Powering Cancer Care With Particle Accelerators at Mayo Clinic

Mayo Clinic is home to the highest-volume radiopharmaceutical practice in the world. As a result, its researchers and clinicians are well versed in radioactive isotopes of all varieties for cancer imaging and care. These radioisotopes are critical for building radiopharmaceutical treatments to target specific molecular markers on cells such as those found in cancerous tumors. But these isotopes can be difficult to come by and often do not occur naturally in our environment.

Enter particle accelerators, powerful machines for generating radioactive compounds. Particle accelerators, which include machines like cyclotrons and linear accelerators, allow medical teams to produce specific radioisotopes on demand, generating opportunities for researchers to explore new radioactive compounds and providing clinicians with the building blocks of radiopharmaceutical drugs to diagnose and treat a multitude of cancers.

Mayo Clinic is ready to install the next level of high-tech equipment to drive drug discovery and cancer therapy. This new equipment will allow Mayo Clinic to double down on leading the charge to develop new, lifesaving cancer therapies, and particle accelerators are making it possible.

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Radiopharmaceuticals for Illuminating and Eliminating Cancer

In cancer care, the radioactive isotopes generated by particle accelerators are used for two main purposes: diagnostics and treatment.

In cancer diagnostics, radioisotopes that emit relatively low amounts of energy can be combined with molecules like antibodies that can target specific markers on the surface of cancer cells. Once the molecules have attached to the cancer cells, clinicians can use a positron emission tomography (PET) scanner to visualize the energy released by the radioisotope, allowing them to pinpoint the location of tumors in the body.

When it comes to treating cancer, radioisotopes that emit high-energy particles are similarly combined with targeting molecules. In this case, however, instead of visualizing that signal on a PET scanner, the particles released by the radioisotope are absorbed by the cancerous cells. The energetic particles released by these radioisotopes, known as beta or alpha particles depending on the treatment, break apart the DNA of the cells to kill the cancer.

In both approaches, clinicians need ready access to the correct radioisotopes to develop and administer the right treatment.

Overcoming Resource Challenges With On-Demand Isotope Production

While some of the radioisotopes used for generating these treatments can be found in nature, there are a variety of reasons that it is challenging to use naturally sourced isotopes.

First, not all radioisotopes are found in the environment. Secondly, even for those found in nature, often it is not in the amount needed to produce treatments for patients, and it can be quite difficult and costly to extract and isolate the isotopes. Finally, these radioisotopes frequently decay very rapidly, meaning they release the energetic particles that make them valuable for medical applications and become inactive. This can make it difficult to transport the material to hospitals while it is still active.

The effort, expense and logistical challenges of sourcing radioisotopes from nature have led the field of medicine to turn to particle accelerators (among other manufacturing approaches), which allow for production of these compounds on demand. These machines use particle acceleration technology to fire particle beams at stable isotopes. The interaction between the beam and the stable isotope produces short-lived radioisotopes for use in medical applications.

Expanding Capabilities With Next-Generation Technology

Because these radioisotopes are unstable and decay rapidly, the ability to produce them on-site makes it possible for medical teams to quickly generate radiopharmaceutical drugs and get them to the patients who need them. This is why Mayo Clinic has cyclotron particle accelerators on each of their three campuses in Jacksonville, Florida; Phoenix, Arizona; and Rochester, Minnesota. The goal is to ensure that the patients who need these treatments can get them as soon as they need them.

However, not all accelerators are created equal. The current cyclotrons at Mayo Clinic can produce the radioisotopes needed for various types of medical imaging, such as choline-11, fluoride-18 and nitrogen-13. These radioisotopes are comparatively light. The isotopes needed for cancer treatment, such as lutetium-177, actinium-225 and radium-223, are much heavier and can’t be produced using the existing equipment. These heavier isotopes require manufacturing processes using higher-energy particle accelerators or other powerful equipment to generate the correct radioisotopes.

Larger accelerators have other benefits too. With their greater capacity, they can more quickly produce radioisotopes, providing researchers and clinicians with more access to the elements needed for research and medical use. They are also capable of generating a wider range of radioisotopes, allowing for the creation of diagnostic, therapeutic and research particles all in the same machine.

Philanthropy Fuels Innovation in Cancer Care

The Mayo Clinic Comprehensive Cancer Center sees nuclear oncology and radiopharmaceutical therapies as essential elements in the array of cancer treatment options. As research breakthroughs advance the field of theranostics for cancer diagnostics and care, so too do the efforts of clinicians and investigators to translate and apply these advances.

To stay at the forefront of nuclear medicine and ensure that our patients are never left behind due to material shortages or operational challenges, the Mayo Clinic Comprehensive Cancer Center hopes to build new, larger accelerators at each of the three campuses to ensure that all sites can produce any radioisotopes needed for all possible medical and research applications.

Mayo Clinic researchers are developing the therapies of the future, licensing these new therapies to companies, and running clinical trials to validate that they are safe and effective. Larger machines capable of producing therapeutic radionuclides allow Mayo Clinic scientists and physicians to accelerate the discovery science needed to develop these new therapies and attract the best and the brightest in the field to join the Mayo team.

The generosity of benefactors plays a crucial role in allowing Mayo Clinic to invest in cutting-edge technologies like larger accelerators, which are essential for advancing patient care. These philanthropic gifts provide the financial foundation necessary to undertake ambitious projects that might otherwise be out of reach, allowing Mayo Clinic to remain at the forefront of medical innovation.

By supporting the acquisition of advanced equipment, benefactors directly contribute to improving diagnostic capabilities and treatment options for patients, ultimately helping Mayo Clinic stay true to its primary value — putting the needs of the patient first.

The post Powering Cancer Care With Particle Accelerators at Mayo Clinic appeared first on Mayo Clinic Magazine.

On the Cutting Edge of Care

Michael Story, Ph.D., was on the road to retirement.

