Hampton University developing proton-beam cancer treatment center

Hampton University developing proton-beam cancer treatment center
By TAMMIE SMITH
Published: February 28, 2009

In the war on cancer, protons may be about to take center stage as universities across the country invest millions in cancer-treatment centers based on these tumor-zapping radiation particles.

Hampton University is one of a handful of institutions nationally developing proton-therapy treatment centers. Hampton's investment is $175 million for a stand-alone facility on land donated by the city of Hampton.

"This is something I thought would be good to bring to Virginia after I became aware of some of the statistics," said Hampton University President William R. Harvey, adding that prostate-cancer deaths in Hampton Roads are higher than in other regions.

"Right now the closest one is Jacksonville [Florida] to the south and in Boston to the north."

The Hampton University Proton Therapy Institute will have five treatment rooms and designated space for research.

Proton-beam therapy, because it deposits cancer-killing radiation into tumors more precisely, is used frequently to treat cancers where spillover radiation can have bad side effects. In prostate cancer, for instance, radiation can damage tissues and nerves and leave men impotent and incontinent.

"When you think of radiation therapy in hospitals, in our community and so on, it's photons," said physicist Cynthia Keppel, scientific and technical director of the Hampton project.

"Photons and protons are different particles. . . . The way photons react, they deposit most of their energy right when they enter -- so in a patient, that is just below the skin -- and continue to deposit energy all the way through," Keppel said.

Protons, by contrast, don't deposit any energy until they get to their target and release it all in one burst.

In 2005, when Hampton University initiated efforts to build a proton-treatment center, there were three such centers in the United States. One was in California, at Loma Linda University Medical Center's Proton Treatment and Research Center, which in 1990 became the first hospital-based proton treatment center to treat a patient. The others were in Boston and Bloomington, Ind.

Treatment centers in Jacksonville and Houston came on line later.

"There is no question there is a huge demand out there for proton therapy among patients, particularly prostate-cancer patients," said Leonard Arzt, executive director of the National Association for Proton Therapy, a nonprofit agency financed by member agencies.

Along with Hampton, centers are being developed in Oklahoma City, in Pennsylvania and in northern Illinois.

"There is a lot of interest out there, but in these economic times, things have slowed down," Arzt said. "Hampton got started early on and has funding, so I think they are in good shape. Some of the others -- at least two -- are on hold."

For some, such delays are welcome. There is concern that there's no strong medical evidence that proton therapy is better than traditional radiation therapy, particularly intensity-modulated radiation therapy, which also offers more precise tumor targeting. Some experts want randomized clinical trials that compare treatments.

Peter Moon, who runs a prostate-cancer support group in the Richmond area, said proton therapy has produced mixed results for the men he knows.

"One seemed to do fine and was very positive about his experience. The second was experiencing bleeding from his bowel about a year later, most likely from radiation damage," said Moon, who works at Virginia Commonwealth University.

"The third man was a patient of an excellent Virginia prostate-cancer oncologist who was treated by proton beam and died from complications from bowel infection produced by radiation damage. . . . With this experience and what I have read, I have misgivings about this mode of treatment, which is widely touted as being less damaging -- fewer side effects -- for the patient."

There also are worries about rising health-care costs, because proton-therapy treatment is expensive. In addition, efforts to create smaller, more efficient proton-treatment configurations may make $100 million-plus investments necessary.

Hampton this month received delivery of a 230-metric-ton cyclotron -- a cylinder containing a giant magnet used to accelerate particles to high speeds to create proton-beam radiation.

Harvey said the project will create about 125 jobs. He also is talking with other research institutions about collaborations.

Hampton, which is financing most of the project, has received some grants and has sought state and federal funds.

"We have had a tough time getting Virginia lawmakers to see the efficiency of what we are doing." said Harvey, who added that the project is "shovel ready" and so might qualify for federal economic-stimulus funds.