October 8, 2019

By SonjaLother , ROAR Communications and Public Relations Director

Members of ROAR the Cure (Radiation Oncology Accelerated Research) a nonprofit organization raising funds exclusively for cancer research performed by UAB Radiation Oncology Department physicians got a "sneak peek" tour today of "Emma", the affectionally named new 90-ton cyclotron. The machine will begin serving patients in early 2020 at the University of Alabama (UAB) Proton Therapy Center, a Proton International facility located at 400 20th Street South in Birmingham, Alabama.

The tour was led by Rex Cardan, PhD., Director of UAB's Proton Physics department and Assistant Professor at UAB Department of Radiation Oncology. Previous ROAR the Cure honorees Tony Petelos and Jimmie Stephens joined members of ROAR as we learned about the world-class capabilities of the proton machine.


Standing before the machine, Cardan shared that we were seeing on the front side of the machine was just a very small slice. "This is actually 160 tons, and when we walk around, we'll see the rest of that in the back which extends another 60 feet or so," he said.


The cyclotron produces a proton beam that is configured to deliver the majority of its energy precisely at the tumor location, minimizing damage to normal tissue. Pencil beam scanning (PBS) is the most precise form of proton therapy. Using an electronically guided scanning system and magnets, PBS delivers proton therapy treatment via a proton beam that is just millimeters wide.

Pointing at the front of the proton machine, Cardan said, "This looks pretty complicated in here and it is. There's a series of magnets that let us to move a pencil beam back and forth, so if the tumor is like a circle, we can paint that pencil beam just on the tumor and nothing else. We can also paint in 3-D, in depth, so if the tumor is wide, we can start at the most distal edge and work our way back with that pencil beam to only treat the tumor and very little normal tissue."


Cardan pointed out the benefits of proton therapy versus traditional radiation. "With conventional radiation therapy, the beam will go right through you, it can't stop—x-rays will just go all the way through. Protons will actually stop at a specified place depending on the speed that we shoot them in."


In response to a ROAR member question, Cardan estimated that the beams are calibrated to enter the patient's affected areas at approximately 100,000 miles a second. "As a result, it allows us enormous control to make sure that normal tissue is not harmed," he shared.


It's hard to comprehend the scale of Emma unless you are standing in front of the machine. Here are a few shots that show the part of the machine patients won't see when they are receiving treatment.

According to Cardan, the facility is designed to have longer hours of operation and will be open from 6 a.m. to 10 p.m. when it is at full capacity. "At 10 p.m. we turn the machine over to the vendor so they can perform all of the maintenance the machine requires," he shared with us.

Emma can be used to treat a wide variety of cancers including pediatric cancers. As part of the tour Cardan showed us the room where pediatric patients receive anesthesiology prior to visiting Emma. "It opens directly into the treatment area via this door," he indicated.


Cardan showed us the sunny, well-lit room where medical dosimetrists work with UAB physicians to create customized treatment plans based on the patient's initial scans. We learned that dosimetrists are experts with knowledge of how Emma and proton machines like her, can be calibrated to work in the most effective manner when delivering the customized doses of radiation that individual patients need.

"Dosimetrists spend about a week after they get the patient's 3-D scans creating 'artwork' that is going to be the treatment based on the physician's instructions. They're the ones that figure out the right angles to come in from. They play with a lot of different options to make sure its exactly what the physicians want" Cardan said.

ROAR members also learned that some treatment plans require the production of molds, casts, and other immobilization devices for accurate treatment delivery like the face mask shown below.


When Emma is in full swing, it will be one of only 29 proton therapy locations in the United States, most associated with academic medical centers. In March this year when Emma was first delivered, we learned that the UAB Proton Therapy Center is the first in Alabama and one of the few in the Southeast according to James A. Bonner, M.D., the Merle M. Salter Endowed Professor, and Chair of the UAB Department of Radiation Oncology in the School of Medicine.


Also participating in the tour from the UAB Department of Radiation Oncology department were: John Fiveash , M.D., Professor and Vice Chair for Academic Programs, Richard Popple , PhD., Professor and Assistant Vice Chair for Physics, Ruby Meredith , M.D., Professor, and Adam Kole , M.D., Assistant Professor.

A few of our wonderful ROAR members came in later and enjoyed a second wave of the tour. They are pictured below.

ROAR the Cure was honored to take part in the private tour, and we remain steadfast in our commitment to raise funds for further cancer research by physicians at UAB's Department of Radiation Oncology. We are so delighted to learn more about the great things taking place at UAB's Proton Center and can't wait for it to open and start saving lives through more advanced cancer treatment.

If you would like to support UAB Department of Radiation Oncology's cancer research, we invite you to join us at our yearly James Bond themed gala "License to Cure" held Jan. 25, 2020 at The Club. This year our honoree is Jimmy Koikos, legendary co-owner of The Bright Star. Tickets may be obtained by visiting roar2020.givesmart.com or roarthecure.org.