It was 2022, and at the end of that road he would complete an illustrious 35-year career at the interface of cancer, advanced radiation treatments and charged particle radiobiology. He’d been a renowned cancer researcher at MD Anderson Cancer Center and University of Texas-Southwestern Medical Center in the aftermath of completing his Ph.D. in cellular and molecular radiation biology from Colorado State University.

There was just one big goal he’d have to leave behind — a carbon ion radiotherapy facility. Though the original technology and facility was created in the Lawrence Berkeley National Laboratory in California, it closed in the early 1990s, leaving no facility in the United States. This left carbon ion technology to be adopted by other nations, while Dr. Story and others toiled for decades to bring it back to the U.S.  

“We kept getting slapped back — the financial climate, the Great Recession and then COVID-19,” he recalls. He started to think his big goal would be just that — fleeting images in his mind of a world-class carbon ion therapy center in the United States — until Mayo Clinic picked up the gauntlet and decided to build a carbon ion radiotherapy center at the Florida campus.

Not really wanting to retire, and especially not with a new facility so close to fruition, he called colleagues at Mayo Clinic to see if there would be any interest in having someone with his background as a part of the Mayo Clinic in Florida carbon ion radiotherapy team. The answer he got back was resounding. So much so, he now sits in his new office in the Department of Cancer Biology and Radiation Oncology at Mayo Clinic in Florida.

Retirement can wait. Dr. Story is reenergized by helping build the first hospital-based carbon ion radiation therapy center in Jacksonville.

Right Treatment, Right Patients

“That kind of work just hasn’t been done for carbon ion radiotherapy. We’re on the bleeding edge."

Dr. Story is quick to point out that not every person with cancer will be eligible for carbon ion therapy. It’s critical to get patients the exact treatment modality that will work for their cancer, whether it’s chemotherapy, surgery, immunotherapy or some form of radiotherapy. The key is to have as many options as possible.

For example, many patients can be treated with X-rays or protons and have long-lasting positive results. Carbon ions are best used for people with tumors that are radioresistant, like sarcomas and a variety of pancreatic and lung cancers, among others. In an ideal world, it would be best to tailor a patient’s therapy to treatments that are the most appropriate for their disease, whether via carbon ions or some other radiation treatment.  

Dr. Story's research aims to personalize cancer treatment by using genetic analysis to find specific patterns in tumor DNA. These patterns can indicate whether a patient might resist traditional radiation therapy. By identifying these genetic markers, doctors can better determine which patients may benefit from alternative treatments, like carbon ion radiotherapy.

“Looking at biomarkers, especially for patient selection, is a critical feature for personalizing therapy,” says Dr. Story.

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The Science Behind
Carbon Ion Therapy

Mayo Clinic is pioneering the reintroduction of carbon ion therapy in North America with the construction of a new facility in Jacksonville, Florida. This will be the first clinical carbon ion radiation therapy center of its kind on the continent.

How does this innovative therapy work, and how does it stack up against other cancer radiation therapies? Discover the science behind the treatment.

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Abundance of Experts

Dr. Story’s job is to develop the radiobiology research arm of the carbon therapy program and build a program led by multiple top-level investigators. The overall effort in radiation oncology must be multidisciplinary by its nature. It includes researchers from other disciplines, such as Chris Beltran, Ph.D., the program’s lead physicist; Sungjune Kim, M.D., Ph.D., a radiation oncologist and immunologist who leads translational biology efforts; and Brad Hoppe, M.D., M.P.H., the carbon ion radiotherapy medical director.

Together, they’re pushing at the boundaries of what we know about using carbon ion therapy to treat cancer. “Drs. Kim, Beltran and Hoppe are excellent scientists,” Dr. Story says. “We’ll be able to adapt their research from X-rays and protons to use with carbon ions quite readily.”

Mayo Clinic researchers will sample cancerous and normal tissues and examine end points of treatments to see how the course of treatment affects them — to find either advantageous or deleterious effects. This kind of work has been done for many other cancer treatments like chemotherapies, but carbon ion radiation treatment is new to the United States.

“That kind of work just hasn’t been done for carbon ion radiotherapy. We’re on the bleeding edge,” Dr. Story says.

Better understanding the effects of carbon ion therapy on healthy and cancerous tissues will allow clinicians to better tailor treatment for each patient, combining therapies to maximize their cancer-killing power and minimize off-target damage. One area of particular interest is in understanding how DNA repair pathways respond to radiation damage. Every cell in the body has these pathways to fix damage in DNA when it occurs. If there is too much damage, the cell dies. This is the idea behind all radiation therapy — overwhelming cancer cells with DNA damage while avoiding damaging normal tissues as much as possible.

Dr. Story and his team are examining how different DNA repair processes are utilized after radiation therapy to determine which pathways can be amplified or reduced to improve the efficacy of carbon ion therapy.

“What mutations in DNA repair pathway genes could make cancer cells more sensitive to carbon ion radiation?” asks Dr. Story. “What genes can be knocked down, or knocked out, that would make carbon ions that much richer?”

And, just as importantly, what cellular pathways should be protected to keep normal tissues healthy and shielded from damage to give patients the most effective treatment with the best possible outcomes?

Together, the team is working to find ways to genetically prime tumors to be destroyed, prime the immune system to target tumor cells, shield normal tissues from inadvertent damage, and put patients into the treatment pathways that will help them with speed and care.

"Drs. Kim, Beltran and Hoppe are excellent scientists. We’ll be able to adapt their research from X-rays and protons to use with carbon ions quite readily."

Forging Ahead

There will be time for Dr. Story to explore Jacksonville’s restaurants and beaches, the types of things one might do in retirement. For now, he’s busy with his new research lab while watching the Florida campus carbon ion radiotherapy center become a reality, and looking forward to the day when the first patient is treated there.

The post On the Cutting Edge of Care appeared first on Mayo Clinic Magazine.

Understanding to Innovate

By the time most students are finishing medical school, they have a pretty good idea what specialty they’re most interested in.

