15 Frequently Asked Questions : Proton Therapy in India for Zambian Patients

Q1 · What Is Proton Therapy?

Proton therapy, also called proton beam therapy, is a form of external radiation treatment that uses accelerated protons to deliver radiation to cancer cells.

Unlike conventional photon/X-ray radiation, proton beams have a characteristic dose distribution that can allow the treatment team to concentrate radiation within the tumour while reducing radiation exposure to some surrounding normal tissues.

The objective remains the same as other forms of radiotherapy: to deliver an effective radiation dose to the tumour while minimizing unnecessary radiation to healthy structures.

Proton therapy may be particularly useful when:

• The tumour is close to a critical organ
• The patient is very young
• The tumour requires a high radiation dose
• The patient has previously received radiotherapy
• Long-term preservation of surrounding tissue is particularly important

Q2 · What Is the Cost of Proton Therapy in Zambia Compared with India?

Proton therapy is a specialized treatment and its cost depends on the cancer type, treatment complexity, number of sessions, planning requirements, investigations and additional treatment.

For planning purposes, the comparison below uses:

• US$1 ≈ ZMW 19.5
• US$1 ≈ INR 96

Indicative Cost Comparison

Published Indian sources currently give broad proton-therapy estimates of approximately INR 20–30 lakh at Apollo, while Apollo's dedicated proton-therapy information gives approximately INR 30–50 lakh depending on cancer type and treatment complexity. Another Apollo source gives approximately INR 25–50 lakh. These differences demonstrate why the final cost should be based on an individualized treatment plan.

The Tata Memorial Centre's ACTREC proton facility has also reported subsidized and free treatment for eligible patients through institutional support and patient-welfare mechanisms. International patients should confirm eligibility and applicable charges directly with the treating institution.

Important: The Zambia figures are indicative private-healthcare planning estimates and should not be treated as fixed local hospital quotations. The India figures are also planning estimates.

Q3 · Which Major Indian Cities Can Zambian Patients Consider for Proton Therapy?

For a patient specifically requiring proton therapy, the key treatment locations in India are Chennai and the ACTREC/Kharghar facility in Navi Mumbai. The Tata Memorial Centre facility is located at ACTREC in Kharghar, Navi Mumbai, while Apollo's proton treatment is delivered at its Chennai centre.

Q4 · Which Hospitals in India Can Zambian Patients Consider?

Important: The broader city/hospital list is for cancer evaluation and complementary oncology services. Not every hospital listed provides proton therapy. For actual proton treatment, the patient should be evaluated by a dedicated proton centre. The ACTREC facility in Kharghar and Apollo Proton Cancer Centre in Chennai are the key Indian proton facilities referenced in current sources.

Q5 · What Types of Cancer Can Be Treated With Proton Therapy?

Proton therapy may be considered for selected cancers including:

Brain and Central Nervous System Tumours

• Brain tumours
• Childhood brain tumours
• Skull-base tumours
• Chordoma
• Chondrosarcoma
• Selected spinal tumours

Head and Neck Cancers

• Skull-base cancers
• Nasopharyngeal cancers
• Paranasal sinus cancers
• Selected salivary gland cancers
• Other tumours close to critical structures

Paediatric Cancers

Proton therapy may be particularly valuable in selected children because reducing radiation exposure to developing normal tissues can be important for long-term health and development.

Other Selected Cancers

Depending on the individual treatment plan, proton therapy may also be considered for:

• Liver cancer
• Lung cancer
• Prostate cancer
• Oesophageal cancer
• Breast cancer
• Sarcomas
• Gastrointestinal cancers
• Retroperitoneal tumours
• Recurrent tumours requiring re-irradiation

The evidence and suitability vary by tumour type. Apollo lists several of these cancers among potential proton-therapy indications, while the ACTREC centre emphasizes particular benefit for childhood, brain/spine, skull-base, head-and-neck and bone/soft-tissue tumours.

Q6 · What Is the Difference Between Proton Therapy and Conventional Radiation?

Conventional Photon Radiation

Conventional external-beam radiation uses X-rays or photons. Modern photon techniques such as IMRT, VMAT and IGRT can precisely shape radiation around a tumour.

Proton Therapy

Proton therapy uses accelerated protons and can provide a different radiation-dose distribution, with minimal exit dose beyond the target.

The potential advantage is particularly relevant when the tumour is close to critical structures or when reducing long-term radiation exposure is important.

