Major milestones. Community outreach. Inspirational moments.
Those are some of the recurring themes we noticed as we looked back on the highlights of 2019 at Provision CARES Proton Therapy. It was a year marked by plenty of “firsts,” as well as a concerted effort to be an innovative leader in cancer treatment, and a commitment to our mission of making proton therapy more accessible to patients around the world.
Here are some of Provision’s key moments from 2019.
Liver cancer proton therapy can improve the overall survival rate for patients, according to a new study. This good news for proton advocates comes on the heels of another study identifying predictors to help reduce liver damage from radiation, which could give doctors better insight when determining a patient’s treatment plan.
In a news release from the American Society for Radiation Oncology (ASTRO), Laura Dawson, MD, President-elect of ASTRO and a professor of radiation oncology at the Princess Margaret Cancer Center in Toronto, remarked on the promise this shows for patients with hepatocellular carcinoma, an often fatal type of liver cancer. “There is hope for patients with liver cancer, with more treatments becoming available in recent years,” said Dawson. “These studies show that protons, like photons, may be used to treat patients with HCC with a high rate of tumor control and a reduced risk of adverse effects.”
Lung Cancer Awareness Month is dedicated to educating the public about the prevalence of the disease in the United States, and providing resources on prevention, screening and treatment.
According to the American Cancer Society (ACS), lung cancer will kill more than 140,000 people in 2019, making it by far the leading cause of cancer death among both men and women. It is the second most common cancer in both men and women (not counting skin cancer). For men, prostate cancer is the only cancer more common, while in women breast cancer is more common.
WINTER GARDEN, Fla. — Provision CARES Proton Therapy Orlando is under construction in the Hamlin development in Southwest Orange County. The center will offer one of the most promising new cancer therapies available, proton therapy; and will utilize the latest advancement in proton therapy systems, the ProNova SC360 manufactured by ProNova Solutions, LLC located in Maryville, Tennessee.
On Wednesday, November 20, one of the key components of the proton therapy system, the cyclotron, will travel from Cape Canaveral to Hamlin on a flatbed truck along a FDOT pre-approved route. The cyclotron travel time is expected to take approximately four hours before arrival at Hamlin. The cyclotron generates the proton beam that is used to treat patients through the ProNova SC360 system. Delivery of the cyclotron is a milestone event in the construction of the proton therapy treatment center.
Once the cyclotron has arrived at the proton center, the Provision team, which includes personnel from ProNova Solutions, Sumitomo Heavy Industries, Ltd., Barnhart Crane & Rigging Co., will then begin the rigging and installation of the cyclotron into the new proton therapy center building. Following installation of the cyclotron, installation, testing and commissioning of the ProNova SC360 will continue as the proton therapy center building is completed.
The cyclotron accelerates a proton beam that is incorporated into the ProNova SC360 delivery system and then used to deliver this advanced cancer treatment. This treatment provides a means to treat the cancer and spare the patient with fewer side effects.
The Provision CARES Proton Center is located in the 17-acre Provision CARES Cancer Center in Hamlin and is a member of the Provision CARES Cancer Network. Provision CARES Cancer Centers with Proton Therapy are also located in Knoxville, TN, Nashville, TN and recently announced Kansas City, KS, where all Provision centers provide comprehensive and integrated diagnostic and therapy services for all patients and all physicians who need those services.
Provision’s leadership team, cancer center partners, and media will be viewing the cyclotron delivery from the construction site at 15775 New Independence Parkway, Winter Garden, Florida.
Proton therapy is an advanced form of radiation therapy that uses a single beam of high-energy protons to treat various forms of cancer. Proton therapy treats tumors by directing protons into the tumor site destroying cancerous cells. Unlike with other forms of radiation, radiation oncologists can control both the dose and range of protons, which allows the maximum deposition of energy into the tumor. This reduces damage to nearby healthy tissue and limits negative side effects. Proton treatment can be combined with chemotherapy and biological treatments, depending on the cancer type, to provide better outcomes with less tissue damage. According to the National Association of Proton Therapy, there are currently 35 proton therapy centers in operation.