It took Sungjune Kim, M.D., Ph.D., a bit longer.

Dr. Kim, then a medical student at Vanderbilt University, considered multiple options. A career as a surgical oncologist was appealing, but so too was a research career, and marrying the two seemed difficult.

Dr. Kim waffled over his choice. He worried that the decision would lock him into a single track for the rest of his life. He didn’t want to limit his research options or miss out on working directly with patients. And he definitely didn’t want to stray far from the basic sciences, the first of his many academic loves.

Radiation oncology was the answer. Since 2023, Dr. Kim has been the vice chair of research in Mayo Clinic’s Department of Radiation Oncology. It’s an exciting time for the field and for patients, where an innovative technology is improving the precision and speed of care. Carbon ion therapy — also known as carbon ion radiation therapy or CIRT — can kill cancer cells that may be resistant to proton beam therapy, allowing for precise treatment with minimal damage to the surrounding tissue.

Dr. Kim works closely with Brad Hoppe, M.D., M.P.H., medical director of the Department of Radiation Oncology; physicist Chris Beltran, Ph.D.; and radiation oncologist Michael Story, Ph.D. Together, the group seeks to expand the technique’s reach. There are still unknowns about the deeper technical details of how carbon ion therapy works, which must be better understood if the therapy is to be extended to more patients.

“Because of the expenses associated with its infrastructure, we need to provide a really strong rationale for carbon ion therapy to be built to serve the U.S.,” says Dr. Kim.

Mayo Clinic is exploring carbon ion therapy from two directions. Dr. Beltran studies the physics of carbon ion and how it stimulates the immune system in ways that other particle therapies don’t. Dr. Story is building their combined carbon therapy research arm, helping to combine research to keep Mayo’s physicians up to date with critical new knowledge. This knowledge is critical to furthering carbon ion’s clinical applications.

"We really need to understand the underlying biology of carbon ion therapy to innovate the field."

Dr. Kim’s focus is on the clinical evidence for carbon ion therapy.

“We really need to understand the underlying biology of carbon ion therapy to innovate the field,” Dr. Kim says. “Because if it's a black box, and it could be just statistical noise, we would never be able to tell. So that is what I'm trying to set out to do — to give a clear rationale for why some patients may benefit from the escalated therapy with carbon ions.”

Curious From the Start

Dr. Kim excelled at math as a child in South Korea and showed enough promise to earn admission to the ultra-competitive Seoul Science High School for Gifted Students. The school is known for its rigorous selection process and the achievements of its alumni. Of the 180 students in Dr. Kim’s class, about 140 have earned Ph.D.s.

Early in his schooling, Dr. Kim believed he’d be a theoretical physicist like Albert Einstein, but he grew to feel that it would be hard to contribute much more to the field.

So he decided to study chemistry at Seoul National University. It felt like a middle ground. He could go back into physics if he wanted, given the closeness of the fields, but it also left open the possibility of biology, which he viewed as more practical.

Open image in lightbox

The Science Behind
Carbon Ion Therapy

Mayo Clinic is pioneering the reintroduction of carbon ion therapy in North America with the construction of a new facility in Jacksonville, Florida. This will be the first clinical carbon ion radiation therapy center of its kind on the continent.

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Dr. Kim’s interests changed again after he was inducted into the army in South Korea, where military service is compulsory.

Because of his strong English, he expected to serve as a liaison between the South Korean and U.S. armies. Instead, since Dr. Kim’s English was so proficient, the South Korean Army decided to put him in their own medical school to train medics.

That was his first exposure to medicine, and he wasn’t immediately sold. Initially he thought medicine was a purely clinical practice, and after his service he considered going back to a basic science research program.

“I was just flip-flopping,” Dr. Kim says. There were simply too many choices to make. So, he kept his options open while pursuing an M.D.-Ph.D. program, landing at Vanderbilt University in Nashville, Tennessee.  

Finding His Path

Dr. Kim started taking immunology classes at Vanderbilt. He was attracted to the “complex systems with complex problems that challenged your brain.”

He’d done his graduate school research on natural killer T cells, a critical cellular component of innate immune systems, a commonly mutated cell in a variety of cancers, and a common culprit in skin allergies.

As he neared graduation, he contemplated dermatology and rheumatology. Neither felt like the right fit. Instead, he gravitated to radiation oncology. Dr. Kim had the heavy physics background needed for the field, and it helped him stand out among his medical school colleagues.

Dr. Kim interviewed for residencies in 2009, before any immune checkpoint therapy like a PD-1 inhibitor had been available for patients.

“People gave me looks for being an immunologist going into radiation oncology,” he says. “Cancer immunotherapy was more of a discovery area, not in practice yet.”

During his residency, Dr. Kim was exposed for the first time to carbon ion radiation as a treatment modality. He loved the pure physics of carbon ion and was impressed with the benefits offered by the therapy.

“It has high LTE — linear energy transfer — which leads to higher relative biological effects, while retaining the treatment abilities of particle therapy,” Dr. Kim says.

Low-energy photon beams, if shot at a human body, will just bounce right off. High-energy photon beams — like X-rays — will penetrate deep into the body, but deposit radiation along their paths, which can damage healthy tissue. Carbon ion therapy has a unique physical property that precisely delivers a radiation dose within a millimeter-sized target into tumors, reducing the risk to the surrounding tissue.

While there are mysteries about carbon ion therapy, there are already some answers as to why it works. It stimulates the immune system, and it damages cancer cell DNA. The therapy hasn’t had a direct path to patient care, something Dr. Kim can relate to from his past.

In the 2000s when Dr. Kim was a student, research into new cancer immunotherapies was in its infancy, in preclinical studies in mice and cell lines.

"That is what I'm trying to set out to do — to give a clear rationale for why some patients may benefit from the escalated therapy with carbon ions."

