PROMISE& PROGRESS THE SIDNEY KIMMEL COMPREHENSIVE CANCER CENTER AT JOHNS HOPKINS Proton Therapy Is Here A New Standard of Care 2020/2021 & Care. P P Collaboration. THE SIDNEY KIMMEL COMPREHENSIVE CANCER CENTER AT Innovation. JOHNS HOPKINS Promise & Progress PROTON THERAPY IS HERE. The new have the most advanced pencil beam, is published by Johns Hopkins National Proton Center at which paints tumors with cancer cell- The Sidney Kimmel Comprehensive Cancer Center Sibley Memorial Hospital is built upon a killing energy layer by layer, staying within at Johns Hopkins long and rich tradition of excellence in the boundaries of the tumor. The Office of Public Affairs Baltimore, Maryland radiation oncology, bringing nearly a beam adjusts to differences throughout a 410-955-1287 half-century of cancer discovery and tumor to provide the right amount of William G. Nelson, M.D., Ph.D. clinical progress to proton therapy. energy to every different area of the tumor. Director One size doesn’t fit all. Every patient, Amy Mone every cancer, is different, so we are Director of Public Affairs ushering in the most advanced tumor Valerie Matthews Mehl monitoring that makes the already safe Editor and Sr. Writer [email protected] and targeted pencil beam patient-specific Megan Mattis and even more tumor-specific. Advanced Photography Assistant imaging and sophisticated data mining Howard Korn, Joe Rubino, Tim Bloomquist will make complex comparisons of Feature Photography photon and proton therapies to ensure For additional copies of this each patient receives the therapy that is publication or further information best suited to his or her unique cancer. about the Kimmel Cancer Center, We have the world’s leading experts please call 410-955-1287 across all disciplines and specialties or email [email protected]. working in collaboration. This includes MSK Partners, Inc. a collaboration with Children’s National Design and Production Hospital to create one of the largest pediatric radiation oncology programs in the country. Few other centers can claim Connecting this level of expertise. We know cancer Promise to Progress It’s striking that this technology has and proton therapy. That is the Johns On the Web been around for more than 40 years but Hopkins difference. There are centers that CONNECT WITH US HOPKINSCANCER.ORG has never really been tested in the can deliver proton therapy, and then there research setting. This is what sets us apart are centers like ours that combine the FACEBOOK.COM/HOPKINSKIMMEL from other centers. We ask the tough highest level of cancer care with YOUTUBE.COM/HOPKINSKIMMEL questions because we are prepared to go scientific innovation to make sure the after the answers. With a dedicated cancer medicine we deliver is the best TWITTER.COM/HOPKINSKIMMEL proton research laboratory, our experts medicine for each patient. Our new INSTAGRAM.COM/HOPKINSKIMMEL are ready to do the hard work and gather National Proton Center enhances our mis- the much-needed evidence to guide when sion of curing cancer and changing lives. PODCASTS: HOPKINSKIMMEL.LIBSYN.COM and how proton therapy is best used. CANCER-MATTERS.BLOGS.HOPKINSMEDICINE.ORG We waited until the technology was OUR-CANCER.BLOGS.HOPKINSMEDICINE.ORG right to bring proton therapy to Johns William G. Nelson, M.D., Ph.D. Hopkins, and when we did, we made Marion I. Knott Professor and Director FOR APPOINTMENTS AND OTHER INFORMATION, CALL 410-955-5222 it better, customizing it with our own The Sidney Kimmel Comprehensive inventions. Our proton therapy center will Cancer Center at Johns Hopkins ©2019 The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins 2 PROMISE & PROGRESS Proton Therapy Is Here Johns Hopkins excellence is setting a new standard of care Technology without advanced and compassionate care is The translational ingenuity that merges science alone. But technology in an environment of compas- laboratory discovery with clinical care thrives in the Kimmel Cancer Center. It sionate care, discovery and multispecialty collaboration was engaged throughout the planning focused on improving the lives of patients is cancer medicine. and construction of our proton center. As This is the hallmark of Johns Hopkins and the Kimmel Cancer a result, it is one of the most comprehen- sive in the world, one of the very few sep- Center, where innovation that exceeds the standard is the arate, dedicated rooms for research, norm. The result is an unsurpassed level of expertise in radiation pediatric patient care and adult patient oncology, molecular radiation sciences, physics, surgical care. Proton therapy has raised many oncology, medical oncology, cancer biology, engineering, questions about for whom and how it is best used. Our experts are answering quantitative sciences and more that Johns Hopkins Medicine those questions. They are providing the brings to proton therapy. This level of knowledge and “why” and “when” of proton therapy. multispecialty collaboration are fundamentally what set