Radiation therapy was used to save my brother's life from a rare eye cancer by the brilliant folks at MGH. Thanks to everyone involved in developing revolutionary medicine to make our lives better :)
Yeah. Eye cancer is one of the best applications of proton therapy. There is even a chance of saving the eye which you can never hope for with X rays. I hope your brother did manage to keep his.
Thank you, Dr. Lincoln, that was a great explanation. I just started proton radiation therapy at the Chicago Center shown in the video and I marvel at the technology. During each session I think about all the incredibly intelligent people that led up to the machine I'm in that's killing the cancer that's trying to kill me. I'm humbled and deeply appreciative of their life's work, both Doctors and Useful Doctors, alike! Thank you for saving my life.
Dear Dr Lincoln, Thanks for you practical info..... I will refer my patients to your video...very clear and concise. We use the proton beam a lot in our area to treat prostate cancer. Aunt Margaret was wrong; you are the "smarter" type of doctor. : )
This year, a friend of mine needed radiation therapy for the most malignant brain tumor known. He's doing fine for now, thanks to professional medics, AND scientists who paved the way. To say you're not a useful doctor is a grave underestimation. These bits of knowledge you present us with are very nutritious to the brain.
Quite correct Peter. He has a Ph.D in physics while a physician has an MD degree after completing 4 years of medical school after 4 years of college. They then go through 3 to 7 years of residency in a hospital, with the length of residency depends on what specialty. For example, a neurosurgery residency last 6 to 7 years to complete.
Excelente, me encanta el canal y cada uno de los vídeos que hacen. Solo un detalle, en el minuto 2:30, la máquina que sale ahí no es una fuente de radiación gamma, es un acelerador lineal que produce haces de rayos X de alta energía (MV), que también son utilizados en Radioterapia, incluso, hoy en día, se utilizan más que la radiación gamma. Cabe destacar que los aceleradores lineales también puede generar haces de electrones usados para tratamientos de lesiones más superficiales. ¡Saludos desde México!
Dr. Lincoln, would you consider making a video on the interpretation of amplitude in the context of a lightwave? Specifically, how would one think about the amplitude of a single photon? Would this even make sense? This question doesn't seem to have an easy answer, but I feel like it would be perfectly suited to this video series! Thank you very much!
This is an excellent video. I am due to start volunteering at a Proton Beam Therapy hospital in London in November this year. Excellent background information for me. Thank you.
as a medical physicist working in the radiation oncology field for quite few years I both really like the explanation of in the video and hate it at the same time because it's a very nice explanation of the physics and theory behind both technologies but wen you get to the practical aspect of things proton therapy does not have that much pluses compared to conventional photon or gamma ray therapy.... protons are much more expensive much more dangerous need much higher level of competence of the staff and are much more harder to work with with the higher energies (20 to 40 times the energy of normal radiotherapy) you have a not more other effects that are still not well studied how they affect the patient long term, yeas they spare 20-30% more the healthy tissues compared to standard radiotherapy but coverage of the tumor is not that much better if at all better and it has limitations because it has problems with high density structures at the end of the day both technologies are good and work and are much less destructive to normal tissues than few years back one is good for certain things the other is good for other things and we as specialists need to choose the right one for the specific patient go give him the best chance of survival with minimum side effects not to choose based on what's modern and cool or what we get more money from...... both technologies have their place and are better than the other one in specific cases
Thank you for this video! My cousin is having a brain tumor treated by this method and I wanted to know how it differed from traditional gamma radiation.
They used gamma rays back in the days when they used Cobalt sources, but these days conventional radiotherapy are high energetic x rays produced by a linear accelerator Also the photons that past through the person have a build up effect so the first 2 centimeters of the surface aren't getting the full dose
Thank you so much for a simple explanation of the different treatments. I was just diagnosed with tonsil cancer so I want to see if Proton Therapy will work for me. I understand there are less side effects. As you suggested, I will ask my doctor. Unfortunately, we do not have a Proton Therapy facility in my area but I'm willing to travel.
Dr Don, great video on proton RT. Your aunt M seems to be missing the point since you are 'the bomb'. Maybe got her FOR's all confused in your relativity videos. Haha. But really I wish I had a communicator of your quality when I struggled through my BSc many years ago. Physics becomes much easier if a concept is well delivered before the math sets in. Thanks for sharing your phenomenal talent with world. Bob
So, maybe you're not a real doctor. But you did something no real doctor has done for me. I've heard those radio and tv ads for a while and I never bothered to investigate the physics. I had a feeling it was real, but I never knew for sure if it wasn't just another one of those pseudo-science topics. Now I know it's real.
On the other hand, the guy over in the Recommended column to the right, claiming to have a cure for stage 4 cancer using baking soda? You shouldn't listen to him. He's not even a PhD, let alone and MD.
A very interesting and informative video Dr. Lincoln. I would to know if the interesting tee/sweat can be purchased from Fermilab and if so, how does one order them. Thank you for your time.
neutrons work a little bit differently, because they are not charged, but radioactive. If you accelerate neutrons at the right speed and from right distance, you can time it so that most of the neutrons decay when inside the tumour, and very little of them before and after the tumour.
