August 6, 2014 — Imagine a targeted radiation therapy for cancer that could pinpoint and blast away tumors more effectively than traditional methods, with fewer side effects and less damage to surrounding tissues and organs. That is the reality with a treatment called carbon ion radiotherapy, an option that is, for now, available only outside the United States.
Colorado State University, which has noted expertise in understanding radiation as both a cause and a cure for cancer, co-hosted a scientific meeting on the University of Colorado Anschutz Medical Campus in Aurora called “Photon, Proton, and Carbon Ion Radiotherapy: Advances in Basic, Translational, and Clinical Research.” Carbon ion radiotherapy — and efforts to provide this treatment to cancer patients in the United States — was among the key topics of conversation at the meeting.
“It’s almost like a sledgehammer versus a pin,” Jac Nickoloff, a conference organizer and head of CSU’s Department of Environmental and Radiological Health Sciences, said of the new treatment.
Carbon ions are much larger than protons, a standard in cancer radiation. When carbon ions are hurtled around in an accelerator to nearly the speed of light and directed into a tumor, they do much more damage to the DNA strands of tumor cells than their smaller proton cousins.
Unlike photon radiation, or X-rays — the most commonly used therapeutic radiation — carbon ions are not light beams and do not pass through the tumor. Therefore, carbon ions do less damage to areas behind the tumor.
What’s more, Nickoloff said, carbon ions do not deliver the full impact of their energy until they reach their target, meaning that the tissues and organs they pass through on their way to the tumor are subjected to minimal exposure.
Max Matsuura, coordinator of the CSU Center for Environmental Medicine, explained that the ions’ energy peaks at the site of the tumor and then quickly drops off, minimizing damage to surrounding DNA strands.
Nickoloff said the large accelerators used in carbon ion therapy are only available in Japan, Germany and Italy.
An accelerator propels a carbon ion at nearly light speed using magnets around a circular track. The ion is bent off the track into the room where the patient lies, precisely targeted to hit the tumor. It delivers a higher dosage to the tumor than proton or photon ions, doing more damage to cancerous DNA strands than those conventional methods.
The first facility built to deliver such treatments, in Japan, was based on technology developed in the 1970s at Lawrence Berkeley National Laboratory in California, Nickoloff said.
Some of the Japanese creators of that original facility were in Colorado for the fourth annual radiotherapy symposium. They represent the National Institute of Radiological Sciences (NIRS) outside of Tokyo.
CSU has partnered for several years with NIRS to better understand carbon ion radiotherapy — sometimes called heavy ion therapy — and to explore ways to provide the treatment option to U.S. cancer patients.
Last spring, a delegation of Colorado officials visited NIRS to pursue the idea of transporting U.S. cancer patients to Japan for treatment — and even the possibility of constructing a similar center in the United States. The delegation included Colorado Lt. Gov. Joe Garcia, CSU President Tony Frank, University of Colorado Denver Chancellor Don Elliman and CU School of Medicine Dean Richard Krugman.
During the opening session at the symposium, NIRS Fellow Hirohiko Tsujii, a founder of the NIRS Intl. Open Laboratory, outlined the history of carbon-ion radiotherapy and described the handful of facilities in Japan that deliver the treatment. He said more than 11,000 patients have received this type of radiotherapy in Japan since it was started in 1994.
The facilities can cost upwards of $350 million to construct, roughly the price of a 757 jet. And the cost of the treatment is between $20,000 and $40,000.
By comparison, researchers said, chemotherapy drugs may cost $100,000 over the course of a year. Photon and proton radiotherapy might cost $20,000 to $35,000 a year, respectively.
Interdisciplinary science is the foundation of cancer treatment. Investigation in basic science examines therapies at a cellular level; translational research gathers insights from the treatment of animals with naturally occurring disease, a major strength at CSU; clinical studies with humans help to further determine efficacy. Involved are several scientific disciplines, including biochemistry, physics and the genetics of DNA damage and repair, which is Nickoloff’s specialty.
“It’s grown and evolved,” Nickoloff said of the radiotherapy symposium. “We want this to be the go-to meeting that experts from around the world come to in order to share the latest ideas about these lifesaving technologies.”
For more information: csu-cvmbs.colostate.edu/academics/erhs/Pages/radiotherapy-symposium.aspx