“There was basically no human relevance at that point in time,” Dr. Kim says. But evidence began to pile up, and the field, along with Dr. Kim, took notice. “When it took off, it took off very, very quickly.” Dr. Kim and the entire Mayo Clinic radiation team — with unique expertise in the physics and immunology of the field — are expecting the same quick takeoff.

The post Understanding to Innovate appeared first on Mayo Clinic Magazine.

Knowing the Patient Experience

Chris Beltran, Ph.D., found his calling looking at the bright canvas above him. There, high above the Sangre de Cristo Mountains in rural northern New Mexico, lay constellations of stars and planets like Mercury, Venus, Mars and Jupiter.

As a student, Dr. Beltran kept focused on the skies, receiving a scholarship to study the ways Mercury disobeys Newtonian mechanics. He traveled northeast to Indiana University in Bloomington for his doctorate, intending to do experimental work on string theory.

“But there aren’t that many jobs in string theory,” he said with a laugh. So, he switched to another interest with more real-world application — nuclear physics.

At Indiana, he studied proton spallation, shooting protons at different atoms and studying what those atoms ejected in the collision. This is when he first learned about ion therapy, the cutting-edge therapy that can attack difficult-to-treat cancers that resist radiation and chemotherapy. He would come back to ion therapy and use it at Mayo Clinic, but first he returned to New Mexico to finish his doctorate at Los Alamos National Labs, which led to a residency at Mayo in 2004.

By then, work had already started on using proton therapy for cancers, and Dr. Beltran has taken the lead on improving and extending the technique.

Now as a faculty member and medical physicist at Mayo Clinic in Florida, Dr. Beltran is not only pioneering ion beam therapies, but also working to improve accessibility for the many patients for whom these techniques are often unavailable.  

Beyond the math and physics, he is working to make patients’ lives easier and calmer throughout the treatment process. 

“I want to understand what the patient goes through,” he said. “Anything you can do to actually make the treatment quality better but also decrease the amount of time patients have to spend there on the table, we should do.”

"I want to understand what the patient goes through."

That’s why Dr. Beltran has simulated the patient experience by going to the treatment table and lying motionless for the treatment’s half-hour timetable. He wants to improve future therapies in an effort to provide the best possible patient experience. 

Improving the Options

Traditional radiotherapy has been successful for a variety of cancers, but it has its drawbacks. Radiation works by wreaking havoc on a tumor cell’s DNA until the damage becomes irreparable.

But it’s difficult to focus on just the tumor — radiation can damage a patient’s normal tissue, creating single-strand breaks in cellular DNA that may or may not get repaired.

This can result in side effects, like memory loss and fatigue. On top of that, many cancer types can repair radiation-induced damage and won’t even respond to this kind of treatment.

Some cancers, like bone sarcomas in the pelvis, can grow so rapidly and with such tenacity that the dose of radiation needed to combat it would just harm the patient more. Hypoxic and recurring tumors are also frequently beyond the reach of radiation or chemotherapy. 

Proton therapy is a promising alternative that uses a synchrotron, a particle accelerator, to whip protons into a swiftly moving stream that can more directly damage tumors with fewer side effects. And Mayo Clinic, with Dr. Beltran as part of a dynamic leadership team, is bringing a new improvement over proton therapy: carbon ion therapy.

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The Science Behind
Carbon Ion Therapy

Mayo Clinic is pioneering the reintroduction of carbon ion therapy in North America with the construction of a new facility in Jacksonville, Florida. This will be the first clinical carbon ion radiation therapy center of its kind on the continent.

How does this innovative therapy work, and how does it stack up against other cancer radiation therapies? Discover the science behind the treatment.

Read More

All these treatments have the same general scientific concept — hurl high-energy particles at cancer cells to destroy their genomes — but carbon ion therapy comes with a quantum leap of precision. A carbon ion is 12 times heavier than a proton and delivers magnitudes more energy in tighter clusters. 

“This creates a bunch of breaks in small areas, like little explosions,” says Dr. Beltran. “You create so many breaks that the cell can’t repair them all and it dies.”

Radiotherapies also stimulate tumors to release antigens into the bloodstream, with carbon ion therapy producing more antigens than previous methods.

That means, Dr. Beltran says, that it could be nicely combined with something like chimeric antigen receptor T-cell therapy — known as CAR-T — where immune cells are programmed to detect specific antigens and attack tumors.

Thinking of Patients

Through all his experience, Dr. Beltran has learned a critical bit of wisdom when building medical treatments: think of the patient perspective.

“The technical aspects of this fall on me and my team. When we turn on the beam, we have to get the best-quality treatment to the patient,” says Dr. Beltran. “Patients are coming in every day for several weeks, and we need to provide the best experience possible for them.”

Dr. Beltran views his position — a physicist surrounded by doctors, nurses and patients — as a critical fulcrum for many patient outcomes.

“It’s our responsibility to understand all the fundamental physics and to communicate it to the medical staff, the doctors and nurses, so they can communicate it to the patients,” he says. “With carbon ion therapy it’s not just the physics — there’s the biological aspect.

“Normal tissues and tumors react differently, so when something does come up, you can have an informed opinion on different cases.”

Mayo Clinic is investing more than $233 million in a transformational proton and carbon ion center known as the Integrated Oncology Building at its Florida campus, and Dr. Beltran is involved every step of the way.

Millions of electrical connections are being made just for the synchrotron alone, with shielding 3- to 5-feet thick. The synchrotron itself has a 60-meter circumference, is made up of hundreds of tons of auxiliary equipment, and can hit a tumor with precision within 1 millimeter. The facility is the size of a football field. Dr. Beltran wants to be there when it’s all put in place.  

“I go once a week to look at the building and see how it’s coming up,” he says.

Besides checking in on the new center, he frequently visits Japan — where carbon ion therapy is already in use — to meet with collaborators and inspect equipment that the electronics manufacturer Hitachi is producing for the center. Hitachi had never built the kind of facility that Dr. Beltran is working on — one that can deliver both proton and carbon ion therapies simultaneously. 

