Preparing Your Child for Proton Therapy
If you are choosing CHOP solely for proton therapy, we will work in collaboration with your home care team, making recommendations to your primary oncologist and ensuring all parties are kept informed throughout the process.
One of our pediatric oncologists with expertise in your child’s specific cancer will oversee and coordinate treatment while you are in Philadelphia for proton therapy. If your child needs lab work, chemotherapy, imaging or other types of services, we’ll work with your primary oncologist to facilitate these procedures, services and treatments while you are away from home.
You will have access to the full resources of CHOP's Cancer Center, including psychosocial services which provide support for your child's siblings and your entire family. For outpatient children ages five and up who are missing classes at school, our teachers work in partnership with your home teachers to help kids stay on track with their studies. Rest assured, your child is getting the very best care available in the world while at CHOP.
What to send prior to your child's appointment
- Clinical summary or detailed referral letter
- Pathology slides (must be sent by overnight delivery)
- Copies of diagnostic films such as CT scans, MRIs, ultrasounds and X-rays on a DICOM formatted CD
- Surgical reports
- Lab reports
- Insurance information, including copies of health plan cards
Send the above items to: Roberts Proton Therapy Center, Perelman Center for Advanced Medicine, Attn: CHOP Proton Intake Coordinator, 3400 Civic Center Blvd., Suite C-391, Philadelphia, PA 19104.
What to bring to your child's appointment
- Appointment schedule
- All insurance documentation, including medical insurance and prescription cards
- List of your child’s doctors and their contact information
- All of your child’s prescription and nonprescription medications in the original, labeled bottles. This includes vitamins, nutritional supplements, herbal products and over-the-counter drugs
- List of questions to ask your child’s doctor
- A notebook and pen for taking notes
- Personal items: Comfortable clothes, something to read or play with while you and your child are waiting, any medications or other necessary medical supplies, phone number of the place you're staying
Prior to your child’s proton therapy treatment, our intake coordinator will set up a 2- to 3-day evaluation, during which you and your child will visit:
- The medical oncologist
- The radiation oncologist
- Computed tomography (CT) for imaging
- Child life specialists
- The Anesthesia Resource Center (ARC), if necessary
We also perform neuro-psychological testing, as applicable, for brain tumor patients, as part of our brain protocol program.
Each child treated at the Roberts Center will have the opportunity to enroll in studies examining the long-term neuropsychological and developmental effects of proton therapy. The results of these studies could help doctors refine and improve proton therapy treatments for future generations of children.
Customized treatment for every child
Each child scheduled to receive proton therapy has treatment planned weeks in advance by a team of radiation oncologists, physicists and dosimetrists. The team reviews, revises and adjusts the plan until they all agree that it offers the best balance between treating the tumor and sparing the normal tissue. The treatment planning process includes the following steps:
CHOP oncologists consult with The Roberts Proton Therapy Center staff and schedule the child for a CT simulation. During the simulation, the child's body is positioned as it will be during treatment and scans are taken (CT and possibly MRI).
Radiation oncologists use the data from the scans to develop a treatment plan by:
- Defining the amount of tissue they need to treat
- Defining how much normal tissue they can spare
- Deciding how much radiation will be delivered to the tumor
List of instructions
Radiation oncologists create a list of instructions for the physicists and dosimetrists to use in developing the plan for delivering the radiation.
Agreement of team
All members of the treatment team agree on the plan for your child and the plan goes through an extensive quality assurance process.
Confirmation of plan
The child is then again placed in the treatment position she will be in when treatment begins and the team uses imaging to determine whether the treatment can be delivered as planned. Once that has been established, the scheduled treatments can begin.
Once these evaluations and tests are complete, you and your child will return home for two weeks while your child’s proton therapy plan is designed and finalized. Your child’s proton treatments will begin approximately two weeks following the computed tomography (CT) simulation, which identifies the exact location of the tumor within the patient’s body and also simulates the settings and movements of the actual treatment machine that will be used for radiation treatments.
You can expect the proton treatment program to last approximately two months. Children have an average of 30 treatments scheduled during this time, receiving treatment every day from Monday through Friday, except holidays.
Depending on your child's overall therapy program, a single treatment may take anywhere from 30 minutes to an hour and a half. Much of the treatment time involves precisely positioning your child to accurately pinpoint the tumor with the proton beam.