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The Stanford School of Medicine unveiled a novel machine on Tuesday that treats cancer patients with a high degree of precision and is smaller and less expensive than its technological predecessors.
The underlying technology, called proton therapy, has existed since the 1950s. It works by targeting protons – the positively charged particles of an atom — of cancerous tumors inside patients, and can reduce the side effects of radiotherapy. But the machines of old could occupy the space of a three-story building, making them too large and costly to install in many hospitals.
Stanford’s innovation for proton therapy, created alongside two medical technology companies, was twofold: it compacted the device and positioned patients in a seated position, so that the patient could rotate instead of the machine. Previously, patients would have proton therapy treatment lying down while the machine moved around the patient. Now, the new synchrocyclotron machine that conducts the particle accelerator technology used in the proton therapy is static.
Dr. Billy Loo, a professor of radiation oncology in Stanford’s School of Medicine, played a key role in bringing the technology to fruition. Dr. Loo, who is an physician and holds a doctorate in bioengineering, leveraged his clinical expertise in lung cancer and his engineering background to conceive of the smaller machine. The innovation will be the first of its kind in the country, and it will bring the treatment to a region that some in the field previously referred to as a proton therapy desert.
The first high-energy linear accelerator for medical use was developed at Stanford in the 1950s, built in the Department of Physics. In 1956, the first patient was treated: a little boy with an eye tumor. The boy lived into adulthood with his vision intact. Courtesy Stanford Medicine. 
Patients with head and neck or lung cancer could sat on a mounted chair for treatment. The radiation oncologist used a retractable diagnostic tube and a ceiling-mounted image intensifier to guide the radiation. Courtesy Stanford Medicine.
“This is an example of where necessity is the mother of invention,” said Dr. Loo. “Even though we’re in the advanced technology world of Silicon Valley, it [was] an eight-hour drive to the nearest facility that has proton therapy.”
Because of its precision, proton therapy is particularly adept at treating cancers located near critical structures like the brain, spine, head and neck, lungs, liver, and prostate with minimal damage to the surrounding tissue. In traditional radiation therapy, the beam travels through the tumor and exits out of the body, exposing tissue to radiation. In proton therapy, doses of radiation are delivered directly to the tumor without exiting the body.
Proton therapy minimizes side effects of radiation. That means it’s often a good choice for treating cancers in children, who are particularly susceptible to low doses of radiation, said Dr. James Rao, an associate director of proton therapy in the department of radiation oncology at Stanford.
“Since children often can be cured of their cancer and live for many years and decades afterwards, it is very important to reduce the overall radiation dose that their body receives during their cancer treatment,” Dr. Rao said. “Even low doses of radiation could potentially increase their risk of another cancer later in life.”
While Stanford Medicine will initially be the only location in the world with the new proton therapy machine, dozens of healthcare centers around the world are adopting the device over the coming months and years. The swift uptake of the new machine – which is cheaper, more compact and easier to install — suggests that there is high demand for the technology.
“The adoption of new technologies is often measured and conservative,” Dr. Loo said. “To see centers committing to adopting this without yet having seen the first patient being treated gives you an idea of the excitement that there is about this, that people see the value of it.”
The compact proton therapy machine has been several years in the making, and Stanford researchers partnered with medical technology companies Mevion Medical Systems and Leo Cancer Care Inc to bring the device from a “napkin drawing” to a prototype to a functional machine, Dr. Loo said. The research was funded by Stanford and its industry partners.
On Tuesday afternoon, medical personnel and community leaders, including Palo Alto Mayor Vicki Veenker, convened at a ribbon-cutting ceremony to celebrate the creation of the new technology.
“Soon, we’ll be able to treat our first patient using the smallest proton therapy machine in the world at Stanford Medicine,” said Dr. Quynh-Thu Le, chair of the Department of Radiation Oncology at Stanford University, at the ceremony. “I call it the little proton engine that could.”
In the last year, academic institutions have experienced a reduction in federal funding that some universities indicate could impact their ability to conduct research. Last month, the U.S. Department of Justice under the Trump administration opened an investigation into the Stanford School of Medicine and threatened to withhold federal funding if it did not comply with demands to submit years of admissions data. Stanford’s School of Medicine spends about $1 billion per year on medical research.
“Federal funding has been kind of the core engine for fundamental research in academic institutions, which is traditionally the source of innovation and new discoveries that then translates out into industry,” Dr. Loo said. “Funding cuts from federal research threaten that.”