An affiliate of Provision Healthcare, ProNova Solutions, LLC is committed to making proton therapy accessible to a greater number of patients and physicians worldwide. ProNova was founded by former leaders of CTI Molecular Imaging, which brought positron emission tomography (PET) technology out of the laboratory and made it a clinical reality for millions of cancer patients. Today the same team is redefining cancer treatment once again with the introduction of the first and only superconducting 360-degree compact proton therapy system. It is the only proton therapy system developed in a clinical setting, benefitting from continuous input from physicians, medical physicists, and therapists during design and development. The system includes state-of-the-art features such as pencil beam scanning and advanced imaging with cone-beam CT, all in a compact design.
Provision Healthcare, LLC was formed in 2005 with the purpose of developing innovative healthcare solutions focused on improving patient care and clinical outcomes and developing support for research, educational and charitable causes. Provision has developed a unique, comprehensive expertise in proton therapy including Provision’s patient focused “Culture of Care” that distinguishes Provision from other proton and cancer center developers and operators that have a much narrower focus. The combination of unique expertise and an innovative, entrepreneurial approach continues to propel Provision towards a position of industry leadership with respect to both cancer care and proton therapy.
Every year in early November, the American Society of Radiologic Technologists (ASRT) celebrates National Radiologic Technology Week. It’s an opportunity to recognize the crucial role that medical imaging and radiation therapy professionals play in patient care and safety. The celebration takes place during the week of November 8, which is the day Wilhelm Conrad Roentgen discovered the x-ray in 1895.
The Radiologic Technologists (R.T.s) at Provision CARES Proton Therapy are an integral part of our team. They are educated in anatomy, patient positioning, examination techniques and radiation safety, allowing them to perform highly skilled and precise procedures. Most importantly, though, they are on the frontlines of caregiving during treatment. All of our R.T.s are passionate about Provision’s Culture of CARE, putting the patient’s comfort, safety and overall experience first.
To show our appreciation for the Radiologic Technology (Rad Tech) staff at Provision, we’re taking a closer look at the industry to which they’ve devoted their lives, and how their jobs help shape the cancer patient experience.
Following Roentgen’s discovery, the x-ray gained popularity as a way to diagnose and treat illness in the early 1900s. The x-ray machine remained the primary tool of medical imaging until the 1960s and 1970s, when newer procedures like computed tomography, mammography and sonography became commonplace in the healthcare industry1. The x-ray is also a traditional tool used for radiation therapy to treat cancer. In the 1950s, however, proton radiation therapy for cancer treatment was introduced. Since then, studies have shown proton therapy avoids unnecessary radiation to nearby healthy tissue and organs, reducing the risk of side effects2. There are now more than 30 proton therapy centers in the United States.
Modern Radiologic Technology covers two main areas – medical imaging and radiation therapy. According to the ASRT, there are several practices in which an R.T. can specialize, including general radiography, computed tomography (CT), mammography, magnetic resonance imaging (MRI), radiation therapy and others.
In the medical imaging field, an R.T. is responsible for making sure the patient is properly positioned for a quality diagnostic image. Rad Techs in medical imaging are typically specialists, like Radiographers, Mammographers, Sonographers, MRI techs or CT Techs.
A Radiologic Technologist may also choose the radiation therapy path. Radiation Therapy is the administration of targeted doses of radiation to a patient’s body to treat cancer or other diseases. In this case, an R.T. would be a member of the Radiation Oncology team and could work as a Medical Dosimetrist or Radiation Therapist.
Radiologic Technology is part of the patient experience from diagnosis all the way through treatment and the cancer care experts at Provision can help coordinate each step of the process. Of course, radiation therapy is at the heart of what we do – treating cancer with proton therapy – and we are proud of the work our Radiation Therapists do and the passion they show for everyone who walks through our doors. Along the course of your treatment, you may also meet MRI Techs, CT Techs, Medical Dosimetrists and other radiologic specialists.