Thank you for the video it was a very great simplistic yeah detailed overview. I have been told I need a biopsy of the prostate. So I’ve been looking up information online
A different kind of work here for sure but as usual great. Keep them coming. Also, how about a video on identical particles. How can fields be so perfect to produce electrons identical including their charges. Something perfect producing perfect particles. That seems more unlikely than than being at the mercy of straying too much or little of the cosmological constant.
The device you show for conventinoal radiation therapy is an accelerator. It accelerates electrons via a linac and either uses them directly with the specific energy achived with an electromagnet filter or it slams them into a gold or tungsten target releasing high energy xrays in the 6 to 20 Mev range. I do not think those are high energy enough to be called gamma.
@Mekratrig The first reply didn't say much except implying that it might be on the Fermilab site. Yes, it is. I am not an MD but worked in labs of all sorts during my working like. If a tumor has a high Oxygen content then conventional EM radiation will have a chance of killing the tumor by producing ions from the Oxygen. But some tumors are low in oxygen and therefore have a chance of recovering from EM radiation. Neutron therapy doesn't require Oxygen because a Neutron has no charge but attacks the nucleus of cancer cells. That's just a basic outline but I hope it helps.
Dr. Wilson is my hero. He is the BEST kind of doctor. One that knows, loves, and celebrates the secrets of physics and is excited to tell us in layman’s terms all about it. You will know a wise man because he will be the first to admit the limits of his expertise. Unlike crackpots that will give you unlimited “answers” until pseudoscience exhausts them.
Can the “Bragg” area be tuned? Do you know the percentage of energy delivered to the target area vs the entry beam? Excellent video. My wife is about to undergo this therapy and I want to know as much as I can. Thank you.
Yep, you can tune the area where the bragg peak (where the protons stop and relay the most energy) by adjusting the kinetic energy, essentially speed, of the protons, which is fairly easy. Not so sure about the energy delivered, I'd say about 20% (tissue) to 80% (tumor), but I might be wrong and you might wanna check wikipedia on that... Hope your wife gets better!
Being both a "useless" physicist and a "real" doctor, I decided to work in proton therapy. I realized that one problem is that we do not know exactly where the Bragg peak occurs in the patient. Have been working on a solution of that problem.
+ScienceNinjaDude They don't anymore (iirc), but they used to - there is literally an old room off of one of the accelerators where a number of doctors did this for years! It was called the Fermilab Cancer Therapy Facility
Due to ionized electrons having enough energy to ionize other electrons the dosis maximum with gamma rays actually is not at its maximum at the surface. With rising energy, the dosepeak gets shifted deeper into the tissue (we call that Aufbaueffekt in germany, no idea how it's called in english), one of the reasons why radiotherapists use energies at 6-20MeV.
But there was almost no detail on why proton beams are different. How is the fact that they have charge used? Why is there this Bragg bump? How does the beam know to stop just where the tumor is? This is the first time I've been disappointed by one of Dr Lincoln's videos. Follow up video please!
@1:43 Alpha particle doesn't posses electrical charge? But what i had always read is, alpha particles are helium nuclei with +2 charge and a proton has +1 charge.
My daughters skin was burnt black from radiation, her black skin rubbed off when I tried to put the medicated cream on and she was in so much pain she screamed.
I was Diagnosed with Throat cancer in February 2020 and have been going through a terrible time figuring this all out since. I felt alone, as many cancer Patients do, at first. I didn't want my family to know or for this to hurt them in any way. However, I slowly learned we are ALL INVOLVED. We ALL get hurt. The Psychological impact is huge! Especially for VOICE ACTORS or anyone in the Entertainment industry who has been told cancer is in your throat, tongue, #2 lymph nodes out of #28 removed etc. My goodness, what the he** does one do with this information? None of us are doctors, oncologists, radiologists, 'ENT's', surgeons, robotic surgeons....AND WE LEARNED WE WILL NEED THEM ALL. And we have. Dr. Gernon MD (performed 3 cancer surgeries 2020) , Dr. Arya Amini, Dr. Menzel, Dr. who first brought up 'Proton Therapy' due to my horrific SKIN CANCER PROBLEM since 1989 having had 100+ Basal cell surgeries. 2 Melanoma's. And more BCC where I used UFUDEX, FLOUROOUCIL. Etc. Radiation would do 'Great Harm' to me! Gorlin-Goltz Syndrome per D. Wayne Grody, MD - UCLA. Dr. Donald Morton, MD, UCLA who died himself of Melanoma. Sad. Now we must move quickly on a 'Plan of Action for Proton Therapy Vs Radiation?' and if Chemo is needed? and which hospital? City of Hope, Duarte, CA best option due to 33 miles from home issue.....However, Do they have this Therapy? Other professionals needed - Speech, Nutrition, Rides, ready for emergencies if breathing becomes a problem? Swelling of Tongue LESS than Radiation? Cyst of left nostril causing breathing issues NOW....It gets 'complicated with each new day and new problem/ISSUE' . Thank you, seeing Dr. Gernon, MD 4/20/2020 City of Hope, Duarte, CA CT SCAN #3 - Then plan. This is a scary time. Bless you all. Here we go.....Psalms 46:10
How are you now? I was just diagnosed with tonsil cancer and going through everything that you described above. What did you decide to do? Proton Therapy or Radiation? I would love to hear from you.
