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TODAY news for Thursday, February 11, 2008

Loma Linda University Medical Center news

Slater Proton Treatment and Research Center dedicated

James M. Slater, MD, FACR
James M. Slater, MD, FACR
It takes a lot to keep James M. Slater, MD, FACR, from achieving his goals.

The former student of physics refocused his studies on medicine and dared to dream that tiny subatomic particles would one day be made available to the world for curing cancer. Friends and colleagues expressed their doubts, but Dr. Slater persevered until his dream came true.

How fitting, then, that neither an arctic storm nor a cloud of controversy over the effectiveness of proton treatment could deter a crowd of 250 supporters from attending the renaming and dedication ceremonies for the James M. Slater, MD, Proton Treatment and Research Center at Loma Linda University Medical Center on Sunday, December 9, 2007.

When the ceremonies got underway at 3:30 p.m., the chill factor plummeted in the outdoor parking area where the event was held. But that didn’t stop the crowd from turning up its collars, banding together for warmth, and honoring the man whose pioneering work in beaming protons at active cancer cells has brought new hope and life to thousands of individuals with brain, lung, eye, and prostate cancer.

Following the invocation by former chair of the LLU Board of Trustees Calvin B. Rock, DMin, PhD, Dr. Slater’s accomplishments were observed by B. Lyn Behrens, MBBS, president and CEO of Loma Linda University Adventist Health Sciences Center (LLUAHSC); Ruthita Fike, MA, executive vice president for hospital affairs, LLUAHSC, and president and CEO of Loma Linda Uni­versity Medical
James M. Slater, MD (left), thanks the capacity crowd for attending the dinner in his honor following the dedication and renaming ceremonies for the James M. Slater, MD, Proton Treatment and Research Center.
James M. Slater, MD (left), thanks the capacity crowd for attending the dinner in his honor following the dedication and renaming ceremonies for the James M. Slater, MD, Proton Treatment and Research Center. Pictured with Dr. Slater is his wife, JoAnne Slater; B. Lyn Behrens, MBBS, president of Loma Linda University Adventist Health Sciences Center; and Ruthita Fike, MA, president and CEO of Loma Linda University Medical Center.
Center (LLUMC); Congressman Jerry Lewis of the 41st Congressional District of Southern California; Roger Hadley, MD, dean of the School of Medicine, Loma Linda University (LLU); Ken Venturi, former professional golfer and CBS sports commentator; Jerry Slater, MD, professor and chair of the department of radiation medicine at LLU and medical director and director of clinical affairs for the department of radiation medicine at LLUMC; and Lowell Cooper, MPH, general vice president of the General Conference of Seventh-day Ad­vent­ists and chair of the Board of Trustees of LLUAHSC.

In her remarks, Dr. Behrens called Dr. Slater “our superstar,” and in a taped message, Congressman Lewis—who was unable to be present in person—described Dr. Slater’s groundbreaking work in building the world’s first hospital-based proton center as “a breakthrough” that “really put Loma Linda on the map.”

Following the speeches about Dr. Slater’s remarkable contributions to nuclear science in general —and medical radiology in particular—a group of current and former proton center patients gathered on the roof to unveil the new James M. Slater, MD, Proton Treatment and Research Center sign. As the crowd cheered, the patients waved to Dr. Slater and the dignitaries on the platform. The sign, which features the mathematical proton symbol in a shade of blue teal, sits above the outside front entrance to the proton cente
Officials at the dedication service for the Slater Center include (from left) Jerry Slater, MD; Ken Venturi; Ruthita Fike, MA; Lowell Cooper, MPH; James M. Slater, MD; H. Roger Hadley, MD; and B. Lyn Behrens, MBBS.
Officials at the dedication service for the Slater Center include (from left) Jerry Slater, MD; Ken Venturi; Ruthita Fike, MA; Lowell Cooper, MPH; James M. Slater, MD; H. Roger Hadley, MD; and B. Lyn Behrens, MBBS. Not pictured is Calvin B. Rock, DMin, PhD.
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When the center opened in 1990, it was the first hospital-based proton treatment center in the world. It remained the only such treatment center in the United States until 2003. Thanks to the incredible successes achieved at the renamed Slater Center—which has given more than 350,000 treatments—other health care facilities around the nation are currently making plans to open proton treatment centers of their own.

The proliferation of proton centers has caused some to express concerns about the costs. In a December 26, 2007, article titled “Hospitals Chase A Nuclear Tool To Fight Cancer,” writer Andrew Pollack of the New York Times, noted that a 222-ton proton accelerator—which requires a building the size of a football field and can cost more than $100 million—is an enormously expensive proposition.