All of these Radiologic Technology roles are highly specialized and require quality education and experience. Most importantly, though, each of our R.T.s believes in Provision’s Culture of CARE. It is our mission to respect the dignity and value of every person by providing an environment of compassion, sensitivity and thoughtful consideration.
The Rad Tech staff at Provision is also dedicated to increasing awareness about the benefits of proton radiation therapy. In fact, the ASRT Foundation recently recognized Justin Pigg, Manager of Radiation Therapy at Provision CARES Proton Therapy Nashville, with its International Speakers Exchange Award for his efforts to promote the sharing of research, best practices and professional development in the radiologic sciences. As a recipient of this award, Pigg presented “Technical Aspects of Proton Therapy” at a Radiologic Technology conference in Nova Scotia.
Proton therapy for cancer treatment has become a trusted method for precisely targeting tumors and reducing the risk of side effects. The advantage of proton therapy is distinct from traditional radiation therapy because the timing and dosage of proton energy can be specifically controlled. Since a proton beam can conform to a tumor’s shape and size, maximum beam energy is deposited directly into the tumor, decreasing the risk of damage to surrounding tissue and organs. Protons have unique characteristics that prevent radiation from traveling beyond the tumor. Contrastingly, traditional radiation therapy deposits energy from x-ray beams along the entire path of the beam. Radiation is absorbed from the time the beam enters the body until it exits on the other side of the tumor area.
Provision CARES Proton Therapy uses the most precise form of proton therapy, called pencil beam scanning. Pencil beam scanning provides even greater customization and precision in cancer treatment. Physicians use a proton beam only millimeters wide to target the tumor area with the highest radiation dose, while controlling both the depth and the position of the beam and planning the exact point at which the proton beam stops inside the body. This means there will be no exit dose, sparing even more healthy tissue and organs from unnecessary radiation.
Proton therapy is beneficial for treating patients with a localized tumor where cancer has not spread to other parts of the body, or in situations where tumors cannot be removed with surgery. It may also be an option if a patient requires radiation therapy in addition to surgery or chemotherapy. We encourage you to speak with one of cancer care experts to find out if proton therapy is right for you.
Ultimately, Provision CARES Proton Therapy is passionate about caring for anyone who is fighting cancer. In honor of National Radiologic Technology Week, thank you to all of our Rad Techs who help us live up to that mission.
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One of the toughest parts about researching breast cancer online is trying to sort fact from fiction. The internet is full of half-truths, conflicting reports and flat-out myths about the disease. Provision CARES Proton Therapy is committed to our Culture of CARE, putting the patient experience first. So, for Breast Cancer Awareness Month, we’re debunking five of our most commonly heard myths. All of these breast cancer facts have been verified for quality and accuracy by our cancer care experts to help you make an informed decision about your healthcare.
TRUTH: Lumps don’t always indicate cancer. Likewise, the absence of lumps doesn’t always mean you don’t have breast cancer.
While the most common symptom of breast cancer is a lump, most breast lumps are caused by conditions other than cancer. According to the Centers for Disease Control and Prevention (CDC), the two most common causes are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, while cysts are small fluid-filled sacs that develop in the breast.
The American Cancer Society (ACS) says lumps are more likely to be cancerous if they are painless, hard and have irregular edges. However, some breast cancers can be painful, soft or round. That’s why you should always check with your doctor if you notice any changes in your breasts.
There are many other symptoms of breast cancer, even if a lump is not detected. These can include swelling of the breast, skin dimpling, breast or nipple pain, nipples turning inward, red or flaking breast skin, nipples discharging fluids other than breast milk, and swollen lymph nodes under your arm or around your collar bone. The ACS recommends contacting your doctor if you experience any of these symptoms.
TRUTH: Breast cancer can develop in younger women, too, as well as men.
