San Diego — Cancer care in San Diego County took a major step forward today with the start of installation of the region’s first cyclotron, a remarkable piece of medical equipment that will be the driving force behind the Scripps Proton Therapy Center, and one of only a small handful of such proton therapy medical devices and delivery systems in the United States.
Manufactured by Varian Medical Systems of Palo Alto, Calif., the 90-ton cyclotron is about the same weight as a fully loaded 737 jetliner, but just 6 feet high and 9 feet wide. The cyclotron’s job is to accelerate protons to extremely fast speeds; roughly 100,000 miles per second or 0.61 times the speed of light; to create a beam that can precisely reach tumors, even if deeply seated and located near critical organs. These beams can also be shaped in three dimensions to avoid surrounding healthy tissues, targeting tumors with unprecedented accuracy.
Made predominantly of extremely pure iron to optimize magnetic power, the cyclotron uses water and electricity to create a plasma stream, from which protons are extracted. Protons are then accelerated by the magnetic energy between the upper and lower halves of the cyclotron; the force of which is equivalent to 200 tons. The protons are then sent through a beam transport system using a series of electromagnets to steer the beams for delivery to patient treatment rooms.
Construction on the 102,000-square-foot center began in October 2010, and is expected to be open for patient care by late 2013. The Scripps Proton Therapy Center will have the capacity to treat approximately 2,400 patients annually. It is being built on a 7-acre site in the Carroll Canyon area of Mira Mesa, at 9730 Summers Ridge Road.
There are currently nine proton therapy patient treatment centers operating in the U.S., and just one west of the Rockies. They are located in Loma Linda, Calif. (opened 1991); Boston, Mass. (opened 2002); Bloomington, Ind. (opened 2004); Houston, Texas (opened 2006); Jacksonville, Fla. (opened 2006); Oklahoma City, Okla. (opened 2009); Philadelphia, Penn. (opened 2010); Hampton, Va. (opened 2010); and Warrenville, Ill. (opened 2010).
The cyclotron has taken an extraordinary journey from inception to installation in San Diego. It was manufactured and tested in Troisdorf, Germany over a 20-month period by a team of about three dozen engineers, physicists, electricians, welders and others with specialized expertise. It was then shipped across the Atlantic Ocean, through the Panama Canal and into Port Hueneme, just north of Los Angeles. From there it was transported via two specialized 200-foot-long, 19-axle trailers, to evenly distribute the exceptionally heavy load.
After arriving at the Scripps Proton Therapy Center, the cyclotron will be lifted in two separate sections, using a specially designed crane that is usually deployed to move heavy industrial equipment weighing up to 1,000 tons. During the course of two straight workdays, the cyclotron will be painstakingly aligned into place, due largely to the sub-millimeter accuracy required of its placement.
Following the cyclotron’s installation, the beam transport system and other equipment will be installed in patient treatment rooms. Meanwhile, the cyclotron will undergo testing to meet various acceptance criteria under the guidance of a team of engineers, physicists, software engineers and other experts.
Scripps Proton Therapy Center will include five treatment rooms, three of which will include gantries, which are three-story, 360-degree rotational machines designed to deliver the therapeutic beam at the precise angle prescribed by the physician. Each gantry weighs 280 tons. The other two treatment rooms will have fixed-beam machines. The center will also offer MRI, CT and PET/CT imaging services in support of proton therapy; 16 patient exam rooms; and offices for 14 physicians.
The facility is being developed by Advanced Particle Therapy (APT), LLC of San Diego and will be operated by Scripps Health and Scripps Clinic Medical Group. Scripps Health will provide clinical management services to the center and Scripps Clinic Medical Group will oversee the medical services. APT has arranged the financing to build the center and purchase the proton therapy equipment from Varian Medical Systems. Additionally, APT will manage and maintain the building and equipment. The architect and general contractor for the center is The Haskell Company of Jacksonville, Fla., one of the nation’s leading design-builders of health care facilities.
For certain cancers, proton therapy offers a more precise and aggressive approach to destroying cancerous and non-cancerous tumors, compared to conventional X-ray radiation. Proton therapy involves the use of a controlled beam of protons to target tumors with control and precision unavailable in other radiation therapies. The precise delivery of proton energy limits damage to healthy surrounding tissue and allows for a more potent and effective dose of radiation to be used.
Patients will be able to access this treatment through a referral to a specialist credentialed by the Scripps Proton Therapy Center. Proton therapy has an established history of reimbursement by Medicare and private health care payers.
A non-invasive treatment, proton beam therapy is usually performed on an outpatient basis and is considered most effective on solid, deep-seated tumors that are localized and have not spread to distant areas of the body.
Varian will equip the facility with a fully integrated ProBeam proton therapy system. The center’s superconducting cyclotron will feature pencil-beam (or spot) scanning, which allows for modulation of the proton beam’s intensity. This allows doctors to precisely shape the dose distribution to concentrate on the targeted tumor while minimizing exposure of normal healthy tissue.
Nearly 80,000 people worldwide have received proton therapy at centers in Europe, Asia and the United States. Patients typically receive approximately 30 treatments during a four- to six-week period. Each treatment lasts for approximately 15-25 minutes, after which the patient is free to carry on with daily affairs.
In addition to providing patient care, Scripps expects to be at the forefront of new and developing clinical applications as part of its proton practice and connection with other national centers.
Radiation generated by the proton therapy system will be contained by installing the equipment in a bunker with concrete up to 15 feet thick. Two completely independent monitoring systems are also being installed to ensure safe operation. A personnel protection system (PPS) will monitor the safety of individuals inside the facility. Additional radiation monitors are being installed outside the facility to prevent environmental exposure.
With more than 300 affiliated physicians, Scripps Cancer Center is a nationally recognized leader in cancer care, providing comprehensive care at its four hospitals and various Scripps Clinic locations. Scripps Cancer Center seeks to provide the best possible treatment and cutting-edge research trials for patients by coordinating medical expertise in the areas of clinical cancer care, community outreach and clinical, translational and basic research. Scripps is the only cancer care provider in San Diego to earn network accreditation from the American College of Surgeons’ Commission on Cancer.
Learn more about Scripps Health, a nonprofit integrated health system based in San Diego, Calif.