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Proton Pioneers: Celebrating 10 Years of the Roberts Proton Therapy Center

By James M. Metz, MD,

In January of 2020 we passed a ten-year milestone anniversary of the Roberts Proton Therapy Center at the Abramson Cancer Center. At that time, I was reflecting on all the accomplishments at the center. When it opened on January 25, 2010, it was the largest and most advanced proton center in the world. In 2020, it continues to be both. 

Then, as we planned to celebrate the anniversary, everything changed. As we have all learned rather quickly, “the best laid plans of mice and men oft go astray…” I was looking forward to seeing each and every one of our alumni patients and their guests at our annual alumni reception on April 16. Big plans were underway to include a red carpet debut of our anniversary video, great food and drink, and the opportunity to showcase all of the amazing work the Department of Radiation Oncology has done to get to this point. Friday, March 13, was the last day that I have seen many of my colleagues in person who are now working remotely as a result of physical distancing protocols that minimize everyone’s risk of COVID-19. As I walk through our doors each day, I am greeted with the smiling eyes of our amazing staff and faculty who remain on site, tirelessly treating cancer patients behind their masks, goggles, and shields. 

Despite all the recent changes, large and small, and even though we aren’t having the party we’d planned, I’m still so proud of the incredible array of accomplishments and firsts this team has achieved over the past ten years, and what those accomplishments continue to mean for our ability to improve the lives of cancer patients every day. With four gantry treatment rooms, a fixed beam room, and a research room with two beam lines, it is the most complex center ever built. It was the first center in the world built with gantry rolling floors, allowing safer access to patients during treatment. Our center has pioneered technology like multileaf collimators to shape the beam and was the first center in the world to place them in every gantry room. We have treated the most patients with pencil beam scanning technology, which has revolutionized the precision with which proton therapy is delivered. The Roberts Proton Therapy Center was the first proton facility in the world to integrate soft tissue imaging with Cone Beam CT, which also allows for more precision in targeting tumors. The list goes on and on; at Penn Medicine, we have become the leading institution in the world for cancer treatment with proton therapy.

From a research perspective, our team has defined the future of proton therapy. This includes technical, clinical, and educational research that has changed the way protons are utilized. We are the leading institution in the world investigating FLASH proton therapy and have published the first research in this area. FLASH radiation is the ability to give an extremely high dose of radiation, typically an entire treatment course that takes weeks, in less than a second, with similar tumor control and reduced toxicity. We have pioneered the use of virtual reality in education for proton therapy. The Roberts Proton Therapy Center is the leading training institution in the world after 10 years of setting new standards. Our clinical research, with multiple clinical trials, has also paved the way for the expansion of proton therapy to multiple types of cancer in our adult and pediatric populations. We have shown that in patients receiving radiation with chemotherapy, those receiving protons have much less significant side effects and hospitalizations.

Now, as we head into the summer and our response to COVID-19 remains ongoing, I have never felt more proud to be the chair of Penn Radiation Oncology. What I have seen unfold on a daily basis both onsite and remotely by our incredibly devoted staff and faculty has confirmed what I have always known. We are a team who is stronger together. We stepped up as a group from the very beginning of this global crisis and forged new paths. Our collective expertise and comfort working as a team to deliver the safest and most effective treatment to our patients has been in place from day one and will continue as we start our resurgence as a health system. We are adhering to every precaution possible to ensure the highest level of safety for all of our patients, staff and faculty. Safety has always been and will continue to be our priority as we offer the highest level of treatment with compassion to all of our patients.

Tables Turned

When I talk about my pride in this team, I’m not just thinking about how things have changed from pre-pandemic to post-pandemic in the clinic and research. I also have a very personal before and after from right around the same time.

When I think back just a few months ago, pre-pandemic, I experienced a completely different vantage point. I was sitting in the waiting room. I sat in the seat in an exam room waiting for a physician. I watched in the hallway as the light flashed “beam on.” I was a caregiver. My father was diagnosed with colorectal cancer in December 2019, and the tables radically turned, as did my perspective. Little did I know, in all the years I worked on bringing this center to reality, that eventually my father was going to benefit from treatment here. As I met my dad each day during his treatment, I saw my work environment and team through new eyes. I felt supported by the compassion and kindness of every person who took care of my dad along the way. I felt a renewed appreciation for the team and their incredible expertise in caring for cancer patients. There was a great amount of pride and confidence I felt knowing that my dad was receiving the best treatment possible. Through the ups and downs, the expertise and support that was provided to my dad and my family was simply exceptional. It gave him the strength to fight through some difficult moments, and I am happy to say that he has completed his treatments and continues to rest at home comfortably. I will never forget how it feels to sit on the other side as a caregiver, watching my loved one go through the fight of his life.

This is a profoundly challenging time for all of us, as there is so much uncertainty and a lot of changing information on a daily basis. It has been a source of great pride to lead a department that is so resilient, collaborative, and innovative. We are a strong team devoted to providing the most advanced and safe care to our patients and support to their caregivers. My awareness about the power of our team was heightened as I became a caregiver and has been repeatedly confirmed through the challenging times that COVID-19 has brought. All of the thanks that I have received from patients and family members over the years about our staff suddenly crystalized through this experience. We really do have an incredible team and I have been blessed to see that from both sides of the fence. I bring that to my daily work. As we celebrate the tenth anniversary of the Roberts Proton Therapy Center, I want to say how incredibly proud I am to be a part of the strongest team and look forward to the new advances we will continue to make together over the next ten years. Stay safe out there.

James M. Metz, MD, is the Henry K. Pancoast Professor and Chair of Radiation Oncology and director of the Roberts Proton Therapy Center at the Abramson Cancer Center.

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