Medical Milestone for Scripps, Rady Children’s: First Pediatric Proton Patient

Proton therapy reaches part of tumor in brain stem that past treatments could not

Scripps Health physician Andrew Chang helps prepare pediatric cancer patient Natalie Wright for her proton therapy treatment.

Seventeen-year-old Natalie Wright has battled a brain tumor since age 2, going through multiple surgeries and years of chemotherapy treatments, only to see the tumor grow back time and time again.

Today, after becoming the first pediatric cancer patient to complete proton therapy treatments in San Diego at Rady Children’s Hospital at Scripps Proton Therapy Center, Natalie and her medical team are optimistic that this advanced form of radiation therapy will keep the disease in check for the long haul.

Natalie traveled from Provo, Utah, for her treatments, which were delivered as part of a collaboration between Scripps Health and Rady Children’s. Every weekday for the past six weeks, she has been treated with a highly accurate beam of protons to target a cashew-shaped tumor situated on – and partially within – her brain stem.

“We chose proton therapy because of its ability to safely penetrate into the brain stem to reach a part of the tumor that couldn’t be touched before,” said John Wright, Natalie’s father. “And since the technology at the Scripps center is the newest and most advanced in the country, we thought ‘why go anywhere else?’”

Tumor located in sensitive area

Natalie’s treating physician, Andrew L. Chang, MD, said Natalie’s tumor was located in a highly sensitive area that is the main highway between the brain and the body. “This is an area that controls breathing, heartbeat and movement, so accuracy of treatment is critically important,” said Dr. Chang, who practices at Scripps and Rady Children’s.

Dr. Chang said further surgeries were deemed too risky, carrying the possibility of paralysis or even death. Additional chemotherapy was determined to no longer be an effective treatment option. And since Natalie’s tumor was growing and required intervention to save her life, the only treatment option was external beam radiation, either with X-rays or protons.

A conventional X-ray treatment beam would have continued past Natalie’s tumor and irradiated her brain, face and throat, increasing her probability of side effects such as secondary cancers caused by the radiation. By comparison, doctors can control a proton radiation beam to stop where the tumor stops, protecting nearby critical organs.

The Scripps Proton Therapy Center uses pencil-beam scanning, the latest advancement in proton therapy. Pencil-beam scanning sweeps a narrow proton beam across the tumor in fine strokes, building up the dose layer by layer. The result is a dose of cancer-killing radiation that conforms precisely to the unique shape of the tumor. The center opened for adult and pediatric patient care earlier this year.

Preferred treatment for childhood cancers

“Proton therapy is recognized as the preferred form of radiation therapy for many childhood cancers, and that is certainly the case for Natalie’s tumor,” said Dr. Chang, one of the nation’s leading pediatric radiation oncologists. “Because children’s bodies are still growing, they are extremely sensitive to the harmful effects of radiation. We are delighted to be able to deliver this life-saving care to Natalie.”

“This is an important milestone for Rady Children’s in providing a full range of treatment options to our pediatric cancer patients,” said John Crawford, MD, who heads Rady Children’s neuro-oncology department and is part of the tumor board that reviews pediatric patients who are considered for proton therapy. “We can now offer proton therapy to children and teenagers with cancer closer to home. In fact, our second pediatric patient is from Orange County and has recently started a course of treatment with this advanced technology.”

A non-invasive treatment, proton therapy is also considered highly effective for adults who have solid, deep-seated tumors that have not spread to distant parts of the body. Proton therapy has been used in the United States since the 1950s but is only recently becoming more available. The Scripps Proton Therapy Center in Mira Mesa is just the 15th in the United States and fourth west of the Rockies.

Keeping active during treatment

Natalie said she experienced minimal side effects from her proton treatments, which allowed her to continue her favorite activities, including artwork and spending time with family. She even took a short break in the midst of treatments to travel back to Utah to enjoy summer camp with friends. Dr. Chang indicated the treatments were delivered successfully, though it will take several years to determine the outcome.

Immediately following Natalie’s final proton treatment on July 18, family, friends and caregivers gathered at the Scripps Proton Therapy Center to celebrate. Natalie put the finishing touches on a special sketch she created during her time in San Diego, which she is donating to be hung in the Rady Children’s Hospital area of the Scripps Proton Therapy Center. The picture will be available for future pediatric patients to sign, upon completing their treatments.

Superhero connection

Natalie and Dr. Chang share a fondness of comics and the pair took to wearing matching superhero shirts during Natalie’s course of treatments. Natalie also wore a special mask to keep her head perfectly still during treatments, and a radiation therapist who is involved in her daily treatment at the center decorated it in superhero style. “We view Natalie as a superhero in her own right, and her positive impact will be felt by children and caregivers here for many years to come,” said Dr. Chang.

Looking to the future

Natalie will begin her senior year of high school in Provo later this year. She hopes to go on to study at Brigham Young University to become a child life specialist – a pediatric health care specialist that works with ill children and their families to help provide comfort and support as they go through treatments. “The child life specialist who helped me when I was 2 really made a big difference and I’d like to have that kind of impact on others,” Natalie said.

In addition to Dr. Chang, Natalie’s proton treatment team included Scripps radiation oncologists Carl Rossi, MD, and Ryan Grover, MD.

Advanced Particle Therapy is the developer and owner of the Scripps Proton Therapy Center. Scripps Health provides the center’s clinical management services and Scripps Clinic oversees the medical services. Rady Children’s is an affiliate provider at the proton center and operates its pediatric clinic. Varian Medical Systems of Palo Alto, Calif., developed and installed the center’s ProBeam proton delivery system.

About Rady Children’s Hospital-San Diego

Rady Children’s Hospital-San Diego is a 520-bed pediatric care facility providing the largest source of comprehensive pediatric medical services in San Diego, Southern Riverside and Imperial counties. Rady Children’s is the only hospital in the San Diego area dedicated exclusively to pediatric healthcare and is the region’s only designated pediatric trauma center. In June 2013, U.S. News & World Report ranked Rady Children’s among the best children’s hospitals in the nation in all 10 pediatric specialties the magazine surveyed. For more information, visit

About Scripps Health

Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.