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Visit: U F Health Proton Therapy Institute

At the end of March (2017), I visited one of the oldest and most venerable proton therapy centers in the United States. After Loma Linda University proton therapy center opened in 1990, it took until 2006 for several more to come online, one of which is this one at the University of Florida in Jacksonville in a stand alone 98,000-square-foot facility that also houses conventional radiation.

The term "conventional radiation" implies that protons are unconventional, which in many ways is their strength. They are not more of the same, but rather, considerably different. In my book about proton therapy, I originally differentiated x-rays and protons by calling them x-radiation and p-radiation (but then changed it to the more simple x-rays and protons). Both are emissions of energy (and hence, radiation) in which x-rays are electromagnetic waves and protons are moving subatomic particles. Anyone considering proton therapy should be cognizant of the significant difference between these two technologies. Virtually all proton therapy centers have on their websites a section called "what is proton therapy?". For UF it can be found at this link:

Part of the UFHealth system, this is also a teaching center, with all of the radiation oncologists, physicists, engineers and computer scientists being faculty members at the University of Florida. Perhaps this's why they call it an institute rather than the more common proton center. In looking at the future of proton therapy, one of my concerns has been staffing. When a new center opens it often entices skilled workers from other centers, but as more and more centers open, such an approach won't be viable. Here at the University of Flordia they are training the next generation of technicians to meet this future need. Being the leading center for treating pediatric cancers, it comes as no surprise that they were the first to offer a pediatric fellowship. They have treated the most pediatric cases and the fourth most total patients in the world.

Research is a big deal here, as you would expect. They have many trials on going, which are listed on their website. They also track 98% of their patients to follow their outcomes. This is essential to build a body of proof as to the superiority of proton therapy. Having been in business for more than a decade, they have reported the following in a study conducted by medical director Nancy P. Mendenhal, MD:

A large-scale study of men treated with proton therapy for prostate cancer confirms proton therapy is a highly effective treatment for low-, intermediate-, and high-risk prostate cancer. The cohort of 1,327 men was treated at the University of Florida Health Proton Therapy Institute between 2006 and 2010 with median follow-up of five-and-a-half years.

Researchers report that 99 percent, 94 percent and 74 percent of men with low-, intermediate-, and high-risk prostate cancer, respectively, have no signs of cancer recurrence after five years of follow up. Less than one percent in the cohort experienced serious gastrointestinal side effects and approximately three percent experienced serious urologic side effects.

Another study by Curtis Bryant, MD, also on the faculty here, showed similar results. Even better statistics have been shown for facilities that have pencil beam scanning, an upgrade in the capability of proton therapy that extends the types of cancers treated from 20% of all cancer types to 80%. Proton centers established before 2014 may not be equipped with pencil beam scanning, so I suspect they will all be adding that capability. Such is the case here, at UF, which is planning to add an IBA ProteusOne single treatment room installation within the next few years. This will give them a fourth gantry and another, smaller, cyclotron. (Up to now, Provision in Knoxville, Tennessee, is the only center with two full-size cyclotrons.) I'm sure their protocols give them excellent outcones, but if it were up to me, knowing what I do about proton therapy, I would choose to be treated at a center that has pencil beam scanning equipment. Even when one gantry has it here, the others still will not. Newer centers, such as Provision, Texas Oncology, Scripps, and the Univesrity of Maryland, have all pencil beam scanning, in all of the treatment rooms. I think this will give them an advantage over those who do not have that technology.

My wife Linda Ricketts and I spent a very enjoyable hour and a half talking with Theresa Makrush, sitting in the lobby which features a large chime. Just as I rang a bell when my treatment was complete, here they ring the chime (see photo). I still have more to learn about insurance. I had heard that Florida was a state in which proton therapy for prostate cancer is covered by mainline insurance companies. Perhaps that's because there are more old folks in Florida, and hence, more prostate cancer. I need to research that further and update the insurance article on my blog ( I called here when seeking a center for myself and remember being told that United Healthcare wouldn't cover proton therapy. Eventually I went to Provision because they did get Medicare coverage for me, as long as I entered their registry to track me for the rest of my life.

Due to demand, at UF they treat up to 150 patients a day. That's thirty-seven peopIe per treatment room. All proton centers focus on getting clients. Here, they have a relationship with several foreigh countries, includiing England, Norway and the Canadian provence of Quebec, to offer proton therapy to their patients. Very clever. They have had patients from forty-nine states and thirty different countries. I wonder which state they are missing? As is typical with proton therapy centers, almost half of the patients here are self-referred. That means they conducted their own research and decided first on proton therapy and secondly, oto come here.

I have read books by two people who were treated here, Ron Nelson and Don Denton. Ron has a blog filled with interesting articles found here: After you read my book, you might want to read one of theirs. Here are links:
PROTONS vs. Prostate Cancer: EXPOSED (Ron Nelson) and Calming the Storm (Don Denton). My book, you remember, is found here: Best Prostate Cancer Treatment: Proton Beam Therapy. Hint, hint. These links take you to Amazon but are not "buy now" links.

"At a Glance" is a quick summary of facts about UFHealth Proton Therapy Center. I scanned the two pages and have posted them here in pdf format: At a Glance. UFHealth is the first center that I visited since starting this website. I learned a lot and look forward to my visits of other centers.

Robert at UF Proton Center

Here I am in Jacksonville. I'm not going to include photos of me in front of every proton therapy center, although I do hope to visit all of them. (This isn't a Burger King commercial.)

UF Proton chime

Above: The chime patients ring after completing their treatment.

Below: A real-time assessment of waiting times for the gantries. This is available as an app for one's cell phone.

Above: Wednesdays seem to be the day of the week for meetings with prospective, current, and past proton therapy patients.

Below: The Bar-B-Cue food truck parked outside the entrance was very popular.