Feature | Proton Therapy | October 11, 2023 | By Christine Book

Dr. Michael Butkus is Co-medical Director and Head of Proton Physics at the Dwoskin Proton Center at the Sylvester Comprehensive Cancer Center, part of the University of Miami/UHealth Medical System; and Board member of the National Association for Proton Therapy (NAPT)

Dr. Michael Butkus is Co-medical Director and Head of Proton Physics at the Dwoskin Proton Center at the Sylvester Comprehensive Cancer Center

A University of Miami Radiation Oncology department summary noted: “In radiation oncology, the art of patient care meets the science of physics. For this reason, medical doctors and physicists both play a role in ensuring that the patient receives the finest and most appropriate treatment possible.” ITN  spoke to Michael Butkus, PhD, to learn about the latest advancements in technology and proton therapy treatment. A summary of that discussion follows. The full video interview with him can be found here.

ITN: What does the imaging community need to know about advancements in proton therapy?

BUTKUS: The current status of protons starts with the current status of radiation oncology and as a whole. The general point of all our treatments is to be able to deliver a high energetic dose to tumor cells that will cause those cells to die, while minimizing the dose to healthy tissues, thus enhancing survival and long-term benefit to patients. Proton therapy has a unique characteristic that allows it to get even greater dose to the treatment volumes that we’re trying to put energy in, while reducing the dose to the healthy tissues. From a single beam direction, we can have minimal dose in all the tissues leading up to a tumor then maximum dose in the tumor. That by itself is the advantage of protons compared to other forms of radiation oncology. The changes going on right now in proton therapy are mostly on the availability of the technology. The cost of these centers has come down quite a bit, though very expensive still. That has allowed more centers to install them … so the technology can be used by more people, we can gain more clinical experience with it, and as with anything that’s growing, use it in ways we didn’t in the past. So with more access comes better work. Also, a lot of pediatric patients are treated with protons because of the sparing effects ... so it is the standard of care for most pediatric patients.

ITN: How do you view the value and viability of collaborations between vendors and universities?

BUTKUS: There is value on both sides. Being able to move the field forward takes many people, especially when we’re working on such a large, consequential problem as cancer. From the university’s side, it’s having partners qualified and able to build programs, analysis techniques, computer software and hardware that’s actually needed. From the vendor side, it’s having the clinical knowledge that what we’re actually building is viable to a clinic, what’s best needed to advance care. So it’s about sharing the expertise of clinical staff and vendors of how to do something right so that advances can be made and implemented in a timely manner.

ITN: Can you tell us about NAPT and the work it does?

BUTKUS: NAPT (The National Association for Proton Therapy) is both an advocacy group for patients and a resource for providers. For advocacy, they focus on ensuring proton therapy is a potential treatment option for those that may benefit from it and building national frameworks to help patients navigate through this often complex and confusing time. As a resource for providers, they provide coordination between multiple centers so that there are shared experiences between diverse providers from which all can benefit.

ITN: What’s most exciting on the horizon in proton therapy?

BUTKUS: The exciting part is seeing more and more institutions be able to bring this technology to areas that didn’t have it in the past. From a scientific point of view, I’m particularly interested in the biological impacts of these particles, both protons and heavier ions that are treated in some countries (not the US) as they present differences we can learn from and try to advance care through. It’s very interesting research, because not a lot of people have been able to look into it, as it involves very large technology, very large capital investments. That’s probably the biggest research interest for me. Also, a lot of companies are building technologies that are just more accessible for patients. We’re learning how to do everything better, quicker — to try to get more patients on beam, more treated. Watching the field grow by seeing how people are tweaking what we thought was standard is always exciting, as is seeing how people engineer technology around patients to increase treatments and the health of the people we are treating.

You can view the full video interview with Dr. Butkus here.

Related proton therapy content:

Targeting Cancer, Tracking Collaboration: A Progress Report on Proton Therapy

ASTRO23 conference coverage

VIDEO: First FLASH Proton Therapy Trial Completed in Humans


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