The Beam: Updates from proton patients; new CT machine; alcohol and cancer; meet our new IT specialist

Updates from four proton therapy patients and their intentions for the new year

The turn of the calendar year marks a natural time to check in, evaluate goals, measure success and reset for the coming year and former patients of Fred Hutch Cancer Center – Proton Therapy are no different. Four patients shared updates on their health and their goals for the year. 

Matt Randall, age 30, from Tacoma, Wash., was diagnosed with his third bout of cancer in 2020 — he went through childhood cancer twice. This time it was Hodgkin lymphoma, a rare lymphoma subtype. Randall finished treatment in March 2022 and recently received news from his care team that a surgical biopsy revealed no signs of lymphoma. 

Randall is starting his junior year at the University of Washington, working towards a bachelor’s degree in psychology with a focus on mental health counseling.

“I decided to study mental health because I struggled significantly with my own mental health while battling cancer during the pandemic,” he said.  “I’m also very relationship-oriented and have the gift of gab, so if I can get paid to listen and talk with others through hardships, then I'll be using my innate skills for good.”

His plans for the year are to study hard in the spring, fall and winter, and spend time outdoors rock climbing in the summer.

“My favorite place to climb is on Mt. Erie on Washington's Fidalgo Island,” he said. “With no need for further treatment as of right now, I can spend more time having fun.”

Kathy Gill was treated at Fred Hutch for a type of breast cancer called invasive lobular carcinoma in 2017.

Gill went through treatment and was cancer free for several years, however, her physicians discovered small cancer lesions on her spine in the spring of 2024. She was tested to see if she could join a clinical trial; so far, she has responded very well to her new treatment. 

“The daily [cancer inhibiting] pills can leave me feeling a bit fatigued but I've learned to nap without guilt,” she said. “I'm grateful to be living near such a first-class cancer center as Fred Hutch.”

Gill resolved to stay busy despite cancer treatment. She retired from the University of Washington last July after teaching there for 21 years. Now she’s auditing classes through Washington ACCESS Program, which provides discounted tuition to Washington state residents aged 60 and older, space-permitting.

She’s also looking forward to traveling in between her classes.

“My husband and I are going to Iceland and Scotland in May, scheduled in between my monthly estrogen-blocking injections,” said Gill. “We are both very excited because it's been several years since we were in Europe. I'm also planning an annual April trip with five women to the Outer Banks. We’ll share a house on the beach. It's the first time I have been the chief planner!”

Gill also plans to remodel her kitchen and hopes to resume weekly qigong sessions with other cancer patients and survivors, whom she met through Cancer Lifeline in 2017.

Hedley Elliot and his mother, Alaynna Elliot, are doing well and staying optimistic after Hedley, at 8 years old, received proton therapy for a third brain cancer recurrence in summer 2023. He and his family traveled from their home in California following guidance from their brain tumor team and radiation oncologist, who thought proton radiation might be able to destroy any lingering tumor cells.

“Now, we’re on a good track with our health and happiness for all our family,” said Alaynna Elliot.

This past winter, some of Hedley’s Australian relatives visited them in California. They spent time together in Lake Tahoe drawing, watching movies and reconnecting as a family.

“I think being able to make life as normal as possible is important,” Elliot said. “Having support from family and friends is such a big part of normalcy.”

Hedley will start middle school this fall because his growth was stunted due to the tumor and the subsequent treatment he had when he was 4, he’s taking growth hormones to help him catch up on his height.

“Both mean that he’s growing up and hopefully growing taller, too,” said Elliot. “This year we’re looking forward — to making plans for middle school and seeing what comes in the next school chapter.”

David Rosenberg was diagnosed in early 2023 with throat cancer, shortly after having received neurosurgery for a spine condition. His throat cancer was treated with proton therapy since the precision of proton therapy means more healthy tissue is spared from radiation.

Although he found the science behind proton therapy fascinating, Rosenberg said he especially appreciated the staff. 

