As Noah Reeb lists the blessings—“my house, my favorite sports, my friends, my family, my dogs”—a gratitude point brings more joy than might be expected from a 9-year-old with brain cancer.
“I’m so happy!” Reeb cheers. “I don’t have to leave!”
Reeb is one of the first patients to receive proton therapy, an advanced form of radiation, in the mountain west.
Long confined to larger cities, the Huntsman Cancer Institute’s new proton therapy facility in Salt Lake City is poised to treat hundreds of patients who previously had to relocate for the therapy or abandon it altogether.
“It’s just a miracle,” said Taylor Lambert, whose six-week treatment for a brain tumor is almost over. “For me, it just got going.”
If her only option had been to go out of state for treatment, she added, “My husband … couldn’t leave his job for a month and a half. So we couldn’t have afforded it.”
Proton therapy is a more targeted, precise form of radiation than traditional photon therapy.
In photon therapy, radiation enters the body, through the cancer, and exits the body behind it. The rays are aimed at multiple angles, so the cancer takes the brunt of the radiation — but the tissue around the cancer is also exposed to low doses, said oncologist Dr. Ryan Price.
That exposure can cause organ damage or even trigger new cancer development, said Dr. Matthew Poppe, another oncologist at the institute.
Proton therapy drastically reduces that risk because the beam enters the body and stops on the cancer itself instead of going through it. This means that much less tissue is exposed to the radiation.
“It can target that specific area instead of blasting through my brain with radiation,” Lambert said. With her tumor pressing against her pituitary gland, she said, that reduces the risk of future endocrine problems from 3% to 5% with conventional radiation, to about 1% with proton therapy.
Meanwhile, the lower, more targeted doses may reduce side effects such as nausea and diarrhea and may require fewer treatments, said Dr. Robert Foote, an oncologist at the Mayo Clinic in Rochester, Minnesota. Those improvements can dramatically improve patients’ quality of life while they undergo treatments, he said.
“People feel better. They don’t have to be hospitalized as often or on so many medications, and they can continue to work,” Foote said.
But not every cancer patient who needs radiation is eligible for the upgrade. About 2,000 to 2,500 patients a year undergo radiation treatment at Huntsman Cancer Institute, Poppe said, but the new proton therapy facility will only be able to treat about 250 patients a year.
“We will soon find that the need is greater than our capacity,” Price said.
For some patients, the benefits of proton therapy are too minor to justify filling such a much sought-after slot. For example, Price said, “It’s a wash” if the cancer grows in an area of the body that is not susceptible to organ damage from conventional radiation treatments.
And some patients choose it, Foote said, because their insurance plans still don’t cover proton therapy, even though it has become more effective and cheaper.
“it just took years for the technology to mature and develop to the point where you can produce” [the machinery] commercial. Initially, the equipment was quite expensive… but like most things, it’s getting smaller, faster and cheaper,” Foote said.
For example, the system on the University of Utah campus is extremely compact, says engineer Adam Bunker-Worley. The equipment that generates the radiation there is adjacent to the equipment that delivers it; in other facilities, the radiation usually travels in conduits between two separate structures.
Because proton therapy so significantly reduces the risk of radiation causing new cancer later, children are often high-priority candidates, Price said.
Children live longer after their treatments, Poppe said, meaning the mutations that the radiation causes in the surrounding tissue have more time to trigger new cancer developments. Radiation causes secondary cancer in one in 1,000 adults who undergo it, Poppe said; in children, the risk is 10 to 30 times higher.
Meanwhile, the risk of conventional radiation treatments causing organ damage may also be greater in children — especially those whose cancer is in the developing brain.
“That can affect memory, IQ and hormone production,” Poppe said.
While Lambert, 23, said she would have accepted the increased risks of conventional radiation therapy in Utah had proton therapy not been available here, the benefits for 9-year-old Reeb would have been too great to pass up.
In December, Reeb started experiencing sudden and severe headaches, and in February doctors found a tumor the size of a ping pong ball in the center of his brain, his father, James, said. If the proton therapy hadn’t started at the Huntsman Cancer Center during his treatment, Noah Reeb would have had to move to another city temporarily; the closest facilities to his home in the Highlands were previously in Seattle, Phoenix, and San Diego.
“It would have split the family when he needed us all,” Reeb’s mother, Jacque, said.
Instead, Reeb plays flag football with his friends, sees his sisters every day and asks his parents for energetic music playlists to listen to during treatments, even though they’re not sure he can lie still under the proton beam while captivated. by a bop.
“I’m just happy to be able to stay in the state,” said Jacque.