However, just bringing new technologies and new treatment options to the United States isn’t enough. Mayo’s ion therapy center in Florida will be the first and only of its kind in the Western Hemisphere.

"It’s very important for the U.S. to be at the forefront of clinical therapies and patient experiences. I’m glad Mayo Clinic is leading the way."

Dr. Beltran estimates that between 30,000 and 200,000 patients per year in the United States could benefit from carbon ion therapy alone. The new facility initially will be able to handle 300 carbon ion patients per year. That leads Dr. Beltran to his true North Star for the patient experience — making these therapies even more accessible to all.

“It’s very important for the U.S. to be at the forefront of clinical therapies and patient experiences,” Dr. Beltran says. “I’m glad Mayo Clinic is leading the way.”

The post Knowing the Patient Experience appeared first on Mayo Clinic Magazine.

How does this innovative therapy work, and how does it stack up against other cancer radiation therapies?

How Does Carbon Ion Therapy Work?

Carbon ion therapy is a type of radiation treatment that uses beams of carbon ions to target and destroy cancerous tumors. At its core, carbon ion therapy works by accelerating carbon atoms to nearly the speed of light and stripping them of their electrons, creating positively charged carbon ions that are sent directly into the tumor. Within the tumor, these ions damage the DNA of the cancer cells. This leads to breaks in the chromosomes that can kill the cells.

When carbon ions enter the body, they deposit most of their energy at a specific depth, known as the Bragg peak, which can be adjusted to coincide with the location of the tumor. This means that the radiation from the carbon ions can be finely tuned to just that targeted location, damaging and killing cancer cells while minimizing damage to the surrounding tissue. This precision is especially important when treating cancers located near or in vulnerable or sensitive parts of the body.

How Does Carbon Ion Therapy Compare to Other Radiation Therapies?

Radiation therapy has been a part of cancer treatment for over a century and is currently used in approximately half of the people diagnosed with invasive cancers in the U.S. Conventional radiation therapy uses X-rays, which kill cancer cells using a beam of high-energy photons. However, X-rays can’t be precisely targeted. In addition, due to the molecular makeup of the tumor, some cancers are radioresistant and don’t respond well to X-ray therapy.

Proton therapy uses protons, which have mass and charge as opposed to photons, allowing for more precisely targeted radiation to the cancer. This ensures most of the radiation falls within the target, reducing the amount of radiation that hits normal tissue, which is expected to minimize side effects from treatment.

Carbon ions are bigger and more massive than protons, which means they are more effective at killing cancer cells than protons or photons. They are so powerful that they can even kill cancer cells that are resistant to proton and X-ray radiation. All these traits mean that carbon ion therapy can be used to precisely target and kill tumor cells while minimizing the damage to the surrounding healthy tissue, and that patients can be treated with a lower dose of radiation and fewer treatments.

Possible side effects of carbon ion therapy include those commonly seen with other radiation therapies, such as hair loss, fatigue, headaches and skin reactions.

Where Is Carbon Ion Therapy Available?

There are many challenges facing the widespread use of carbon ion therapy because of the significant infrastructure and costs required to build and operate carbon ion facilities. In 2023, there were only 15 carbon ion therapy centers worldwide, across Asia and Europe.

Mayo Clinic is developing its new carbon ion therapy center in Jacksonville in partnership with Hitachi Ltd., experts in particle therapy technologies. It will be part of an integrated oncology facility that also includes proton therapy and conventional radiation treatments.

Mayo Clinic has been studying carbon ion therapy since the 2010s, with its radiation oncologists and physicists gaining expertise through collaborations with centers in Asia and Europe. The new facility will enable Mayo Clinic to conduct clinical trials and further research into the efficacy of carbon ion therapy for various cancer types. This research will explore new and expanded treatment options, including combining different kinds of therapies.

The construction of the new facility at Mayo Clinic in Florida is already underway, with the first carbon ion treatments expected to be available by 2028. Adding carbon ion therapy to Mayo Clinic’s patient care offerings will enable the organization to continue providing comprehensive and cutting-edge cancer care. This will allow Mayo Clinic’s care teams to continue offering patients access to a full spectrum of treatment options, enhancing the ability to tailor therapies to individual needs and improving outcomes for patients.

The post What Is Carbon Ion Therapy? A Look Inside the Cancer Treatment appeared first on Mayo Clinic Magazine.

Across the globe, we are providing 21st century healthcare in 20th century buildings. Not only do we need new and better spaces, but we must also rethink how we use space in healthcare, including how to merge inpatient, outpatient and digital care into a platform model of healthcare that is seamless, dynamic and self-improving.

A History of Transformation

Mayo Clinic has a rich history of inventing and reinventing the future of exceptional, Category-of-One care for patients. For example, in 1928, Mayo Clinic opened the Plummer Building, which fostered the integrated group practice of medicine by bringing together multiple medical specialists under one roof and facilitating medical record sharing via an innovative pneumatic tube system. Three decades later, Mayo Clinic studied and developed a novel concept at the time — the radial or “circular” nursing unit, with a central desk surrounded by patient rooms that enabled the care team to see all the patients, all of the time. These design concepts became models for how people practiced medicine in the United States.

Today, we continue to lead patient-centered healthcare transformation through our Bold. Forward. strategy, which importantly includes designing space for the future of care. Launched five years ago, Bold. Forward. aims to discover more Cures for our patients; Connect people and data to create new scalable knowledge; and Transform our entire healthcare system from a linear pipeline model to an entirely new model — a scalable, highly collaborative platform model. But to accomplish Bold. Forward., we must also think creatively about the space we need for our patients, our staff, and a transformed healthcare system.

Bold. Forward. Unbound.

Bold. Forward. Unbound. is our vision for the future of healthcare infrastructure and represents a once-in-three-generations investment across all our sites. Physical transformation is already underway at Mayo Clinic in Florida, Mayo Clinic in Arizona, and Mayo Clinic Health System, and the Bold. Forward. Unbound. in Rochester plan was unveiled last fall.