His scans and scopes continue to show no evidence of disease. He does have lingering side effects like some lymphedema in his neck and chin. And, as a result of the spine surgery and radiation, he has some discomfort in his neck for which he sees Fred Hutch’s physical therapists.

“Emotionally, I feel grateful every day,” said Rosenberg. “I have the same sources of stress that most people have, including sending my daughter to college next year. However, I put these into context because less than two years ago, my goal was just to be there when she went to college.”

Because he feels so grateful for the care he received, Rosenberg began to volunteer as a patient advisor with Fred Hutch.

“I am really looking forward to participating and helping others,” he said. “It feels like 2025 will be an important year because I am reaching the two-year post-treatment. I really look forward to seeing what happens and how I can make a positive impact.”

Rosenberg said that having had cancer made him want to be the best he can, each day. In addition to giving back as an advisor, he’s trying to visit more new places, make dinners together with his family and catch some live music when he can. He’s working out and enjoying life.

Proton therapy facility gets new CT machine

Starting later in February, patients will receive their CT simulation on the new, state-of-the-art Siemens dual energy (DE) CT machine currently being installed and commissioned at Fred Hutch Cancer Center – Proton Therapy.

Cancer treatment centers and hospitals continually monitor their equipment. Recently, Fred Hutch made the decision to install a much more powerful dual-energy CT imaging system, ideal for use in proton planning.

“Dual energy CTs help us in different aspects of treatment planning,” said Stephen R. Bowen, PhD, DABR, professor of radiation oncology and radiology at the University of Washington, who manages technical upgrades of the radiation oncology CT machines used across Fred Hutch and UW Medicine clinics.

Bowen explained that the CT scanner splits the X-ray beam that’s used to get the images of the body into higher and lower energy beams following different paths so that the images generated contain more detailed information. 

“Not only can we measure the density of the tissue reported by traditional CT scanners, but we can also see the elemental makeup of the tissue in terms of water, fat, calcium and iodine contrast content,” he said. “This extra imaging formation can assist our clinicians to identify and contour tumors with greater confidence.”

In addition, the DECT machine gives clinicians information about the stopping power ratio of protons, which is critical to proton therapy dosimetry. On conventional CT images, there are uncertainties on how different tissues slow and stop protons. This means that dosimetrists and physicists must build proton beam margins into the treatment plan. With the new DECT machine, these proton range margins can be reduced for certain patient plans, making proton therapy even more precise.

The new machine comes with additional features that will help improve the clinical workflow of radiation oncologists, dosimetrists and therapists.

“We will be able to reconstruct images out to greater distances to include all patient support devices,” said Bowen, “which gives the dosimetry team more flexibility in their plans. The scanner will also reduce artifacts from a variety of metal implants, which on older systems leave streaks in the image. It will be better for scanning larger patients by generating higher quality images deeper in the body through what we call beam hardening corrections.”

The new machine comes equipped with a Varian camera that interfaces with the scanner to give information on a patient’s breathing as part of four-dimensional (4D) CT imaging. The system adapts in real time, pausing the CT scanner if a patient’s breathing becomes irregular, such as from coughing, and resuming the scan under regular breathing conditions to ensure more reliable 4D CT simulations.

The simulator suite will include the C-RAD surface imaging system, which guides initial patient setup and monitors patient setup throughout treatment. The C-RAD camera captures the image of the patient’s surface in their treatment position and sends this image to the C-RAD cameras in the treatment rooms. This allows precise real-time position verification in the event that a patient shifts out of position during treatment delivery and the radiation therapists can pause the beam and reposition the patient if necessary.

The DECT machine also features a cardiac imaging solution that supports SBRT (photon) planning to treat ventricular tachycardia, which is an arrythmia from false electrical signals within the heart.

Bowen is enthusiastic about the clinical potential of the new CT scanner, explaining that the team can future proof it as much as possible. 

Alcohol and cancer risk

By Laura Martinell, RD, CSO, CNSC

You may have seen the recent headlines about alcohol causing cancer and wondered what this means for your personal alcohol intake.

