Contact: NIU Office of Public Affairs
December 6, 2004
Answers provided by Dr. Aidnag Diaz and medical physicist Arlene Lennox
of the NIU Institute for Neutron Therapy at Fermilab
What is neutron therapy?
Surgery, chemotherapy and radiation are typical treatments for cancer. Neutron therapy is a highly effective form of radiation therapy.
Neutron therapy is often able to treat tumors that conventional therapy deems untreatable, sparing patients from undergoing amputation, loss of functioning or death. Positive results can be seen in cancers that are resistant to the low LET radiation offered at most cancer treatment centers. If a cancer is inoperable or amputation is offered as a treatment option, neutron therapy may be the treatment of choice.
Neutron therapy is not a “last resort” option to be used only if all other treatments fail. It is the better option for some types of cancer. If a patient has a form of cancer that responds well to neutron therapy, it is best to seek neutron therapy first. Undergoing traditional radiation before neutron therapy can make it more difficult to optimize neutron therapy’s effectiveness.
Who might be considered candidates for neutron therapy?
Neutron therapy has been shown to be superior for some types of cancer, including adenoidcystic carcinoma, locally advanced prostate cancer, locally advanced head and neck tumors, inoperable sarcomas, and cancer of the salivary glands. The Northern Illinois University Institute for Neutron Therapy at Fermilab will focus on treating these cancer types. Patients with other types of cancer may be considered on a case-by-case basis.
How does neutron therapy differ from conventional radiation therapy? Conventional treatment for cancer applies photon (X-ray) or electron radiation, which is available at many clinics and hospitals. Electron accelerators or radioactive sources such as cobalt produce these beams. The radiation damages DNA strands, destroying the ability of cells to divide and grow, but there is still a chance that tumor cells will repair themselves.
Certain tumor types, particularly dense tumors that contain little oxygen, are resistant to conventional radiation treatment. Neutron therapy specializes in treating these inoperable, “radio-resistant” tumors. Neutrons are much heavier particles than photons or electrons. Think bowling balls compared to ping pong balls. The heavier neutrons, which don’t require an interaction with oxygen to be effective, destroy the nucleus of a cancer cell, so it can’t repair itself. Fermilab boasts the most penetrating neutron beam in the world; it can reach cancer cells anywhere in the body.
How long is the duration of treatment?
Patients typically require only 12 treatments over four weeks— compared to 30 to 40 treatments lasting eight weeks for conventional radiation. Neutron therapy allows patients to get back to their normal activities faster than traditional radiation. Neutrons damage tumor cells very effectively, since neutron therapy is three times more powerful than traditional radiation.
Why isn’t neutron therapy better known?
Fermilab is one of just three neutron therapy facilities operating in the United States today. Though access is potentially limited because so few facilities exist, the clinics that provide neutron therapy still are not using their full capabilities. This is true because people do not know about neutron therapy.
Why aren’t there more neutron therapy clinics?
The linear accelerators needed to produce neutrons haven’t been commercially developed for medical purposes. So hospitals don’t have the equipment. Similarities between the development of neutron therapy and proton therapy, yet another cancer treatment, provide some hope for the future. Fermilab built one of the first accelerators specifically designed for proton therapy on cancer patients and shipped it in 1990 to Loma Linda University Medical Center in California. Once Medicare began to provide full reimbursements after 2002, proton therapy clinics began to spring up nationwide. Loma Linda now treats 150 patients a day.
Is neutron therapy a relatively new technology? The University of California at Berkeley began treating patients with neutron therapy in 1938, just six years after the discovery of the neutron. Shortly after the start of these early clinical trials, the Berkeley accelerator was converted to exclusive use of isotope production for the war effort. Research resumed in the 1960s in England, where cell and animal studies showed promising results. International clinical trials started in the mid-1970s, including at Fermilab, and researchers eventually learned that the efficacy of neutron therapy depended largely on the energy of the neutron beam. Fermilab produces the highest energy neutron beam in the world.
Over the last 35 years, the field has advanced into an accepted treatment for advanced, inoperable tumors that are resistant to conventional radiation treatments. The neutron therapy clinic at Fermilab has treated more patients and has been in operation longer than any other neutron therapy program in the United States.