The goal of Bold. Forward. Unbound. is not simply different buildings, but radically better spaces that bring teams and patients together in an environment that is designed to transform the patient experience, advance teamwork, create more cures, and improve outcomes.

The physical spaces where today’s care teams work, conduct research and train future healthcare leaders are central components of what makes exceptional care possible, but they are now largely obsolete. To create the future of care, we must invest in physical infrastructure that takes into account the evolving needs of patients with serious or complex care needs, their families and healthcare staff.

Imagine a healthcare world where a patient’s hospital room is an integral part of their care team, where physical infrastructure is complemented by artificial intelligence and robotics operating in the background to provide added support for clinicians and nurses so they can spend more time with their patients. Bold. Forward. Unbound. brings to life this future state of care where a patient’s room sees, hears, anticipates and reacts to their needs alongside their care team to re-imagine the experience of healthcare.

Bold. Forward. Unbound. in Rochester

Bold. Forward. Unbound. in Rochester is our biggest, most ambitious and most forward-looking vision for healthcare physical infrastructure. Like the Plummer Building in 1928 and the circular unit in 1957, Bold. Forward. Unbound. in Rochester will serve as an inspiration for the future of healthcare.

At first glance, it may appear that we’re simply constructing a few new buildings in Rochester. But inside those buildings lies transformational change that will blur the lines across hospital, clinic and digital care to meet patients’ needs — wherever they are.

Flexible Spaces With People at the Center

Our new buildings, designed in collaboration with Foster + Partners and CannonDesign, are being built with a universal, flexible grid to allow the building to adapt to change over time. We will provide patients with personalized arrival experiences tailored to their specific healthcare needs, with spaces designed to transition patients intuitively among diagnostic imaging suites, to operating rooms, to patient rooms throughout their stay. Spaces will also adapt seamlessly to digital, outpatient, inpatient and post-hospital care needs as they arise, allowing the care team to personalize care for patients and their loved ones.

Our new spaces will include built-in resources to deliver next-generation care experiences. For example, we are designing spaces that integrate automation to streamline daily tasks, such as reminding hospitalized patients about their upcoming tests as well as incorporating predictive AI tools to help clinicians make early diagnoses. With these efforts, our patient rooms and other spaces truly enable better healthcare and become another member of the care team.

Of course, we also want our spaces to be warm and welcoming for patients, who often come to us at vulnerable times of their lives, and therefore we have created “neighborhoods” that will serve as “home” while they are receiving care. Neighborhoods bring familiarity to our spaces, conveniently locating essential services in close proximity to patients and care teams to minimize trips across campus and better support our collaborative model of care. Neighborhoods will also feature natural materials, sunlight, winter gardens and interconnected public spaces to create a calming atmosphere that supports a patient’s overall well-being.

Arizona. Bold. Forward: Building Synergies Between Research and Education

Each Mayo Clinic campus has unique needs based on the regions it serves, but all share a common mission to serve as a beacon of hope and healing to those in need. Mayo Clinic launched Arizona. Bold. Forward. to better serve the growing complex care needs of the Southwest, a project that not only doubled the campus size to accommodate more patients but is also transforming care delivery and research and education capabilities.

Like in Rochester, Arizona. Bold. Forward. is adding remote care platforms for chronic and acute care needs and advanced AI protocols to better predict and more reliably treat complex and serious illnesses.

Additionally, a new Integrated Education and Research Building will fuse medical education and research, bringing scientists side by side with learners to find new answers while simultaneously training future healthcare leaders. Within this new space, we are integrating technology to provide next-generation medical training, including organizing our multidisciplinary teams around common research focus areas and sharing critical technologies such as augmented and virtual reality training scenarios and 3D-model rendering for radiographic images and biological specimens. With the new building in close proximity to Discovery Oasis and the Arizona State University Health Futures Center, Mayo Clinic in Arizona’s campus will transform into a highly collaborative innovation hub focused on finding new cures and growing the workforce of tomorrow.

Mayo Clinic in Florida: Advancing cancer care, creating a healing environment

Bold. Forward. Unbound. in Florida is creating a smart campus through human-centered spaces that expand patient care capabilities, biomedical research and education, all connected through integrated technology.

With an added 750,000 square feet by 2026, Mayo Clinic in Florida’s campus will transform into a member of the patient’s care team. Patient rooms will be meticulously designed to promote healing, connection and adaptability, equipped with ambient clinical intelligence and wireless vitals monitoring to allow care teams to gather just-in-time clinical information with minimal disruptions. Technology will become nearly invisible to the patient, allowing care teams to maintain personal connections to their patients while having access to resources that continuously improve outcomes.

To further create a healing environment, our designs will increase sunlight in patient rooms by over 80%, and rooms will be equipped to react to patient preferences, such as voice commands to adjust room lighting or temperature. Behind the scenes, care teams will benefit from added automation to support clinical documentation, supply needs and fall-risk notifications.

As we look to better meet the needs of our patients with novel treatment options, a new integrated oncology building will give patients more access to cutting-edge cancer treatment options through proton beam therapy and North America’s first carbon ion therapy unit. Located near other hematology and oncology services, the new building will further integrate cancer care on the Florida campus to create a more seamless, coordinated care experience.

Mayo Clinic Health System: Transforming Community Care

We must think innovatively about what the future of healthcare looks like for everyone, regardless of physical location. Community-based patients deserve access to timely, specialty care, delivered by compassionate care teams equipped with Category-of-One resources and technology. Expansions at our community-based facilities, Mayo Clinic Health System in La Crosse and Mankato, will transform local healthcare and set the standard for community health systems nationally through future-oriented spaces designed for convenience, safety and quality.

Within these new spaces, patients will have connected care experiences tailored to their unique needs, including virtual access to subspecialty clinicians at Mayo Clinic in Rochester, to get the answers they need without leaving their communities. Patients and staff also will feel more connected to care plans with the addition of smartboards in patient rooms, virtual nursing resources and digital technology to enhance workflows.