However, when Mr. Pollack journeyed to Loma Linda to interview three prostate cancer patients who were either undergoing treatment at the Slater Center or had just completed treatment, none of the men expressed concerns over the costs. To the contrary, they were extremely grateful for the new lease on life provided for them by proton therapy.

Dr. Slater is no stranger to opposition. There were thousands of hurdles to overcome in applying the rarified science of nuclear technology to the health care environment in the first place, and he is certain the current confusion surrounding proton therapy will be cleared up in the course of time. In fact, Dr. Slater and several of his colleagues are currently preparing a major research document to be published in a medical journal this summer. The article will compare and contrast the costs, benefits, and effectiveness of conventional x-ray technology, the new IMRT x-ray therapy, and proton treatment.

“The equipment selected by the physician for proton therapy must be capable of performing in a manner that the physician needs,” Dr. Slater observes. “There are many machines on the market that cannot.” He adds that many of proton therapy’s critics come from the ranks of doctors and institutions that purchased inferior equipment in the first place.

He also debunks the notion that individual physicians are becoming rich from protons. “The Medicare payer system pays physicians basically the same amount of money whether they’re treating with x-rays or protons,” Dr. Slater asserts. “Protons require much more time-consuming work on the physician’s part, so the physician’s paycheck does not benefit from providing proton therapy. Physicians actually get paid less per hour with protons. Hospitals, however, get paid much more to treat with protons than with x-rays, but that’s as it should be because proton technology is much more expensive.”

When asked to address concerns that protons aren’t significantly better at treating cancer than IMRT x-rays, Dr. Slater takes care to point out that the assertions cannot be proven or denied on the basis of clinical trials because the studies have not been conducted and, he notes, “probably won’t be.”

Why not? “It’s almost certain there will never be a study comparing IMRT and proton technology because of the downside of IMRT x-rays,” he says. “IMRTs injure so much of the surrounding normal brain tissue that no patient who fully understood the risks involved would submit to IMRT radiation.”

Dr. Slater goes on to clarify that while IMRT technology is, in some ways, an improvement over earlier conventional x-ray treatment, because the IMRT rays spread a smaller amount of radiation over a wider field than conventional treatment, more brain tissues are damaged in the process. “A physician who understands the damage potential of the IMRT process couldn’t talk a patient into submitting to it if he’s honest about the risks,” Dr. Slater declares.

But while corroborative scientific evidence may never exist to demonstrate the superiority of proton therapy, practical clinical experience clearly does.

“We know that we have saved the lives of many patients whom we absolutely could not have saved with x-rays,” Dr. Slater insists. “We’ve been able to treat prostate cancer, brain cancer, tumors of the eyes and lungs—we’ve treated many forms of cancer that would have had absolutely no possibility of curing with x-rays because the cases were far too ad­vanced for x-rays—and they have responded positively to protons.”

That point was not lost on the men and women standing on the roof at the unveiling of the proton sign. Many of them were only alive because of the benefits of proton radiation. Unlike conventional x-rays, and to a lesser extent, IMRT x-rays—proton beams can be precisely positioned in 3-D accuracy. They produce almost no damage to normal tissues, nor do they pass through the patient’s body and out the other side. With protons, a very precise amount of radiation is delivered to the cancer cells directly. As a result, they are annihilated; yet damage to surrounding tissues is almost non-existent.

But while Dr. Slater is reluctant to cite statistics regarding protons versus IMRT technology, he does not hesitate for a moment to assert the superiority of protons over conventional x-rays.

“I can give you an example,” he notes. “In treating tumors of the brain, protons have shown a cure rate of 85 percent versus a 25 percent cure rate for the same tumors using conventional x-rays.”

Following the outdoor dedication ceremonies, guests and dignitaries retreated to the warmth of the Wong Kerlee International Conference Center inside the Coleman Pavilion for a commemorative dinner. At the conclusion of the meal, an audiovisual presentation highlighted Dr. Slater’s remarkable career, and a cadre of dignitaries, including some of the top nuclear physicists in the world, called attention to his achievements.

The festivities ended with Dr. Slater and his wife, JoAnne, taking the podium to thank colleagues, friends, and guests for supporting this dream of curing cancer with invisible particles. After that, the couple mingled with the crowd, talking about the past and pointing to the radiant future of cancer treatment at the James M. Slater, MD, Proton Treatment and Research Center.

By James Ponder

TODAY news for Thursday, February 11, 2008