The Proton Treatment Center
Thursday, August 01, 1996
June, 1996, was a red-letter month at the Loma Linda University Proton Treatment Center. During that month, the Center treated its 2,000th patient with proton therapy. The patient—a retired race car designer and developer from San Bernardino—underwent proton treatment for prostate cancer.
The 2,000 patients treated from October, 1990, when the Center opened, to June, 1996, came from all over California, across the nation, and around the world. Through March, 1996 (the latest date for which these statistics are available), 25 percent of the Proton Treatment Center’s patients traveled to Loma Linda from 41 states and the District of Columbia. Patients also came from 18 other countries.
People from all walks of life have been treated. One patient was a Nobel Prize winning scientist with prostate cancer, who, after carefully checking out various types of treatment, traveled from his home in France to Loma Linda to be treated with proton therapy. It was the benefits of proton treatment that attracted him and the other patients.
James M. Slater, MD, FACR, chair, radiation sciences, School of Medicine, and director of the Proton Treatment Center, explains some of the advantages of proton treatment: "The proton beam is a form of radiation, and it has precisely the same effect on the cancer cell as conventional x-ray or cobalt radiation. The difference is that the proton beam can be focused much more precisely than either x-rays or cobalt gamma rays, because it can be focused in three dimensions. Therefore, proton treatment introduces greater selectivity in destroying cancer cells and reduces damage to surrounding healthy tissue."
The side effects of proton therapy, though identical to those of conventional x-ray, are greatly diminished, because the proton beam is so wellfocused that damage to normal tissues is reduced. It is the normal-tissue damage that causes side effects, Dr. Slater points out.
Because proton treatment is receiving scrutiny by the medical community worldwide, the Proton Treatment Center has had many short-term visits of one or two weeks from physicians and scientists from various sites in this country and abroad.
"In addition," Dr. Slater says, "each year we have an opening for someone to come as a visiting professor for one year of training in proton therapy."
This program, however, has not been a one-way street. Dr. Slater states that Loma Linda has benefited from the knowledge and experience of these visiting professors.
The first, in 1989, was Reinhard W. M. Schulte, MD, PhD, a resident in radiation oncology at Hannover University Medical School in Germany. Dr. Schulte has decided to remain in the United States to continue research at the Proton Treatment Center, where he is developing techniques for treating small lesions of the brain.
Cai Wei-Ming, MD, came as a visiting professor from Beijing, People’s Republic of China. He is an associate professor in the department of radiation oncology in the Cancer Institute of the Chinese Academy of Medical Sciences and a member of the Chinese Cancer Research Foundation. Dr. Cai was interested in studying proton-beam irradiation as an alternative to conventional irradiation for head and neck cancers. He has done long-term research on radiation and laser treatment of cancers of the head and neck and the integration of traditional Chinese herbal medicine with these treatments. While at Loma Linda University, he shared his
research with Loma Linda scientists.
Another visiting professor from China was Li Gaofeng, MD, an attending physician in the department of radiation oncology at Beijing Hospital. He was interested in the precise treatment that can be given with proton therapy and in the decision-making process used to determine the dosage each patient should receive. When Dr. Li returned to Beijing Hospital, he was made assistant director of the radiation oncology department.
Stanislav M. Vatnitsky, PhD, came as a visiting professor from St. Petersburg, Russia. There, he was chief of the Central Research Scientific Institute of Radiology and Roentgenology dosimetry laboratory. He plans to remain in the United States to continue research at Loma Linda. "Dr. Vatnitsky is developing the most precise technique for calibrating proton beams," explains Dr. Slater. "His work has been established now as the world standard for this procedure."
Because of the growing interest in proton therapy, Dr. Slater and a number of his colleagues are in demand as speakers around the world. They have given lectures in many places in the U.S. and in at least 14 other countries. Dr. Slater has been invited to present his work at the United Nations Atomic Energy Commission on three occasions in Japan and Vienna, to NATO (North Atlantic Treaty Organization) at its annual meeting in Sicily, and at NASA (National Aeronautics and Space Administration) meetings in the United States and Europe. He and his colleagues also have had numerous articles on proton therapy published in scientific journals in this country and abroad.
Additionally, they have developed technology for computer-assisted radiation treatment planning, which has proven to be a major breakthrough for radiation oncology. After being presented internationally, it was rapidly accepted and produced by all major manufacturers of radiation equipment worldwide. Dr. Slater says that virtually everyone in the field uses computerassisted treatment planning, and it has had a strong impact on the quality of radiation delivery. He and his group have won honors in the United States and in Europe for the technology.
In the continuous search for advances in medical treatment, the Loma Linda University Proton Treatment Center has alliances with prestigious institutions and organizations in the United States, including NASA.
"Loma Linda is the West Coast radiation biology laboratory for NASA," Dr. Slater says, "with the primary purpose of doing research aimed at making space travelers safe from the effects of radiation."
Scientists at the Proton Treatment Center are also involved in other types of research on an ongoing basis. According to Dr. Slater, the area of research and development currently in progress has four major thrusts.
The first is to develop computer-based technology that will make the facility much more efficient. The aim is to further reduce the cost of proton therapy, which will make it available to more patients.
The second thrust is to develop new technology that will allow Loma Linda’s proton system to treat more types of cancer and, eventually, cancer in all sites of the body. To date, Loma Linda has provided proton treatment for both malignant and nonmalignant tumors mainly in four areas of the body: head, neck, brain, and prostate.
"The third thrust," Dr. Slater explains, "is clinical research, which is accomplished by placing all patients on protocols for analysis. Publications of results will be made to describe the effectiveness of protons in the treatment of many types of benign and malignant tumors.
"The fourth thrust," he says, "is molecular genetics and cancer biology research as it relates to proton and conventional photon and electron radiation."
In its quest for new ways to provide optimum care to its patients, the Loma Linda University Proton Treatment Center plans to stay on the leading edge of radiation treatment.