Doc, we use X-rays (MV, megavolts), produced by LINACs. Not gamma rays anymore... but sure, proton beam has a better delivered dose! The problem is the cost...
So today we took my sister in law to the Miami Cancer Center and there is a Proton Unit, so was diagnosed ca of pancreas...besides which I am giving her to make Graviola shakes (soursop) and and antioxidant from 4Life..Rio Vida...Emergen C; and plant protein for shakes...We have hope...
Just wanted to let you know that its not doctors, but radiation therapists that operate the linac and administer the radiation. The doctors, medical physicists and radiation therapists do however work together to make the best "recipe".
Proton therapy sounds great and all - but you have to consider safety as well. A proton beam get boosted to a certain energy level. As it passes through the skin, the brag peak is occurs at a certain dept in the patient. If that dept changes or the tissue in that path varies too much - then the brag preak will put its energy down elsewhere. It might miss the target. And thats far worse than spreading out low doses to surrounding tissue. A photon beam can also get its energy boosted or lowered to change how fast it loses its energy in tissue, but it will still go all the way through a patient, losing most of its energy. Current techniques allow heavy metal slides in the head of the device to block off parts of the beam and give it really odd shapes. These shapes have been computer calculated, to lay down dose where it should go - and block as much as possible where it should not go. Protons are heavier and require different techniques of shielding and shaping. You could say, current techniques make photons more agile, and treatment options more varied. Additionally, not all treatments are the same. Take a child with a tumor in the spinal canal. You would say, lets hit that tumor with protons and spare the rest of the healthy tissue. But this is bad medical advice (I am a radiotherapy technologist - people think we are the nurse - but i make these treatment plans in software for the machines). If you hit part of a vertebra with a dose, then later in life, the child will grow lopsided. And so, you must spread out the dose over the entire vertebra evenly, so the reduced growth is even and the patient ends up only a bit shorter in adult life - rather than tilted to the side. These quirks in treatment may mean that the benefit of proton therapy actually works against it, and photon therapy has the benefit still about 50% of the time in most child cases.
@@dwayneholmes8498 Kinda... If you are talking about the american flavor of what a Dosimetrist is, then definitely not. The proper term is a Radiotherapy Technologist. We get broadly schooled for working on the departments: radiology, radiotherapy, nuclear medicine and have basic skills for taking ultrasounds. Basically we do all medical image by request of the doctors. Graduates typically choose one of the 3 departments of their liking. Within radiotherapy a graduate has a strong basic level of understanding of treatment planning - thats what a dosimetrist does. Close enough to it. To work on plans still requires about half a year of on the job training to reach a productive and high quality level required. However, unlike a Dosimetrist, we worry less about the physics background. There are Medical Physicists on the departments that have better insight in how the physics impacts patient safety and treatment success. When we are presented by an edge case, they make the decisions. There are also Radiation Engineers, which do the QA to keep the machines within spec and also QA on the software plans. We need to make sure our treatment plans stay within the limits they set, so we can say with accuracy that what we plan in software, is also what will happen on the treatment table. And much more than a Dosimetrist, we Rad. Technologists do all the work with the patient. The radiotherapist does the consultation based on medical imaging and patient wish - gives us a radiation prescription - and we prep, treatment planning, position and treat the patient. The doctor only sees the patient maybe once a week or if the patient has further questions. Its hard to explain - hope it gives an idea :)
Sorry, that was actually me asking if you are a Dosimetrist (didn't realize I was on my husband's RUclips account) I am a radiation therapist but I am also currently a Dosimetry student doing my clinical rotation for live treatment planning. Where I am, radiation therapy and dosimetry are two very distinct professions requiring different educational programs and licensing. Radiology is even further separated from either of these two. It sounds like where you are from, those fields are more intermingled?
Depends on beam energy and field size, but it would be over 50% beam intensity for even a deep brain tumor. Also the dose can be spread out in three dimensions by using noncoplanar fields creating a very sharp dose fall off outside the treatment region for photons as well.
It depends on how deep the tumor is. The deeper it is, the less % goes into the tumor, even with proton therapy. slideplayer.com/slide/9374651/ This is why the gains from proton therapy are so more visible in cancers near the skin like eye cancer and spine cancer.
zodiacfml The depth of the Bragg peak depends on the proton energy. The protons are accelerated to the same energy, then that ous decayed to the treatment energy by passing through a material in the beam. This way the treatment energy can be defined so the protons stop at the correct depth.
You need a model of the brain (in the case of brain cancer) of the patient. A model that shows the density of matter inside. And then a whole bunch of maths to compute the energy required to hit the target. I have seen those models. I don't know how they make them but I guess they used IRM or something like that (I'm no doctor either). The energy going out of the nozzle is of course monitored.