While your risk does increase with age, the NCI reports women in their 30s have a 1 in 208 chance of developing breast cancer. By the time a woman reaches her 40s, that risk has increased to 1 in 65. Overall, it’s estimated that 1 out of every 8 women in the United States will develop breast cancer at some point in her life.7
Breast cancer in men accounts for less than 1% of cases in the United States. However, the ACS says male breast cancer is on the rise.1 Unfortunately, a higher percentage of men are diagnosed with advanced-stage breast cancer, likely a result of less awareness and fewer early-detection screenings.
If you’ve been diagnosed with breast cancer and would like to learn more about proton therapy as a possible treatment, please visit our Proton Benefits page or contact a Care Coordinator.
TRUTH: While a family history of breast cancer does put you at greater risk, most women who develop breast cancer do not have a family history of the disease.1
According to the CDC, a family history of breast cancer may put you at higher risk for the disease, but is not indicative of whether you’ll actually develop cancer.2 In fact, the ACS says most women with one or more affected first-degree relatives (parents, siblings, children) will still never be diagnosed.
The CDC provides a table with examples of average, moderate and strong family health histories, along with suggestions for preventative measures each group can take. Regardless of your family history, the CDC recommends you get mammograms and other breast exams as recommended by your doctor, maintain a healthy weight and exercise regularly. As family history of breast cancer increases, genetic counseling becomes an option to test for hereditary breast cancer. Be sure to talk to your doctor about what screenings are best for you and when you should get them.
TRUTH: If the cancer is detected early enough, other treatment options can eliminate the cancer without removing the entire breast.
A mastectomy involves removing the entire breast and is typically performed when breast-conserving surgery (lumpectomy) is not an option. However, women with early-stage cancers can typically choose between the two types of surgeries. The ACS notes that while it’s normal for your gut reaction to be to “take out all the cancer as quickly as possible” with a mastectomy, the fact is that, most of the time, a lumpectomy combined with radiation therapy results in the same outcome.
Many patients at Provision CARES Proton Therapy choose to combine a lumpectomy with proton radiation therapy. Proton therapy for breast cancer treatment is non-invasive and painless, causing less cosmetic damage than conventional x-ray radiation. It is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. Because proton radiation has little to no impact on a patient’s energy level, quality of life during treatment is improved.
For women who do opt for a mastectomy, it’s important to remember that post-surgery treatment is still necessary. Even after removing the breast, there’s a small chance the cancer could recur on residual breast tissue or the chest wall. You should continue to perform self-breast exams and see your doctor on a regular basis.
TRUTH: There has been no conclusive evidence linking antiperspirants or bras to breast cancer.
Rumors have swirled across the internet claiming underarm antiperspirants cause breast cancer. The National Cancer Institute (NCI) says the basis of these claims is the aluminum-based active ingredient in antiperspirants. Some scientists have suggested that absorbing these aluminum compounds into your skin could increase your risk factor for breast cancer.4 Still, no clear link has ever been established between antiperspirants and breast cancer. In fact, the NCI even cites a study from 2002 that concluded there is no increase in risk for breast cancer among women who reported using an underarm antiperspirant.3
Another rumor making its rounds across cyberspace is that wearing a wire bra can increase your risk of breast cancer. This myth was debunked by a 2014 study published by the American Association for Cancer Research. According to the authors, it had been suggested in the media that bras impede lymph circulation and drainage, interfering with the process of waste and toxin removal.6 However, the study concluded that wearing a bra had no effect on your risk of breast cancer.
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Proton therapy for breast cancer treatment is “safe and effective.” That’s the conclusion of a new study released in the Journal of Clinical Oncology, which highlighted proton therapy’s ability to control cancer cells with much less toxicity in the heart and lungs as compared to conventional (x-ray) radiation therapy.
“In our prospective trial of women with locally advanced breast cancer who required treatment of the internal mammary nodes, proton beam radiation therapy was safe and effective,” says Shannon M. MacDonald, MD, of Massachusetts General Hospital in Boston, and colleagues.
