Hematology and Oncology

Proton Center Offers Safer Cancer Treatment Option

The UAB Proton Center, a technologically advanced, 32,500-square-foot facility, opened in 2020. (Andrea Mabry/UAB)

Until 2020, pediatric cancer patients in Alabama who could benefit from proton radiation needed to travel far and wide to receive the state-of-the-art treatment. Now, Children’s of Alabama, in a joint program with the University of Alabama at Birmingham (UAB), offers the first and only proton center in Alabama, enabling young patients to stay closer to home and attracting others from surrounding states.

The center, which opened at the advent of the COVID-19 pandemic, has more than doubled the number of pediatric cancer patients it treats in just the last three years—from 11 in 2020 to 23 by the midpoint of 2023.

Before the proton center opened, Children’s and UAB would send many patients to be treated at other hospitals. “Now, we draw patients from all of Alabama as well as from Mississippi, Georgia and the Florida panhandle,” said Michael Soike, M.D., a radiation oncologist at Children’s and an assistant professor of radiation oncology at UAB. “It has also grown the trust and collaboration between UAB and Children’s in meaningful ways.”

Unlike traditional X-ray or “photon” radiation, proton therapy delivers positively charged particles to tumors at extremely high energy. This energy enables protons to stop at the desired depth in the body instead of traveling all the way through. The result? Cancer cells are destroyed with pinpoint precision without damaging healthy surrounding cells.

This equates to fewer side effects and less long-term damage that could seriously impact a child’s quality of life and future, including problems with growth and cognition as well as secondary cancers, Soike said.

About 85% of Children’s oncology patients undergoing radiation now receive proton therapy instead of traditional radiation. Proton therapy is particularly well-suited for certain brain and spinal cord tumors, lymphomas and sarcomas since it avoids sensitive tissues around the brain, heart and lungs.

“In young patients, we want to spare brain tissue from radiation as much as we can,” Soike explained. “It can mean the difference between a child being able to excel in life, attend college and live a normal life after treatment for a brain tumor instead of a child that struggles to finish high school and is significantly impaired.

“Proton therapy isn’t more effective for treating cancers—the cure rates are similar—but the late side effects are reduced,” Soike added.

Clinical trials in proton therapy at Children’s are building on prior research to test personalized treatment protocols appropriate to each patient’s case. For example, the Head Start 4 trial now in progress allows the use of a chemotherapy-first approach and then radiation tailored to the response of the tumor in children up to age 10, Soike said. “As with every clinical trial, it is experimental, but it significantly reduces the dose and field of radiation we would typically deliver. The protocol takes a chance at giving the child a head start on life after cancer—pun intended.”

The proton center includes 20,000 square feet of clinical space, offices, exam rooms and prep/recovery areas. Multidisciplinary tumor boards meet weekly to discuss individual cases, tailoring treatment to each patient.

“What stands out at Children’s is that we have this really well-oiled machine where we know each other’s expertise and what each of us can do,” Soike said. “Our culture here is collaborative, and we all learn from each other in important ways.”

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