Philippe Nachtergal Great answer. I was treated for prostate cancer using proton therapy and the doctors inserts 2 gold seeds into your prostate. After that they take MRI pictures and physics to determine the depth for the braggs peak.
@@Biga101011 That's true if a cyclotron is the accelerator (which most proton therapy systems use). Some use synchrotrons, where you can simply dial up the energy you want, no degrader needed.
If I were President - and God knows I would have to be an improvement - Dr. Lincoln would be in my cabinet, maybe Secretary of Explaining Complicated Stuff.
Doping1234 Primarily DNA double strand breaks. Single strand damage can be repaired by reading the other side. This is not specifically through direct interaction of the incident radiation with DNA though. The incident radiation will create secondary electrons or harmful particles that interact with the DNA.
Something weird is happening. Any motion (e.g., Dr. Lincoln's hands) seems to be exhibiting some kind of tearing. Anyone else observing this? EDIT: I'm watching the video in 1080p.
The diagnostician makes use of the fruits borne of a physicists' labours. I'm altogether reliant day-to-day, upon the imaging techniques unlocked by the natural philosophers.
tardisrepairservice Neatrons have no charge, so there would be no Bragg peak. They do however transfer their energy at a high rate (high LET, linear energy transfer) so they have a greater biological effect for the the same absorbed dose than photons or protons.
I read somewhere about inserting gold nano-particles into a tumor and hitting it with radio waves. Somehow it cooks the tumor. Do you have you any idea how that would work?
put aluminium into a microwave and you'll see exactly how it works... Only reason why gold nano-particles are used is because gold is non-toxic, but in principle any conductor works.
I wonder if the criteria nowadays doctors use when they choose the best option for treating tumours is medical, physical or economic : ( I mean, it seems to me this is far less harming to healthy tissue than gamma ray therapy... but, which hospitals can afford such an expensive machine? Which countries have at least one of these beasts? Interesting video, as always!
What happens then to the protons? Wouldn't they just build up in the patient body and cause damages? Because photons can just disappear but not protons. I guess one could fire electrons to cancel their charge but they would turn into hydrogen atoms which would be chemically super reactive wouldn't they? I mean I'm sure it shouldn't be that bad (or at least less bad than cancer itself) but I wonder how bad it is anyway.
Radiation therapy was used to save my brother's life from a rare eye cancer by the brilliant folks at MGH. Thanks to everyone involved in developing revolutionary medicine to make our lives better :)
Yeah. Eye cancer is one of the best applications of proton therapy. There is even a chance of saving the eye which you can never hope for with X rays. I hope your brother did manage to keep his.
What was the cancer? We're in Houston with my son for treatment for adenoid cystic carcinoma behind his eye
What is worms
Any updates on any of these cases?
Thank you, Dr. Lincoln, that was a great explanation. I just started proton radiation therapy at the Chicago Center shown in the video and I marvel at the technology. During each session I think about all the incredibly intelligent people that led up to the machine I'm in that's killing the cancer that's trying to kill me. I'm humbled and deeply appreciative of their life's work, both Doctors and Useful Doctors, alike! Thank you for saving my life.
Dear Dr Lincoln, Thanks for you practical info..... I will refer my patients to your video...very clear and concise. We use the proton beam a lot in our area to treat prostate cancer. Aunt Margaret was wrong; you are the "smarter" type of doctor. : )
This year, a friend of mine needed radiation therapy for the most malignant brain tumor known. He's doing fine for now, thanks to professional medics, AND scientists who paved the way. To say you're not a useful doctor is a grave underestimation. These bits of knowledge you present us with are very nutritious to the brain.
I had 33 straight days of proton radiation therapy, that has got to be the coolest thing I have ever seen or experienced. The side effects were zero.
I love how you take complex knowledge and translate it into simple layman terms! Thanks!
Of course you are a real doctor ;) the best one!
Quite correct Peter. He has a Ph.D in physics while a physician has an MD degree after completing 4 years of medical school after 4 years of college. They then go through 3 to 7 years of residency in a hospital, with the length of residency depends on what specialty. For example, a neurosurgery residency last 6 to 7 years to complete.
You make youtube a better place, Dr. Don. Keep them coming.
Great way to explain proton therapy. I'm currently in treatment using this type of therapy
You explained this way better than I was told!
How was it
Excelente, me encanta el canal y cada uno de los vídeos que hacen. Solo un detalle, en el minuto 2:30, la máquina que sale ahí no es una fuente de radiación gamma, es un acelerador lineal que produce haces de rayos X de alta energía (MV), que también son utilizados en Radioterapia, incluso, hoy en día, se utilizan más que la radiación gamma. Cabe destacar que los aceleradores lineales también puede generar haces de electrones usados para tratamientos de lesiones más superficiales. ¡Saludos desde México!
