two scanning magnets that, based on feedback of the beam monitoring system, move the “brush” along the outline of the tumor
In this way, section by section, the tumor is destroyed.  The transition from one section to another deeper section is achieved  by increasing the beam energy. The entire radiation lasts a few minutes.

Come to Italy to get healed
Synchrotron is an advanced machinery and there are only four prototypes in the world.
This is because the medical specialization and the required techniques are very high, and the machineries and technologies are very expensive.
It is not available in America, because it’s based on Italian and European researches:
Italy is the place to treat cancer.

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