Dr. David Wazer has sent hundreds of cancer patients to Boston because the treatment they needed didn’t exist in Rhode Island.
Brown University Health, where Wazer is the director of radiation oncology, has very advanced technology to treat cancer patients. But in some cases, Wazer felt he didn’t have the resources to treat patients in a way that would be safer than using proton beam radiation therapy.
Proton beam radiation therapy is more precise than traditional radiation. However, the closest centers to Rhode Island offering it are located in Boston and New York.
But that will soon change.
In December 2024, the R.I. Department of Health approved a proposal from American Shared Hospital Services to create a proton beam radiation therapy center in Johnston.
Wazer and Gregory Mercurio, senior vice president of radiation oncology for American Shared Hospital Services who partnered with Wazer to propose the facility, say proton beam radiation therapy will be a huge boost to the state’s cancer care offerings.
“Without this tool of proton therapy, you can’t deliver comprehensive care,” said Mercurio, who is also CEO of Precision Radiation Oncology of Rhode Island. “Proton therapy is the pinnacle of radiation.”
Before construction can begin, the site must be assessed to make sure it can hold all the necessary equipment. After that, construction and getting the facility ready for its first patient is expected to take 30 months, Mercurio said.
Proton radiation works by using proton beams, instead of traditional photon beams, to deliver radiation.
A photon beam must send radiation through healthy tissue to reach the tumor and then it passes through even more tissue when exiting the body. This can damage a cancer patient’s healthy tissue and cause lifelong consequences, Wazer said. But with proton radiation, the beam goes through healthy tissue on its way to the tumor, then stops there, which means much less healthy tissue is damaged in the process.
“Proton is the ultimate technology to allow us to be very, very focused in terms of where the radiation goes and avoid giving unnecessary radiation to surrounding tissue,” Wazer said.
Indeed, 60% of cancer patients will likely need a course of radiation treatment, Wazer said. Proton therapy is particularly useful for cancers in the brain, neck, lung, esophagus, liver, upper gastrointestinal tract and deep within the abdomen – this is because a proton beam can deliver radiation to those areas much easier than a photon beam.
Also, Mercurio said about 20% of all cancer patients who are qualified for photon radiation would be better off with proton radiation. Each year there are about 400 patients in Rhode Island who qualify for proton radiation, he said.
Even though proton radiation is beneficial, it’s also much more expensive than photon radiation. The average photon radiation facility costs between $8 million and $10 million to build, while the average proton facility costs $50 million to $60 million, Mercurio said.
It’s expected to cost about $32 million just to provide the equipment for the proton beam radiation therapy in the facility that Mercurio and Wazer proposed. This cost will be covered by American Shared Hospital Services. The building is being developed by owners of the land, Carpionato Corp., and an oncology and advanced imaging space. The building is expected to cost about $20 million to build.
The Carpionato Corp. will lease the space back to Rhode Island Proton Beam Radiation Therapy LLC, the entity created to operate the facility.
A major component of the technology costs comes from a cyclotron, which generates particles that create the protons and then delivers them to the treatment facility. The cyclotron must also be surrounded by a vault, made of 6-foot-thick reinforced walls. The cyclotron and vault weigh about 230,000 pounds, meaning the site ground must be strong enough to hold this weight – or reinforced – before construction begins.
Mercurio emphasized that the proton facility is located on what he called neutral ground, which means it’s not affiliated with a specific health system. This is so physicians will feel more comfortable referring patients to proton therapy without the concern of losing them to a competing health system.
The company has an agreement for Brown Health’s Radiation Oncology Department, led by Wazer, to provide the proton therapy, while American Shared Hospital Services will run the facility’s administration. Wazer said physicians from any health system in the state are welcome to join the team. The facility will be available to researchers from Brown University’s Legorreta Cancer Center at no cost.
Before patients receive proton beam radiation therapy, their case will be reviewed by a board made up of all kinds of health care professionals to ensure they will notably benefit from proton therapy versus photon, Mercurio said.
While more and more patients have been qualifying for proton beam radiation each year, Mercurio said the proposed facility should be more than enough to meet the state’s needs, as well as attract patients from other states.
“Usually, technology is available in the states around us,” Mercurio said. “We will actually have patients from neighboring states coming into Rhode Island and bringing health care dollars into the state, instead of health care dollars leaving the state.”