Dr. Lincoln, would you consider making a video on the interpretation of amplitude in the context of a lightwave? Specifically, how would one think about the amplitude of a single photon? Would this even make sense? This question doesn't seem to have an easy answer, but I feel like it would be perfectly suited to this video series! Thank you very much!
This is an excellent video. I am due to start volunteering at a Proton Beam Therapy hospital in London in November this year. Excellent background information for me. Thank you.
I love him inspecting the cooling lines on the magnet when he was in the vault with the cyclo like it was something very interesting.
My 15 y old son got 5 weeks of treatment and his tumor is GONE. Proton therapy is my new best friend. Much better use of atoms than proton bombs.
Any update? i wish for a miracle.
Will definitely ask my doctor for this procedure.
as a medical physicist working in the radiation oncology field for quite few years I both really like the explanation of in the video and hate it at the same time because it's a very nice explanation of the physics and theory behind both technologies but wen you get to the practical aspect of things proton therapy does not have that much pluses compared to conventional photon or gamma ray therapy.... protons are much more expensive much more dangerous need much higher level of competence of the staff and are much more harder to work with with the higher energies (20 to 40 times the energy of normal radiotherapy) you have a not more other effects that are still not well studied how they affect the patient long term, yeas they spare 20-30% more the healthy tissues compared to standard radiotherapy but coverage of the tumor is not that much better if at all better and it has limitations because it has problems with high density structures at the end of the day both technologies are good and work and are much less destructive to normal tissues than few years back one is good for certain things the other is good for other things and we as specialists need to choose the right one for the specific patient go give him the best chance of survival with minimum side effects not to choose based on what's modern and cool or what we get more money from...... both technologies have their place and are better than the other one in specific cases
5:29 Is it really a coincidence that Robert R. Wilson looks like he could be Don Lincoln's grandfather?
Love your humor and explanation! Thank you!
Thank you for this video! My cousin is having a brain tumor treated by this method and I wanted to know how it differed from traditional gamma radiation.
How is your cousin doing now? Hope the best for yall.
They used gamma rays back in the days when they used Cobalt sources, but these days conventional radiotherapy are high energetic x rays produced by a linear accelerator
Also the photons that past through the person have a build up effect so the first 2 centimeters of the surface aren't getting the full dose
Thank you. That's what I was thinking. Full dose at Dmax ranges from .5 to several cm under the surface.
Thank you so much for a simple explanation of the different treatments. I was just diagnosed with tonsil cancer so I want to see if Proton Therapy will work for me. I understand there are less side effects. As you suggested, I will ask my doctor. Unfortunately, we do not have a Proton Therapy facility in my area but I'm willing to travel.
Very interesting video. However, I would have found it interesting to hear why the Bragg effect happens, in qualitative terms of course.
Dr Don, great video on proton RT. Your aunt M seems to be missing the point since you are 'the bomb'. Maybe got her FOR's all confused in your relativity videos. Haha. But really I wish I had a communicator of your quality when I struggled through my BSc many years ago. Physics becomes much easier if a concept is well delivered before the math sets in. Thanks for sharing your phenomenal talent with world. Bob
So, maybe you're not a real doctor. But you did something no real doctor has done for me. I've heard those radio and tv ads for a while and I never bothered to investigate the physics. I had a feeling it was real, but I never knew for sure if it wasn't just another one of those pseudo-science topics. Now I know it's real.
On the other hand, the guy over in the Recommended column to the right, claiming to have a cure for stage 4 cancer using baking soda? You shouldn't listen to him. He's not even a PhD, let alone and MD.
The way SRT/SRS is similar to this, with the area the beams cross being the area that get the most radiation. Great video by the way. Liked.
Please, do more of this videos. I mean, medical physics videos!
Thank you for continuing to upload educational videos.
A very interesting and informative video Dr. Lincoln. I would to know if the interesting tee/sweat can be purchased from Fermilab and if so, how does one order them. Thank you for your time.
I wonder if using neutrons would work as well. Great presentation.
neutrons work a little bit differently, because they are not charged, but radioactive. If you accelerate neutrons at the right speed and from right distance, you can time it so that most of the neutrons decay when inside the tumour, and very little of them before and after the tumour.
Thank you for the video it was a very great simplistic yeah detailed overview. I have been told I need a biopsy of the prostate. So I’ve been looking up information online
I am a survivor....gamma saved me. 26yrs now. Proton therapy is promising. Focused gamma camera multiple beam awesome idea. שלום
How old are you?
Very clear. Now I have to be educated on the Bragg Effect. Thank you.
clear information abt proton therapy....thnku
Very cool, very informative. More please! Thanks!!
The 11 down votes must be Aunt Margaret.
Great video! Thank you! Very informative 🙏
Thank you so much Dr. Extremely informative.
A different kind of work here for sure but as usual great. Keep them coming. Also, how about a video on identical particles. How can fields be so perfect to produce electrons identical including their charges. Something perfect producing perfect particles. That seems more unlikely than than being at the mercy of straying too much or little of the cosmological constant.