In January, the U.S. Surgeon General put out an advisory on alcohol and cancer risk. It's been known since the late 1980s that there are correlations between alcohol and cancer, and evidence has strengthened over time. Alcohol use is a leading preventable cause of cancer in the United States, contributing to nearly 100,000 cancer cases each year, according to the Surgeon General's Office.

Alcohol is known to be a class 1 carcinogen (cancer-causing substance) which is considered the highest level of carcinogenicity within the International Agency for Research on Cancer (IARC) classification system. Other examples of class 1 carcinogens include tobacco smoke, asbestos and UV radiation from the sun. 

Consuming alcohol in any amount increases the risk of developing at least seven types of cancer including mouth (oral cavity), throat (pharynx), voice box (larynx), esophagus, breast, liver and colon. How does alcohol increase cancer risk? There are several ways:

1. Alcohol breaks down into acetaldehyde which damages DNA and prevents your body from repairing that damage, causing an increased risk of cancer.
2. Alcohol causes oxidative stress, increasing the risk of cancer by damaging DNA, proteins and cells and increasing inflammation.
3. Alcohol alters levels of multiple hormones including estrogen, which can increase the risk of breast cancer.
4. Alcohol leads to greater absorption of carcinogens by reducing folate absorption in our bodies. Folate and vitamin B can help the body maintain DNA integrity and reduce the risk of DNA mutations.

What happens if I stop drinking? 

The good news is that reducing or stopping your intake of alcohol can lower your cancer risk over time. 

Does it matter what type of alcohol I drink? 

No. When it comes to cancer risk, all alcohol has the same effect. You may have heard that a glass of red wine is good for heart health. However, it’s likely the resveratrol (a phytonutrient) in the skin of grapes that has antioxidant and anti-inflammatory properties that may reduce the risk of cardiovascular disease. Other food sources of resveratrol include peanuts, pistachios, grapes, blueberries, cranberries and even cocoa and dark chocolate.

You can still enjoy a drink in the form of a mocktail. Here are some ideas of non-alcoholic drinks from Cook For Your Life:

• Mock Sangria
• Pomegranate Lime Sour
• Orange Mint Twist

For most people —even people who drink very little — it can be hard to give up alcohol. The truth is, risk is nuanced and has multiple factors, but if you want to help reduce your risk, you should limit or eliminate alcohol use.

Meet IT specialist Frank Romero

Frank Romero is the newest member of the Information Technology Department at the Fred Hutch proton therapy facility. Before joining the proton IT team, he worked in Fred Hutch IT helping research departments and clinical operations at the South Lake Union campus and also the Northwest hospital campus.

Before he came to Fred Hutch, he worked for Microsoft, helping with the release of Microsoft Edge and providing support around the world for multiple platforms. 

“While I was working at the Northwest [hospital] campus, I was asked if I would be interested in shadowing the proton therapy facility. I enjoyed the type of support and care we provide here at this center so much that I stayed,” said Romero. “I like helping people and figuring out ways to improve accessibility and I love being able to keep learning at work.”

Romero was born in Kake, Alaska and spent some childhood years in Juneau, before he and his family moved to North Seattle 15 years ago. His grandmother is Tlingit and leads multiple groups and organized powwows, a North American Indian ceremony involving feasting, singing and dancing, which influenced Romero’s respect for nature, wildlife and the ocean.

Romero and his family moved to Washington state seeking better health care following a childhood accident he had, which Romero credits for his respect for physicians and care teams. Now he wants to give back whenever he can.

When he’s not doing his part to keep IT operations at the proton therapy facility running smoothly, Romero enjoys spending time with his wife, two kids, and a menagerie of two dogs, two birds and four cats. According to Romero, the family wants to expand their animal farm in the far future by potentially adding chickens.

“I like to spend time with my kids going sightseeing, and my life revolves around them and finding new things we all like to do together or places we like to go back to,” he said. “I love helping my kids learn, and seeing how happy they are when they complete tasks they used to say were impossible.”

Romero applies this same way of thinking towards his work. Say “hi” to Romero when you see him at the proton therapy facility.