Breast cancer tumors usually occur in the lobules and ducts of the breast, which are used in the production and delivery of breast milk. Breast cancer is the most common cancer among women aside from skin cancer. Men are also susceptible to breast cancer, although the disease is rare among males.
As with other cancers, the best possible outcomes for breast cancer treatment come through early breast cancer care. Proton therapy has unique attributes that reduce radiation exposure to normal, healthy organs3,4. This is especially important in left-sided, node positive breast cancer patients (those who need the internal mammary nodes irradiated), as the cancer is close to critical organs such as the heart and the lungs.
Researchers enrolled 70 prospective patients with nonmetastatic breast cancer who required radiation therapy to the chest wall and regional lymph nodes. The average age of enrollees was 45, with patients ranging from 24 to 70 years old. The vast majority (91%) of evaluable patients had left-side breast cancer, and all but four patients had stage II-III disease. Only one patient did not receive chemotherapy in conjunction with proton radiation therapy.
The study, which lasted from 2011 to 2016, specifically chose patients whose treatment would include irradiation of the internal mammary nodes (IMNs). This made them suboptimal candidates for conventional radiation therapy, since exposure to the IMNs would also increase radiation to the heart and lungs. According to the study’s authors, that has been associated with an increased risk of cardiac events.
The benefits of proton therapy, however, significantly reduce exposure to the heart and lungs. It’s an advanced form of radiation therapy that precisely targets a tumor using a single beam of high-energy protons to kill cancer cells. Unlike conventional photons, which have almost no mass and extend beyond a tumor through the body, protons are relatively heavy and will hit their target – then stop. This spares nearby healthy tissues and organs from receiving unnecessary radiation.
Proton therapy for breast cancer treatment received high marks from this study. Of the 69 evaluable patients, the 5-year cancer recurrence rate was just 1.5% and the 5-year overall survival rate was 91%. Those positive results go hand-in-hand with low rates of severe side effects. Study authors reported no patient developed grade 3 pneumonitis (inflammation of the lungs) or grade 4 or higher toxicity in the lungs. They also reported no significant changes in cardiac function or key cardiac biomarkers.
Dr. MacDonald and colleagues concluded that “Proton beam radiation therapy (RT) for breast cancer has low toxicity rates and similar rates of disease control compared with historical data of conventional RT.”
Dr. Ben Wilkinson, MD, FACRO, Radiation Oncologist and Medical Director at Provision CARES Proton Therapy Knoxville says the findings of this study support the success he’s seen at Provision.
“Among mostly young women with left-sided breast cancer receiving regional nodal irradiation, proton therapy produces excellent target coverage with miniscule cardiac doses and low rates of lung toxicity,” Dr. Wilkinson says about the study’s conclusion. “When we treat breast cancer, those lymph nodes run very close to the heart. Proton therapy allows us to deliver the dose to the tumor site and spare the surrounding area – the heart, lung, chest wall, and even the esophagus.”
The authors of the study from Massachusetts General Hospital say their findings open the door for more extensive studies in the future. “No early cardiac changes were observed,” they note, “Which paves the way for randomized studies to compare proton beam radiation therapy with standard radiation therapy.”
In fact, the results of the study bode well for a more comprehensive trial already underway to compare proton therapy with conventional x-ray therapy. The Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial, which began in 2016 and will continue until at least 2022, is being conducted by the University of Pennsylvania, in conjunction with the Patient-Centered Outcomes Research Institute.
According to the U.S. National Library of Medicine, it is a pragmatic randomized clinical trial of patients with locally advanced breast cancer. More than 1,000 patients will be randomly assigned to receive either proton therapy or x-ray therapy. Each patient will have a 50-50 chance of getting into either treatment group. Both groups will be followed for at least 10 years after completing radiation therapy. The trial’s ultimate goal to is to study the patients’ quality of life outcome to help decide which is the best treatment option for future patients with breast cancer – proton therapy or x-ray therapy.