The device you show for conventinoal radiation therapy is an accelerator. It accelerates electrons via a linac and either uses them directly with the specific energy achived with an electromagnet filter or it slams them into a gold or tungsten target releasing high energy xrays in the 6 to 20 Mev range. I do not think those are high energy enough to be called gamma.
A wonderful presentation, and I have an Aunt Margaret too.
Thanks, Professor.
Thank you Don! You're the best!!!
Just out of curjousity, is there such a thing as neutron therapy?
@Mekratrig The first reply didn't say much except implying that it might be on the Fermilab site. Yes, it is. I am not an MD but worked in labs of all sorts during my working like. If a tumor has a high Oxygen content then conventional EM radiation will have a chance of killing the tumor by producing ions from the Oxygen. But some tumors are low in oxygen and therefore have a chance of recovering from EM radiation. Neutron therapy doesn't require Oxygen because a Neutron has no charge but attacks the nucleus of cancer cells. That's just a basic outline but I hope it helps.
Dr. Wilson is my hero. He is the BEST kind of doctor. One that knows, loves, and celebrates the secrets of physics and is excited to tell us in layman’s terms all about it. You will know a wise man because he will be the first to admit the limits of his expertise. Unlike crackpots that will give you unlimited “answers” until pseudoscience exhausts them.
I meant Dr. Lincoln. I’m stupid.
Really like your videos!! Nice job Doctor!!
Can the “Bragg” area be tuned? Do you know the percentage of energy delivered to the target area vs the entry beam?
Excellent video. My wife is about to undergo this therapy and I want to know as much as I can. Thank you.
Yep, you can tune the area where the bragg peak (where the protons stop and relay the most energy) by adjusting the kinetic energy, essentially speed, of the protons, which is fairly easy. Not so sure about the energy delivered, I'd say about 20% (tissue) to 80% (tumor), but I might be wrong and you might wanna check wikipedia on that... Hope your wife gets better!
Sir actually because of 'Build-up effect' surface tissue will not get maximum dose
Excellent presentation for the general public.
My compliments.
dr o
Why do your videos have horizontal interlacing issues? You using an old camera?
Being both a "useless" physicist and a "real" doctor, I decided to work in proton therapy. I realized that one problem is that we do not know exactly where the Bragg peak occurs in the patient. Have been working on a solution of that problem.
ScienceNinjaDude it is them with the system we developed within the pCT collaboration
Why Bragg peak occur?Please do answer as I will be sitting for MD Radiotherapy final exams within 3 months.
Is this useful for peri toneal cancer .
My friend nedd this , have cancer in maind , where this have form ?
I learned all about this on the tour a few months ago - everyone should go check out the Fermilab accelerator!!!
+ScienceNinjaDude They don't anymore (iirc), but they used to - there is literally an old room off of one of the accelerators where a number of doctors did this for years! It was called the Fermilab Cancer Therapy Facility
How can you prevent the anti-protons in your body from destroying the protons injected for therapy?
Due to ionized electrons having enough energy to ionize other electrons the dosis maximum with gamma rays actually is not at its maximum at the surface. With rising energy, the dosepeak gets shifted deeper into the tissue (we call that Aufbaueffekt in germany, no idea how it's called in english), one of the reasons why radiotherapists use energies at 6-20MeV.
Next video on heavy ion therapy, please. Heidelberg (Germany) for example.
Awesome explanation!
You are THE doctor!
But there was almost no detail on why proton beams are different. How is the fact that they have charge used? Why is there this Bragg bump? How does the beam know to stop just where the tumor is? This is the first time I've been disappointed by one of Dr Lincoln's videos. Follow up video please!
@1:43 Alpha particle doesn't posses electrical charge? But what i had always read is, alpha particles are helium nuclei with +2 charge and a proton has +1 charge.
How much cost to have protons radiation done.
3:52 I was just thinking that that would fix the problem... Not suprised they actually do it, as it sounded too perfect not to be the case.
My daughters skin was burnt black from radiation, her black skin rubbed off when I tried to put the medicated cream on and she was in so much pain she screamed.
Great vid You’re a cool cat.. I’m following.. science and physics interests me so much as well as targeting cancer cells by “marking” them.
Great video Don.