A new 96-bed tower in La Crosse, Wisconsin, will bring an unparalleled care experience to community-based patients, integrating these new technologies alongside design enhancements aimed at elevating the overall experience for both patients and staff.

At Mayo Clinic Health System in Mankato, three new recently opened floors are modernizing the patient care environment through automation, noise-reducing architectural enhancements, larger spaces for patient care and staff support, and more. Both projects are bringing transformed environments required to best serve our community patients with consistent and connected care experiences that preserve human interaction while leveraging novel technologies that are advancing cures.

Harmonizing Physical and Digital for the Future of Care

Physical infrastructure and digital capabilities must work together to create the future of care. By successfully integrating the two, we can create a higher-quality, more sustainable healthcare system that will better serve everybody.

This article was originally published on LinkedIn. 

The post Reimagining Healthcare Buildings appeared first on Mayo Clinic Magazine.

This installation marks one of the final projects of Arizona. Bold. Forward. and represents the future of patient care at Mayo Clinic.  

One of the largest capital expansion projects in Mayo Clinic history, Arizona. Bold. Forward. doubled the size of the Phoenix campus in just four years, significantly increasing its capacity to meet the needs of patients. 

The 7T MRI is the first and only MRI of this magnetic field strength used for patient care in Arizona. With its addition, all three Mayo Clinic campuses now have the cutting-edge technology. Mayo Clinic in Minnesota became the first center in North America to use clinical 7T MRI in late 2017, and a second 7T scanner was installed at Mayo Clinic in Florida in 2021.  

Advanced Diagnostic Applications 

The 7T MRI scanner provides more than twice the magnetic field strength of a conventional 3-Tesla (3T) scanner to deliver ultrafine image resolution of the head and extremities.  

MRI — magnetic resonance imaging — scanners use magnetic fields, measured in teslas, and radio waves to create detailed images of organs and tissues in the body. The magnetic field strength, in part, determines the amount of anatomical detail that can be obtained in the images. 

The 7T MRI noninvasively reaches deep into the body, allowing physicians to see anatomical details that were previously invisible, leading to more accurate diagnoses and targeted treatment plans.  

For example, the 7T MRI can reveal subtle brain lesions caused by trauma or multiple sclerosis that might be missed by conventional MRI scans. It can also provide more detailed images of knee cartilage and other tissues, improving noninvasive diagnoses. 

As an early adopter of this technology, Mayo Clinic pioneered the development of advanced clinical imaging protocols, exploiting the high magnetic field strength to push the boundaries of our ability to detect subtle pathologies. Mayo Clinic was also central to efforts to develop safety procedures for this technology. 

Mayo Clinic is one of the few centers that routinely uses 7T MRI to assess individuals with epilepsy. This advanced imaging technology can identify epileptogenic lesions that 3T MRI often misses, increasing the chances of the patient achieving seizure freedom.  

Enhancing Neurological Research 

Beyond its immediate clinical applications, the 7T MRI allows Mayo Clinic neuroradiologists to develop tools to assess patients with unprecedented accuracy. 

The 7T MRI is instrumental in research efforts aimed at understanding and treating conditions like transient global amnesia (TGA) and leukoencephalopathy. 

Researchers used 7T MRI to identify a persistent lesion in the hippocampus of a patient with TGA eight months post-episode. This finding suggests TGA may cause more enduring brain changes than previously believed.  

7T MRI has also been used to detect specific brain calcifications in a young woman with a family history of colony-stimulating factor-1 receptor (CSF1R)-related leukoencephalopathy. These abnormalities, missed by regular neurological exams and 3T MRI, led to better treatment decisions and referral to a clinical trial. 

Mayo Clinic has also developed 7T MRI protocols for these conditions: 

• A novel imaging protocol and stereotactic head frame localizer was developed to perform treatment planning for deep brain stimulation (DBS) electrode placement. 

• A novel protocol allows for imaging neuromelanin in the brain, aiding in Parkinson's disease detection by identifying reduced neuromelanin levels and elevated iron content. 

• High-resolution 7T MRI can detect specific changes in the motor cortex, facilitating earlier diagnosis and treatment intervention for amyotrophic lateral sclerosis (ALS). 

Use of the 7T MRI scanner underscores Mayo Clinic's unwavering commitment to providing patients with the most advanced diagnostic and treatment options available. This technology empowers physicians to deliver exceptional care and paves the way for groundbreaking discoveries that will shape the future of medicine. 

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In 2019, Mayo Clinic embarked on plans to transform the Phoenix campus. The $748 million investment allowed the campus to double in size, including an expanded emergency department, cutting-edge lab space, 99 additional patient beds, five state-of-the-art operating rooms, and the groundbreaking Integrated Education and Research Building.  

Mayo Clinic in Arizona highlights patient-centric design to promote healing through innovative technology and flexible care spaces — allowing staff to serve more patients and address their individual needs. 

To support a project of this magnitude, Mayo Clinic set an ambitious goal of raising $250 million by the end of 2024. United in vision and unwavering dedication, more than 300 benefactors invested in Arizona. Bold. Forward., allowing Mayo Clinic to officially surpass that mark in the second half of 2023.  

Building on the momentum of Arizona. Bold. Forward., expansion efforts will continue through the Discovery Oasis initiative, a new innovative biotech hub that will combine Mayo Clinic’s multidisciplinary expertise and like-minded economic development partners.   

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That’s the motivation behind the newly remodeled Bundy Kitchen + Market at Mayo Clinic in Florida. The cafe is named after Russ and Liz Bundy and reflects their family’s desire to create a comfortable place for caregivers and patients between appointments.

It’s also meaningful for the Bundy family because of their background in the service industry, which began when Russ sold baking pans out of the trunk of his car in the 1960s. Now, the company founded by Russ and his wife, Liz, is known as Bundy Baking Solutions, and it provides baking pans, coatings and equipment to bakers around the world.