Proton therapy shows remarkable promise and advantages over conventional therapy in the treatment of breast cancer. It is a type of radiation that stops at a very specific point in the targeted tissue; conventional radiation continues beyond the tumor. In breast cancer, this means on average no radiation to the heart and on average 50% less radiation to the lung5 as compared with conventional radiation.
Proton therapy is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. It is not a substitute for a lumpectomy. Rather, it is used as an alternative to conventional radiation therapy. After surgery a breast cancer patient may receive 2-6 weeks of proton therapy.
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Knoxville, Tennessee (September 12, 2019) – – Provision Healthcare announces the expansion of the Provision CARES Cancer Network with plans to develop the Provision CARES Cancer Center and Proton Therapy Center in Kansas City, Kansas. The center will be the first in Kansas, located in the Lenexa community of Kansas City to serve patients in the area and surrounding region with advanced cancer care. Proton therapy precisely targets tumors thus reducing the risk of side effects and providing improved outcomes and quality of life for patients both during and after treatment
“The Kansas City Provision CARES Cancer Center and Proton Therapy Center will be the fourth Provision CARES center in the U.S. as Provision Healthcare continues to develop the network and pursue our mission to make advanced cancer care and proton therapy more accessible by developing cancer centers and proton therapy centers in the U.S., Asia, and around the world,” said Dr. Terry Douglass, Chairman and CEO of Provision Healthcare.
Kansas City’s proton therapy treatment center will be a three-treatment room center and will utilize the latest proton system technology of ProNova Solutions, which is a Provision Healthcare company. “Our team is honored to create, deliver and expand innovative technology that brings advancements and solutions to cancer care with our ProNova SC360”, said Joe Matteo, President of ProNova Solutions. Provision Solutions will provide the development, training and management of the proton therapy center and cancer center. It is projected that approximately 1,000 patients per year will be treated at the proton center. The development of other medical office space will provide additional complementary cancer services adjacent to the proton therapy center.
About Provision Healthcare
Provision Healthcare, LLC (Provision) was formed in 2005 with the purpose of developing innovative healthcare solutions focused on improving patient care and clinical outcomes and developing support for research, educational and charitable causes. Provision has developed a unique, comprehensive expertise in proton therapy that distinguishes it from other proton and cancer center developers and operators that have a much narrower focus. The combination of our unique expertise and innovative, entrepreneurial approach continues to propel Provision towards a position of industry leadership with respect to both cancer care and proton therapy.
About ProNova Solutions, LLC and the ProNova SC360 Proton Therapy System
ProNova Solutions, LLC, a Provision Healthcare company was founded by current leaders of Provision and former leaders of CTI Molecular Imaging, which brought positron emission tomography (PET) technology out of the laboratory and made it a clinical reality for millions of cancer patients. Today the same team is redefining cancer treatment once again with the introduction of the first and only superconducting 360-degree compact proton therapy system, making proton therapy a clinical reality. It is the only proton therapy system developed in a clinical setting, benefitting from continuous input from physicians, medical physicists, and therapists during the entire course of design and development. The system includes state-of-the-art features such as pencil beam scanning and advanced imaging with cone-beam CT, all in a compact design.
Contacts:
Nancy Howard
Provision Healthcare – Knoxville, TN
nancy.howard@provisionproton.com
(865) 603-0865
Join us for a free presentation to learn more about the latest developments in prostate cancer. Dr. Wilkinson will discuss the most advanced diagnostic tools and current trends in treatment including multiparametric MRI, genomic classification, when to use active surveillance, and how to preserve quality of life after a prostate diagnosis.
Friday, September 20th from 930-11a
Hosted by: Provision CARES Proton Therapy Knoxville, 6450 Provision CARES Way, Knoxville, TN 37909
RSVP: To reserve your seat, please RSVP to Jenni Turner at 865.321.4539 or jenni.turner@provisionhp.com