"Dual-Line Offensive": Proton Therapy Simultaneously "Snipes" Dual Cancer Foci in Prostate and Rectum, Significant Tumor Shrinkage in Man in His Sixties

Having just entered his sixties, an age often associated with enjoying time with grandchildren and retirement, Mr. C was suddenly faced with the severe challenge of dual primary malignant tumors: prostate cancer and rectal cancer. When this unexpected storm hit, Mr. C did not hesitate and actively sought medical help. After multiple consultations, he came to Guangzhou Concord Cancer Center (GCCC) seeking proton therapy. Encouragingly, the treatment achieved positive results: his Total Prostate-Specific Antigen (TPSA) level dropped significantly, and the lesions in both the prostate and rectum showed marked reduction.

Guangzhou Concord Cancer Center has 4 proton therapy rooms

Diagnosed with Dual Primary Cancers, Seeking the "Global Optimal Solution"

In April of this year, a routine health check raised an "alarm" for Mr. C: his TPSA level had skyrocketed, exceeding the normal upper limit by more than ten times. Subsequent MRI and biopsy results confirmed a diagnosis of prostate cancer. The tumor had broken through the prostatic capsule and invaded the seminal vesicles, classifying it as high-risk, locally advanced. Fortunately, no distant metastases were found, leaving room for curative intent.

For prostate tumors like Mr. C's that have invaded the seminal vesicles, surgery often struggles to completely remove the lesions, carrying a high risk of post-operative recurrence. The National Comprehensive Cancer Network (NCCN) Guidelines clearly state that for prostate cancer staged T3b and above (where the tumor has invaded the seminal vesicles or beyond), "External beam radiotherapy + long-term androgen deprivation therapy" is one of the highest-level recommendations.

However, due to the prostate's specific anatomical location, adjacent to the bladder, small intestine, and rectum, traditional (photon) radiation therapy can damage surrounding normal tissues, leading to a series of side effects like diarrhea, bloody stools, and hematuria, severely impacting the patient's quality of life. With advancements in medical technology, emerging proton therapy has demonstrated excellent efficacy in treating prostate cancer. Research indicates that proton therapy can reduce radiation dose to nearby organs by up to 80%, minimizing exposure to the bladder, intestines, and surrounding healthy tissues. Furthermore, men receiving proton therapy have a lower risk of side effects such as impotence and urinary incontinence.

In pursuit of proton therapy, Mr. C came to GCCC. During examinations, abnormal thickening of his rectal wall was also discovered. Further colonoscopy and pathology results ultimately confirmed he had a second primary cancer: a rectosigmoid junction tumor.

Faced with this complex situation of dual primary cancers (prostate and rectal) with both lesions located in the pelvis, the Multidisciplinary Team (MDT) at GCCC proposed an integrated treatment strategy: concurrently administer "Radical Radiotherapy for prostate cancer + Neoadjuvant Radiotherapy for rectal cancer" along with chemotherapy. The timing for surgery would be assessed after radiotherapy completion, followed by resection of the rectal tumor. This arrangement aimed to effectively control the progression of the prostate cancer while also creating an opportunity for downstaging the rectal cancer preoperatively and improving the chance of cure.

Proton Therapy Shows Marked Efficacy, Providing Key Technical Support for Balancing Survival and Quality of Life

As the first proton therapy center in Southern China to enter clinical operation, GCCC's Proton Therapy Center strictly adheres to MD Anderson Cancer Center's radiotherapy guidelines and standard procedures, committed to providing patients with individualized, cutting-edge treatment plans. The center is equipped with the globally top-tier Varian ProBeam® proton therapy system and is led by domestic authoritative experts. The team has accumulated experience from thousands of clinical cases in proton therapy.

After evaluation, the proton center team developed a personalized proton treatment plan for Mr. C, totaling 28 sessions. The treatment results were gratifying: TPSA levels dropped significantly, and both the prostate and rectal masses showed obvious shrinkage.

Before Proton Therapy

After Proton Therapy, Prostate Lesion Reduced by Half

Before Proton Therapy

After Proton Therapy, Rectal Lesion Significantly Reduced

"For the diagnosis and treatment of dual primary cancers, the core lies in breaking the limitations of single-cancer thinking, emphasizing an overall strategy rather than simply stacking treatment plans. The biggest challenge is how to balance the treatment priorities, sequence, and side effect risks for both cancers, avoiding conflicts between them. This heavily relies on the Multidisciplinary Team (MDT) to tailor an integrated treatment plan for the patient," summarized Dr. Luo Yingshan from the Radiation Oncology Department at GCCC. "The significance of precise radiotherapy technologies like proton therapy is highlighted here – it can efficiently cover multiple tumor targets while significantly reducing radiation damage to surrounding shared organs at risk, providing crucial technical support for the ideal goal of achieving a potential cure while preserving quality of life."

Screening Recommendations

The key to early detection of prostate cancer lies in two main screening methods: Digital Rectal Examination (DRE) and Prostate-Specific Antigen (PSA) testing. DRE is straightforward, allowing the doctor to feel the prostate's texture and any nodules directly through the rectum. PSA testing is core to early diagnosis. It is important to note that while benign conditions like prostatic hyperplasia or inflammation can cause elevated PSA, men over 50 who detect an abnormal PSA level must seek prompt medical evaluation. The Chinese Guidelines for the Diagnosis and Treatment of Prostate Cancer recommend that men over 50 and those over 45 with a family history should actively undergo PSA screening.

For colorectal cancer, the general population is typically advised to start gastrointestinal endoscopy screening after age 40. Those with a family history or personal bowel symptoms (e.g., bloody stools, changes in bowel habits) should start screening earlier. It is crucial to be particularly vigilant: while bloody stools are a typical symptom of colorectal cancer, they are often mistaken by patients for hemorrhoids. If symptoms like bloody stools occur, seeking early medical attention to identify the cause is essential to avoid delaying treatment.