However, proton therapy is not automatically better for every patient. A carefully designed photon plan may provide excellent treatment for many cancers.

The decision should be based on a comparison of the patient's actual radiation plans and expected dose to the tumour and surrounding organs.

The Tata Memorial Centre notes that the goal of particle therapy is to deliver the required dose to the target while minimizing dose to surrounding normal tissues.

Q7 · Who May Benefit From Proton Therapy?

Patients who may particularly benefit include selected:

• Children
• Patients with brain tumours
• Patients with skull-base tumours
• Patients with spinal tumours
• Patients with tumours close to critical organs
• Patients requiring high radiation doses
• Patients with certain head and neck tumours
• Patients with selected sarcomas
• Patients requiring re-irradiation
• Patients with long expected survival where reducing late radiation exposure is particularly important

For children, reducing radiation exposure to developing organs can be particularly important because late effects may involve growth, cognitive development and organ function.

However, being diagnosed with one of these cancers does not automatically mean proton therapy is the correct treatment.

Q8 · What Medical Reports Should a Zambian Patient Send Before Travelling to India?

A complete medical record is essential for proton-therapy assessment.

The patient should ideally provide:

• Oncologist report
• Radiation-oncology report
• Biopsy report
• Histopathology
• Immunohistochemistry
• Molecular/biomarker reports
• PET-CT report and images
• CT scans and images
• MRI scans and images
• Previous surgery report
• Previous chemotherapy records
• Previous radiotherapy records
• Previous radiation dose
• Previous radiation treatment plan
• Treatment-response scans
• Blood-test reports
• Current medication list
• Previous discharge summaries

For patients who have previously received radiotherapy, the exact previous radiation dose, treatment fields and treatment plan are especially important.

For children, also provide:

• Birth history
• Current age
• Current weight
• Height
• Growth information
• Previous anaesthesia records
• Previous paediatric treatment records

Q9 · What Is the Typical Proton Therapy Treatment Process in India?

Step 1 – Proton Therapy Assessment

A radiation oncologist reviews the diagnosis, pathology, imaging and previous treatment.

Step 2 – Multidisciplinary Review

The case may be discussed by specialists from:

• Radiation oncology
• Medical oncology
• Surgical oncology
• Radiology
• Pathology
• Medical physics
• Paediatric oncology, when applicable

Apollo states that patients undergo detailed evaluation including imaging, biopsy confirmation where required and multidisciplinary review before proton therapy is recommended.

Step 3 – Treatment Comparison

The team may compare a proton plan with a conventional photon plan to determine whether proton therapy offers a meaningful clinical advantage.

Step 4 – Simulation

The patient undergoes CT and/or MRI-based treatment simulation.

An immobilization device or customized positioning system may be created so that the patient can remain in the same position during each treatment.

Step 5 – Proton Treatment Planning

Medical physicists and radiation specialists design and verify the proton treatment plan.

Apollo reports that its planning process generally takes approximately one week after simulation, although timing can vary.

Step 6 – Proton Treatment

Treatment is usually delivered on an outpatient basis.

A typical schedule may involve treatment five days per week, with weekends off, although the number of sessions depends on the cancer and prescribed dose.

Step 7 – Monitoring

The patient is reviewed during treatment to monitor:

• Side effects
• Nutrition
• Weight
• General condition
• Treatment tolerance

Step 8 – Treatment Completion

The patient receives a treatment summary and follow-up plan.

Q10 · Are There Alternatives to Proton Therapy?

Yes. Proton therapy is only one radiation option.

Depending on the cancer, alternatives may include:

• 3D-Conformal Radiotherapy
• IMRT
• IGRT
• VMAT
• SBRT
• SRS/SRT
• Brachytherapy
• Surgery
• Chemotherapy
• Targeted therapy
• Immunotherapy
• Hormone therapy
• Active surveillance for selected cancers

The appropriate treatment should be determined after comparing the potential benefits and risks of each approach.

For many cancers, modern photon-based techniques can provide highly precise radiation treatment. Proton therapy may be considered when its specific dose-distribution characteristics are expected to provide a meaningful advantage.

Q11 · What Should a Zambian Patient Ask for in the Final Proton Therapy Quotation?

