I am happy to announce that I now offer cancer patients both conventional radiation (using photons) at Erlanger Health System as well as proton radiation at the Provision Proton Center in Knoxville, TN.

Many patients ask if proton therapy is right for them. The answer is: it depends. Proton radiation can achieve a more precise treatment – meaning that I can get high-dose of radiation to the tumor, and minimize low dose radiation to surrounding tissues. A proton radiation plan, when compared to a photon radiation plan typically shows a significant decrease in the low dose radiation. One of the best examples is prostate cancer:

Proton Therapy for Prostate Cancer
Here is another example of a proton vs photon radiation plan in the treatment of a brain tumor:

Proton therapy for brain tumor

When you compare these radiation plans, you would wonder why we still offer conventional radiation at all. Here’s where it gets interesting. Just because the protons deliver less low dose radiation – it doesn’t necessarily mean you’ll benefit.

Of note, my credentials. I trained at Indiana University for residency and rotated through the Indiana University Health Proton Therapy Center in Bloomington. I’m fortunate in that my residency included conventional radiation as well as the proton center. Consequently, there was minimal bias. As a physician, if we felt that proton therapy offered an advantage, we were able to utilize that technology. If not, we had access to the traditional radiation therapy which included other specialized treatments such as SBRT, SRS using the GammaKnife®.

Like most radiation oncologists, I was taught in residency that even though the proton radiation plans look better, there really weren’t studies showing a benefit. Even just 10 years ago, it was well –established that proton therapy helped reduce radiation side effects for children, but there was insufficient data showing that proton therapy provided better outcomes in adult patients.

What’s Changed My Mind About Proton Therapy?

The Scientific Data.(1-3)

With the increase in proton centers in the US, there are now more convincing proton studies. Multiple studies have been published by well-established academic institutions showing a benefit to proton therapy in several cancer sites including prostate cancer, head and neck cancer, lung cancer, as well as brain tumors. In addition, I feel that protons may provide a better way to protect women with left-sided breast cancer from radiation that could damage their heart.

Provision Proton Center in Knoxville also uses a new proton technology that is more advanced than what was used when I trained at Indiana’s proton center. Pencil Beam Scanning (PBS) has provided radiation oncologists like myself the ability to offer our patients the most precise treatment plans available today.

In summary, I am excited to be able to offer my patients proton therapy in Knoxville. Proton therapy is yet another tool that I can use to treat your individual cancer to obtain the best outcomes. There will be more information to come regarding my recommendations on proton therapy for specific cancer sites.

I look forward to meeting and discussing what type of radiation is right for you or your loved one. Feel free to setup an appointment at Erlanger or Provision at your convenience.

  1. Mendenhall, NP, Hoppe BS, Nichols RC, et al. Five-year outcomes from 3 prospective trials of image-guided proton therapy for prostate cancer. Int J Radiat Oncol Biol Phys 2014;88:596-602.
  2. Pugh TJ, Munsell MF, Choi S, et al. Quality of life and toxicity from passively scattered and spot-scanning proton beam therapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2013;87:946-953.
  3. Bryant C, Smith TL, Henderson, RH, et al. Five-year biochemical results, toxicity, and patient-reported quality of life after delivery of dose-escalated image guided proton therapy for prostate cancer.  Int J Radiat Oncol Biol Phys 2016;95:422-434

Patient-focused treatment, and an individualized approach to oncology means Dr. Norleena Gullett is not just treating cancer, she's treating the whole person.