I was Diagnosed with Throat cancer in February 2020 and have been going through a terrible time figuring this all out since. I felt alone, as many cancer Patients do, at first. I didn't want my family to know or for this to hurt them in any way. However, I slowly learned we are ALL INVOLVED. We ALL get hurt. The Psychological impact is huge! Especially for VOICE ACTORS or anyone in the Entertainment industry who has been told cancer is in your throat, tongue, #2 lymph nodes out of #28 removed etc. My goodness, what the he** does one do with this information? None of us are doctors, oncologists, radiologists, 'ENT's', surgeons, robotic surgeons....AND WE LEARNED WE WILL NEED THEM ALL. And we have. Dr. Gernon MD (performed 3 cancer surgeries 2020) , Dr. Arya Amini, Dr. Menzel, Dr. who first brought up 'Proton Therapy' due to my horrific SKIN CANCER PROBLEM since 1989 having had 100+ Basal cell surgeries. 2 Melanoma's. And more BCC where I used UFUDEX, FLOUROOUCIL. Etc. Radiation would do 'Great Harm' to me! Gorlin-Goltz Syndrome per D. Wayne Grody, MD - UCLA. Dr. Donald Morton, MD, UCLA who died himself of Melanoma. Sad. Now we must move quickly on a 'Plan of Action for Proton Therapy Vs Radiation?' and if Chemo is needed? and which hospital? City of Hope, Duarte, CA best option due to 33 miles from home issue.....However, Do they have this Therapy? Other professionals needed - Speech, Nutrition, Rides, ready for emergencies if breathing becomes a problem? Swelling of Tongue LESS than Radiation? Cyst of left nostril causing breathing issues NOW....It gets 'complicated with each new day and new problem/ISSUE' . Thank you, seeing Dr. Gernon, MD 4/20/2020 City of Hope, Duarte, CA CT SCAN #3 - Then plan. This is a scary time. Bless you all. Here we go.....Psalms 46:10
How are you now? I was just diagnosed with tonsil cancer and going through everything that you described above. What did you decide to do? Proton Therapy or Radiation? I would love to hear from you.
Great video. Very helpful.
Doc, we use X-rays (MV, megavolts), produced by LINACs. Not gamma rays anymore...
but sure, proton beam has a better delivered dose! The problem is the cost...
Is IMRT treatment actually Proton therapy OR Photon therapy either X Ray or Gama ?
I picture Deshawn Raw's "but I'm not a rapper" every time Don says "but I'm not a real doctor"
The gamma technique discussed is also known as Gamma Knife radiosurgery.
King Gizzard and the Lizard Wizard agree completely.
Dr Lincoln! what does it say on your Tshirt?
Thanks.
So today we took my sister in law to the Miami Cancer Center and there is a Proton Unit, so was diagnosed ca of pancreas...besides which I am giving her to make Graviola shakes (soursop) and and antioxidant from 4Life..Rio Vida...Emergen C; and plant protein for shakes...We have hope...
Just wanted to let you know that its not doctors, but radiation therapists that operate the linac and administer the radiation. The doctors, medical physicists and radiation therapists do however work together to make the best "recipe".
I know how youtube therapy works, and a healthy dose of Fermilab videos prescribed by Dr. Lincoln is the medicine for science!
I hear advertisements from Loma Linda on the radio, when I tune to 1070 here in Los Angeles for the traffic reports.
Proton therapy sounds great and all - but you have to consider safety as well.
A proton beam get boosted to a certain energy level. As it passes through the skin, the brag peak is occurs at a certain dept in the patient. If that dept changes or the tissue in that path varies too much - then the brag preak will put its energy down elsewhere. It might miss the target. And thats far worse than spreading out low doses to surrounding tissue.
A photon beam can also get its energy boosted or lowered to change how fast it loses its energy in tissue, but it will still go all the way through a patient, losing most of its energy. Current techniques allow heavy metal slides in the head of the device to block off parts of the beam and give it really odd shapes. These shapes have been computer calculated, to lay down dose where it should go - and block as much as possible where it should not go. Protons are heavier and require different techniques of shielding and shaping. You could say, current techniques make photons more agile, and treatment options more varied.
Additionally, not all treatments are the same. Take a child with a tumor in the spinal canal. You would say, lets hit that tumor with protons and spare the rest of the healthy tissue. But this is bad medical advice (I am a radiotherapy technologist - people think we are the nurse - but i make these treatment plans in software for the machines). If you hit part of a vertebra with a dose, then later in life, the child will grow lopsided. And so, you must spread out the dose over the entire vertebra evenly, so the reduced growth is even and the patient ends up only a bit shorter in adult life - rather than tilted to the side.
These quirks in treatment may mean that the benefit of proton therapy actually works against it, and photon therapy has the benefit still about 50% of the time in most child cases.
So you are a Dosimetrist?
@@dwayneholmes8498 Kinda... If you are talking about the american flavor of what a Dosimetrist is, then definitely not.
The proper term is a Radiotherapy Technologist. We get broadly schooled for working on the departments: radiology, radiotherapy, nuclear medicine and have basic skills for taking ultrasounds. Basically we do all medical image by request of the doctors. Graduates typically choose one of the 3 departments of their liking.
Within radiotherapy a graduate has a strong basic level of understanding of treatment planning - thats what a dosimetrist does. Close enough to it. To work on plans still requires about half a year of on the job training to reach a productive and high quality level required.
However, unlike a Dosimetrist, we worry less about the physics background. There are Medical Physicists on the departments that have better insight in how the physics impacts patient safety and treatment success. When we are presented by an edge case, they make the decisions.
There are also Radiation Engineers, which do the QA to keep the machines within spec and also QA on the software plans. We need to make sure our treatment plans stay within the limits they set, so we can say with accuracy that what we plan in software, is also what will happen on the treatment table.
And much more than a Dosimetrist, we Rad. Technologists do all the work with the patient. The radiotherapist does the consultation based on medical imaging and patient wish - gives us a radiation prescription - and we prep, treatment planning, position and treat the patient. The doctor only sees the patient maybe once a week or if the patient has further questions.