the Despite commercial advertising to the contrary, proton therapy is not new, and Johns Hopkins National Proton Center apart from most other the science is far from settled. “Although proton centers across the U.S. Expertise matters because the it has been around for a long time, it is real value of proton therapy is in the specialists who develop very much in its infancy in terms of ex- and use it. ploration and potential,” says Akila Viswanathan, interim director of the Department of Radiation Oncology and Proton therapy may be a rare commodity, cancer discovery and clinical progress to Molecular Radiation Sciences. with less than 40 centers in the U.S., but proton therapy.” this level of expertise is even rarer. The COLLABORATION Kimmel Cancer Center is among the very Although this technology provides new few that will combine cancer treatment opportunity to move cancer science and Proton therapy has excellence across all disciplines with medicine forward, not all proton ther- proton therapy excellence. apy is created equal. We are not simply raised many questions users and deliverers of proton therapy. about for whom and “Patients and families need the team that Our scientists are also inventors, knows the most about the tumor. You driving, testing and improving the how it is best used. need to know cancer, not just proton technology to create a proton facility Our experts are helping therapy. That is a differentiator for us,” unlike any other. Building upon a says William Nelson, Director of the lengthy history and strong foundation answer those questions. Kimmel Cancer Center. “We bring the of pioneering discoveries in radiation They are providing the full complement of Johns Hopkins therapy, this center has the technology expertise, spanning programs and to deliver the most advanced and “why” and “when” of departments, and nearly a half-century of patient-centered care. proton therapy. THE SIDNEY KIMMEL COMPREHENSIVE CANCER CENTER at JOHNS HOPKINS 3 The Synchrotron HOW IT WORKS A synchrotron is a type of particle accelerator used to accelerate protons for Inside Our Proton use in proton therapy. It is 26 feet in diameter and Therapy Center composed of a ring of small magnets. Protons are The proton is small, but it takes big injected into the ring and begin traveling around machinery to generate and move these the ring at great speeds, subatomic particles for treatment. about 10 million times per second. Put another way, the speed of the protons is so fast, it could circle around the earth five times in one second. It is advanced technology over earlier generations of proton therapy because it can produce beams of a Gantries wide range of energies and Protons travel down reduces the risk of unnec- magnetic devices into essary and unwanted the treatment rooms. radiation to the patient. A 360-degree, rotating, 30-foot-diameter iron framework, called a gantry, controls the speed and direction of protons. It allows radiation oncologists to Pencil Beam Scanning direct the beam at any This new technology funnels angle and deliver the the protons into a narrow proton beam with beam—just a pencil tip’s pinpoint accuracy Respiratory Gating to a patient’s cancer. width—coming out of the The slightest motion proton therapy machine can cause tumors hundreds of times per Our center has four of to move. Our proton these, with one gantry second, scanning the tumor therapy beam tracks back and forth and up and dedicated exclusively directly to the tumor, for pediatric patients down, just to the edges of stopping if the tumor the tumor, to paint it layer by and another for much- shifts with the patient’s needed research. layer with the cancer-killing breathing and starting proton beam. Our advanced up again when the technology is intensity mod- beam and tumor are ulated, making it possible aligned. to deliver varying degrees of energy targeted to the specific composition of each area of the tumor. On-Board Imaging Ours will be among the first to have on-board imaging. Plans for a CT Couch, invented by medical physics Director John Wong in collaboration with Hitachi, will provide a built-in CT scanner that merges images of the cancer taken during treatment planning with ones taken the day of treatment to verify that the tumor being treated has not changed or moved. It facilitates precision treatment within one-tenth of 1 millimeter accuracy. 4 PROMISE & PROGRESS As a result, what truly is new in proton problem, Wong invented the Small Ani- and where can we reduce toxicity? therapy is what the Johns Hopkins mal Radiation Research Platform Where are we not getting such benefit National Proton Center brings: the labo- (SARRP), a miniaturized version of the and can let go? This is an area that is ratory and clinical research to make it machines used to treat humans that is for lacking, and our center can begin to get better and to advance its use as a tool of animal research and potentially other to the answers.” The Johns Hopkins precision medicine.