The Bundys are strong believers in Mayo Clinic, supporting its mission with gifts to capital efforts in Florida as well as arthritis research and a lectureship. Mayo Clinic recognizes the Bundy family as Principal Benefactors.

“Nothing brings us greater peace than sharing moments with family and friends, and these moments are especially important during challenging times,” Russ and Liz say. “We wanted to create a space that would bring comfort to patients and their families while receiving care at Mayo Clinic, and we’re delighted to see that vision come to life.”

In the cafe, one new option that’s part of the re-imagined menu is the Bundy bison burger, which is a favorite in the Bundy household and celebrates the generational relationship the Bundy family has with Mayo Clinic.

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Clyde and Sherry Moore have learned many lessons through Sherry's 21-year journey with cancer and the recent pandemic. One sticks out more than others.

"The future is uncertain," Clyde says. "But the most powerful thing we can do is help other people right now."

There's a simplicity and peace in the Moores' approach.

Simple Items, Significant Impact

An unremarkable 3-by-5 index card held by a remarkable physician.

That's what the Moores remember when they first met Craig B. Reeder, M.D., a Mayo Clinic hematologist, on Sherry's first consultation in 2005.

The card carried heavy symbolic weight for Sherry. Used to physicians carrying reams of medical records, the basic white card became a sign of simplicity on her complex path to healing.

In 2000, Sherry was diagnosed in Memphis, Tennessee, with low-grade non-Hodgkin lymphoma — a type of cancer that originates in the lymphatic system. In non-Hodgkin lymphoma, tumors develop from lymphocytes, a type of white blood cell.  

Through a series of chemotherapy and radiation treatments, Sherry was on the path to remission. When the Moores retired to Arizona, Sherry’s physician in Memphis referred her to Mayo Clinic in Arizona for continued care.

But nearing her five-year remission milestone, Sherry received troubling results from routine bloodwork — she was losing red blood cells. They turned to Mayo Clinic for answers.

A Strong Start, A Twisting Path

Dr. Reeder impressed the Moores from the start by explaining the Mayo Clinic Model of Care, a set of principles that guide how Mayo Clinic practices medicine, including the collaboration of specialists from across disciplines. The Moores and Dr. Reeder also connected on a more personal level — their mutual love of dogs.  

For Sherry, a team of experts uncovered a very rare cause contributing to her deteriorating condition — her combination of medications conflicted with an over-the-counter supplement. She stopped taking the supplement and the problem resolved.   

But Sherry's cancer evolved with a series of recurrent tumors and subsequent treatments. In 2006, a scan revealed a more aggressive tumor had spread to another part of her body.

“As soon as Dr. Reeder saw that scan, he said, ‘Let's start thinking about what a stem cell transplant might do for you,’” Sherry says. “That's when he really got my attention.”

The Moores had investigated the idea of a stem cell transplant years prior but chose not to pursue it further out of fear of devastating side effects. This time, Dr. Reeder's recommendation put Sherry more at ease, and she agreed to an autologous stem cell transplant, which uses healthy blood stem cells from the patient’s body to replace their diseased or damaged bone marrow. 

Sherry's path to remission wasn't smooth. She ended up having complications before and following the stem cell transplant and spent a month at Mayo Clinic Hospital in Arizona. Looking back, there were moments of fear because of the unknown.

Ultimately, the transplant was a success, and the Moores credit the caring, competent staff at Mayo Clinic for carrying them through.

“Mayo is not only a hospital, it is actually a medical system where people put their money where their mouth is,” Clyde says. “They know what they are doing, and they are helping other people.”

Rising to meet future challenges

Arizona. Bold. Forward. is the largest and most visionary capital expansion project in Mayo Clinic history.

By 2024, Mayo Clinic will double the size of the Phoenix, Arizona, campus. Through a combination of new buildings and additions to existing structures, Arizona. Bold. Forward. will provide the necessary infrastructure to support advanced activities across the practice, research and education; to increase access for patients, accelerate new platforms for innovation; and provide more opportunities for research and education.

A Gracious Gift

In 2011, Sherry successfully entered remission. Upon their final visit with Dr. Reeder, Sherry brought a small parting gift — treats for his dogs — a nod to their mutual love for their furry family members.

But that was not all. Reflecting on Sherry’s cancer journey and Dr. Reeder’s care, 10 years later the Moores decided to do even more. 

Clyde and Sherry made a generous gift to Arizona. Bold. Forward. in honor of Dr. Reeder when they learned about the project's immediate impact as Mayo Clinic's largest and most visionary capital expansion in history, which remains on track despite the pandemic.

Mayo Clinic recognizes the Moores as Principal Benefactors and members of The Mayo Legacy. To honor their generosity, the lounge area in the Mayo Clinic Building on the Phoenix campus is named on behalf of Dr. Reeder's medical excellence. Each day, Dr. Reeder is reminded of Sherry, and the many grateful patients to whom he has dedicated his life’s work.

The Moores recognize that the generous investment of those who came before them made it possible for Sherry to access lifesaving treatment at Mayo Clinic. Out of that gratitude, the Moores invest in Mayo Clinic now to support greater access to care and new research capabilities to help patients like Sherry in the future.

“It is going to make such a big difference to patients,” Sherry says. “Frankly, we were impressed by the scale of Arizona. Bold. Forward. It's a huge project, and only Mayo could attempt something like this and make it work. We have confidence in Mayo, and this project will allow Mayo to help more people.”

Join us today to bring a transformative new health care experience to more patients who need us. Together, we can build the future of medicine at Mayo Clinic.

Disclaimer: The individuals featured in images were alone in an outdoor setting following social distancing guidelines, and therefore in compliance with Mayo Clinic’s COVID-19 safety guidelines while unmasked.

The post Arizona Benefactors Give to Ensure Future Generations Receive Mayo Clinic Care appeared first on Mayo Clinic Magazine.