Its hard to explain - hope it gives an idea :)
Sorry, that was actually me asking if you are a Dosimetrist (didn't realize I was on my husband's RUclips account) I am a radiation therapist but I am also currently a Dosimetry student doing my clinical rotation for live treatment planning. Where I am, radiation therapy and dosimetry are two very distinct professions requiring different educational programs and licensing. Radiology is even further separated from either of these two. It sounds like where you are from, those fields are more intermingled?
Doc you show a graphic with absorption in shades of blue. What % of the total beam strength/whatever are we talking here? 50%, 10%, 0.00000001%?
Depends on beam energy and field size, but it would be over 50% beam intensity for even a deep brain tumor. Also the dose can be spread out in three dimensions by using noncoplanar fields creating a very sharp dose fall off outside the treatment region for photons as well.
It depends on how deep the tumor is. The deeper it is, the less % goes into the tumor, even with proton therapy.
slideplayer.com/slide/9374651/
This is why the gains from proton therapy are so more visible in cancers near the skin like eye cancer and spine cancer.
Thank you Dr.
You’re da bomb Doc.
I LOVE THIS MAN!!
How does it determine that the tumor is the Bragg Peak?
zodiacfml The depth of the Bragg peak depends on the proton energy. The protons are accelerated to the same energy, then that ous decayed to the treatment energy by passing through a material in the beam. This way the treatment energy can be defined so the protons stop at the correct depth.
You need a model of the brain (in the case of brain cancer) of the patient. A model that shows the density of matter inside. And then a whole bunch of maths to compute the energy required to hit the target. I have seen those models. I don't know how they make them but I guess they used IRM or something like that (I'm no doctor either).
The energy going out of the nozzle is of course monitored.
Philippe Nachtergal Great answer. I was treated for prostate cancer using proton therapy and the doctors inserts 2 gold seeds into your prostate. After that they take MRI pictures and physics to determine the depth for the braggs peak.
@@Biga101011 That's true if a cyclotron is the accelerator (which most proton therapy systems use). Some use synchrotrons, where you can simply dial up the energy you want, no degrader needed.
If I were President - and God knows I would have to be an improvement - Dr. Lincoln would be in my cabinet, maybe Secretary of Explaining Complicated Stuff.
Excellently presented for a "non-Doctor!!" LOL Best of luck and thanks for sharing.
What's the mechanism of the therapy? Is it purely DNA damage or also rupturing cell/organelle membranes ect
Doping1234 Primarily DNA double strand breaks. Single strand damage can be repaired by reading the other side. This is not specifically through direct interaction of the incident radiation with DNA though. The incident radiation will create secondary electrons or harmful particles that interact with the DNA.
Something weird is happening. Any motion (e.g., Dr. Lincoln's hands) seems to be exhibiting some kind of tearing. Anyone else observing this?
EDIT: I'm watching the video in 1080p.
Don't be too harsh on yourself, Doc. Without "not so useful" doctors, "useful" doctors couldn't be as "useful" by a long shot ;)
Thank you
Thank You Heisenberg for making this man blurry when he moves
The diagnostician makes use of the fruits borne of a physicists' labours. I'm altogether reliant day-to-day, upon the imaging techniques unlocked by the natural philosophers.
Why don't we use some smart Interference patterns to localize the Gamma Radiation?q
Would neutron therapy have the same impact?
tardisrepairservice Neatrons have no charge, so there would be no Bragg peak. They do however transfer their energy at a high rate (high LET, linear energy transfer) so they have a greater biological effect for the the same absorbed dose than photons or protons.
I read somewhere about inserting gold nano-particles into a tumor and hitting it with radio waves. Somehow it cooks the tumor. Do you have you any idea how that would work?
put aluminium into a microwave and you'll see exactly how it works... Only reason why gold nano-particles are used is because gold is non-toxic, but in principle any conductor works.
the video is a bomb! very entertaining and helpful! thanks
I wonder if the criteria nowadays doctors use when they choose the best option for treating tumours is medical, physical or economic : (
I mean, it seems to me this is far less harming to healthy tissue than gamma ray therapy... but, which hospitals can afford such an expensive machine? Which countries have at least one of these beasts?
Interesting video, as always!
None in Canada!
Could you fine people at Fermilab do a show on LFTR, Liquid Flouride Thorium Reactors, better known as MSR's Molten Salt Reactors.
You say Gamma rays are X-rays' "Bigger" brother, but in fact is smaller... it has a shorter wave length..
Sure :) my point was only to point out the mistake of saying "bigger" brother... as a joke..
What happens then to the protons? Wouldn't they just build up in the patient body and cause damages? Because photons can just disappear but not protons. I guess one could fire electrons to cancel their charge but they would turn into hydrogen atoms which would be chemically super reactive wouldn't they? I mean I'm sure it shouldn't be that bad (or at least less bad than cancer itself) but I wonder how bad it is anyway.
Thanks