Will Westwood become a Destination for Cutting Edge Cancer Treatment?

Image by burlesonmatthew from Pixabay 

On Monday, June 7, 2021, representatives from Dana-Farber Cancer Institute presented a proposal to Westwood's Select Board to construct a proton therapy facility at University Station between Bridges Drive and Brigham Way.  Dana-Farber described proton therapy, also known as proton beam radiotherapy or proton radiotherapy, as a cutting edge technology which almost all world-renowned cancer centers have the capability of administering, but which Dana-Farber does not yet have.  

Daphne Haas-Kogan, M.D., Professor and Chair of Dana-Farber's Department of Radiation Oncology, presented for Dana-Farber. Her presentation was followed by one from Dr. Cynthia Keppel, the Town of Westwood's safety consultant, nuclear physicist and self-described proton therapy advocate.

According to Dana-Farber representatives, Westwood's University Station is an attractive location to build Dana-Farber's two-story proton therapy center because of the proximity to public transportation and highways, adjacent parking, nearby hotels, restaurants, retail stores, and lab services from Brigham and Women's Health Care Center. 

Foxborough's Patriot Place is also under consideration as a location, but Dr. Haas-Kogan says Dana Farber favors Westwood because Foxborough's football games would create parking restrictions.  She notes that parking limitations could compromise the ability of patients to get treatment.

Proton radiotherapy is a cutting edge cancer treatment that is said to be more effective in killing cancer and minimizing damage than the more ubiquitous photon radiotherapy. In both therapies, an external beam of radiation is aimed at a cancerous tumor in the body. But unlike a photon beam which will pass through both the targeted tumor and surrounding body structures as it exits the body, the beam from proton radiotherapy is more precise, and does not exit the body.  It passes through much less area, causing less damage to the areas of the body that surround the targeted site.  

The result of  proton therapy is that cancer patients will have less damage to the brain, heart, lungs, kidneys, intestine, liver and ovaries, says Dr. Haas-Kogan.   For children, this could mean fewer problems with behavior, intelligence, school performance and future cancers, she says.

 Select Board Chair Michael Walsh asked, "Will there be a guarantee that there will be no titanium/uranium or radioactive material at any time throughout the lifetime of this [proposed] building?" Both Dr. Haas-Kogan and the Dr. Keppel answered affirmatively.

As explained by Dr. Haas-Kogan, proton therapy works like an x-ray machine.  The patient lies on a table and a beam of radiation is administered by a machine for about 10 to 30 seconds.  When the machine is turned off, the patient is not radioactive and there is no radioactive source that sits in the machine, she says.

"There has never been a radiation safety incident at a proton therapy center," added Dr. Keppel.  She noted, however, that after the accelerator is off, residual radiation would remain from the equipment itself.  The only safety concern that residual radiation poses is to workers in the building, she says. That concern would be addressed by thick concrete walls that would be constructed for the therapy area. Dr. Keppel says the concrete acts as a shield to radiation and is an industry standard for constructing such a treatment facility.  She noted that a transatlantic flight would give a person slightly more radiation than the radiation that might emit through the facility's concrete walls.

Select Board member Robert Gotti questioned whether the shield will become more or less effective as technology evolves.  Dr. Keppel answered that shielding that is designed now will attempt to anticipate what is needed in the next ten years.  Additionally, a steel lining could be added to the concrete walls as a later precaution.

Special Counsel for Westwood, Daniel Bailey, asked that concerns of locating the treatment facility near a water source, the aquifer, be addressed.  Dr. Keppel responded that the concrete barrier is one safety precaution, and monitoring equipment could be installed to detect changes. Human safety checks could also be implemented, she says. An annual check of the facility by safety physicists would be the norm for a proton therapy center.

Although the FDA approved use of protons in 1988, there are currently only 37 proton therapy centers in the United States.  One reason is that it is very expensive. Another reason is that until more recently, imaging technology has been inadequate.  Doctors use imaging to help precisely plan where to apply the proton beam for treatment. 

A review of the company's anticipated project timeline shows that construction is expected to run about thirty to thirty-five months. If the proposal is approved, it will likely take about 3 to 4 years from the time of design to when the treatment center will welcome its first patient, says a Dana-Farber representative.

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