Before confirming treatment, request a written quotation specifying:

Proton Treatment

• Proton therapy technique
• Treatment machine
• Treatment planning
• CT simulation
• MRI/PET imaging, if required
• Number of fractions
• Radiation dose
• Daily treatment charges
• Medical physics/dosimetry charges
• Image guidance
• Immobilization devices

Additional Treatment

• Chemotherapy
• Immunotherapy
• Targeted therapy
• Surgery
• Anaesthesia, if required
• Blood tests
• Additional imaging

Hospital and Travel-Related Costs

• Consultation
• Hospital admission, if required
• Room charges
• Medicines
• Follow-up
• Rehabilitation

The patient should ask specifically whether the quotation is a complete treatment package or whether investigations, medicines, chemotherapy, hospital stay and additional procedures are billed separately.

Current Apollo information states that proton-therapy cost depends on cancer type, complexity, number of sessions, investigations, additional treatment and room/stay requirements.

Q12 · How Long Should a Zambian Patient Stay in India?

Proton therapy is generally delivered over several weeks rather than as a single hospital procedure.

Apollo states that patients commonly receive proton therapy approximately five times per week for several weeks, while MedlinePlus describes typical outpatient treatment courses of approximately 4–7 weeks, depending on the cancer.

Very young children may require anaesthesia or specialized immobilization during treatment. ACTREC reports that its proton centre has facilities for anaesthesia during treatment for very young children.

The final stay should be confirmed by the treating proton therapy team.

Q13 · What Is Recovery Like After Proton Therapy?

Proton therapy is generally delivered without surgery, so many patients can continue normal daily activities during treatment, depending on the cancer and side effects.

Possible treatment effects include:

• Fatigue
• Skin redness or irritation
• Headache
• Hair loss in the treated area
• Mouth or throat problems
• Eating or swallowing difficulties
• Treatment-area soreness

The side effects depend largely on the part of the body being treated.

Apollo notes that fatigue, skin redness, hair loss around the treatment area and treatment-specific eating or digestion problems can occur.

For Children

Children may require:

• Nutritional support
• Anaesthesia during treatment when necessary
• Regular growth monitoring
• Developmental follow-up
• Paediatric oncology follow-up

After Treatment

Radiation effects do not necessarily appear immediately. Cancer response may take weeks or months to assess, so follow-up imaging and oncology review are important.

Q14 · What Follow-up Care Is Required After Returning to Zambia?

Before returning home, the patient should collect:

• Final diagnosis
• Pathology report
• Molecular/biomarker reports
• Proton treatment summary
• Total radiation dose
• Number of fractions
• Treatment dates
• Treatment site
• Proton treatment plan summary
• Imaging performed during treatment
• Chemotherapy summary, if applicable
• Medication list
• Latest blood-test results
• Follow-up imaging schedule
• Follow-up oncology appointment schedule

For patients who have previously received radiation, the complete proton and previous radiation records should be retained for future treatment planning.

Follow-up May Include

• Clinical examination
• MRI
• CT
• PET-CT where appropriate
• Blood tests
• Tumour-specific monitoring
• Assessment of late radiation effects

For children, long-term monitoring may additionally include growth, development, endocrine function, vision, hearing or other organ-specific assessments depending on the tumour location and treatment received.

The patient should coordinate continuing care with an oncologist in Zambia.

Q15 · Is India a Suitable Option for Zambian Patients Seeking Proton Therapy?

India can be considered by Zambian patients whose cancer may benefit from proton therapy after specialist assessment.

India currently has dedicated proton treatment facilities, including:

• Apollo Proton Cancer Centre, Chennai
• Tata Memorial Centre – ACTREC National Hadron Beam Therapy Facility, Kharghar, Navi Mumbai

The ACTREC facility uses pencil-beam scanning and intensity-modulated proton therapy and has treated both adult and paediatric patients. A 2025 Government of India report stated that the facility had treated 541 patients during its first two years of service, including 86 paediatric patients, with patients receiving treatment for CNS, bone, head-and-neck and other tumour types.

However, proton therapy is not automatically the appropriate treatment for every cancer patient.

The decision should consider:

• Exact cancer diagnosis
• Stage
• Tumour location
• Tumour size
• Proximity to critical organs
• Patient age
• Previous radiation
• Expected survival
• Potential late effects
• Comparison with modern photon therapy
• Treatment availability
• Total cost
• Expected treatment duration
• Follow-up requirements

For Zambian patients considering proton therapy in India, obtaining a specialist proton- therapy second opinion based on complete pathology and imaging before travelling can help determine whether proton therapy offers a meaningful advantage for the individual patient.