How Duke is transforming cancer treatment

When Colton Goodman of China Grove, North Carolina, was just 3 years old, he was referred to Duke after an MRI showed a growth behind his right eye. At Duke, he was diagnosed with rhabdomyosarcoma, a life-threatening muscle tissue cancer that is most often seen in children.

The recommended treatment for this cancer is chemotherapy followed by surgery and/or radiation, but because the tumor’s location was not amenable to surgery, his doctor recommended chemotherapy and proton beam radiation. Proton therapy delivers a beam of high-energy protons to a tumor and has fewer side effects than conventional radiation therapy. 

The only problem was that proton therapy was not available at Duke, nor was it available anywhere in North or South Carolina. In fact, there are fewer than 50 proton therapy centers across the U.S., making access for many patients difficult.

Having proton therapy at Duke will enable us to push those boundaries even further, improving current applications and developing new ones through innovative clinical trials. ”

Dr. Michael Kastan

Executive Director, Duke Cancer Institute

The experience was extremely challenging, Colton’s family says. Discovering their child had cancer was difficult enough, and then they learned the closest treatment center was more than 500 miles away.

“Colton had to have treatment,” mother Brittany says. “We didn’t know where we were going  to stay, how we were going to do it, how we were going to afford any of it.”

Brittany moved with Colton and his younger brother, Crew, to Philadelphia for treatment at Children’s Hospital of Philadelphia. There, they rented an apartment for eight weeks so Colton could receive proton therapy. His father, Chad, stayed behind in China Grove to work so he could pay the bills and the extra expenses of relocating.

“From someone that had to spend eight weeks away from his whole family, it would have been amazing to have [a center] closer to home” says Chad.

But now those circumstances are changing for families like the Goodmans.

The largest philanthropic gift ever received by Duke University Health System—$50 million from an anonymous donor—will make it possible to open the Duke Proton Center on Duke’s campus and to ensure patients such as Colton, now 5 years old and cancer-free, have access to proton therapy at Duke. The facility is expected to open by 2029 with a total projected cost of $120 million.

“This is a historic gift, both for Duke and for the state of North Carolina,” says Vincent E. Price, president of Duke University. “The Duke Proton Center will have a profound impact on cancer care in our region.”

With proton therapy, radiation can be controlled so that it is delivered more precisely to a tumor, sparing healthy tissue. This is especially important for children and for tumors located in areas such as the head and neck. 

“What makes proton therapy so desirable as a treatment is our ability to precisely target the radiation and then escalate the dose in increments to more effectively control and eradicate tumors,” says Dr. Chris Willett, chair of the Department of Radiation Oncology. “As compared to standard X-ray radiation therapy, protons cause less damage to healthy tissue, less acute toxicity, and fewer follow-on complications.”

In adults, proton therapy is the preferred treatment for complicated head and neck malignancies, large base-of-skull tumors, esophageal cancer, localized recurrent cancer, and certain ocular tumors.

“Having proton therapy at Duke will enable us to push those boundaries even further, improving current applications and developing new ones through innovative clinical trials,” says Dr. Michael Kastan, executive director of the Duke Cancer Institute.

Plus, the precision at which proton therapy can be applied helps to reduce side effects to improve patients’ quality of life and function.

“For brain tumor patients, that means reducing toxicity that damages cognition, and in breast cancer patients that means limiting damage to heart function,” Willett says.

What is more, many cancer patients will come to Duke for proton therapy and have access to Duke’s excellence across all the specialties that touch their care. Today, with his cancer in remission, Colton receives follow-up care at Duke—and the Goodmans look to a future where children and adults needing proton therapy can access it and their post-treatment care closer to where they live.

“[The Duke doctors] just care for him, for our family,” Brittany Goodman says. “We could never repay the people who have helped us along our journey.”