A Quilt Becomes a Messenger

Thanksgiving quilt art book

By Theresa Edwards Makrush

A unique art project by patients is enjoying a “third life” as an online feature on floridaproton.org and our Facebook and Twitter accounts. It started out as a patchwork quilt made of paper squares and cut paper designs that was displayed near the art table in the lobby.

It was later transformed into a book, each square a page, bound with three lengths of twine. The twelve squares were then filled with thank you notes from individuals – patients and caregivers – as a Thanksgiving gift to the Institute’s staff.

Today, the pages are a graphic art feature on the website. When a website visitor rolls the computer mouse over a quilt square/page, one of the 40 heartfelt thank you messages is revealed. A few examples are:

“Thank you for every smile and greeting, for every encouraging word and smile and for all the extras that just materialize. The staff is wonderful! The facility and technology are amazing – thus the experience here has been far less stressful.”

“We have had a life-changing experience here at UF Proton in so many ways. The love and caring of the staff, the camaraderie of the patients, the friends we have made, we are so thankful for. The science, the engineering, the collective knowledge, the ability to cure cancers and safely care for all of us, we are thankful for this, too. We will miss you all. Thanks for all of you!”

To read more, click here.

Pink Envelope Project Brings Smiles

Students from Boys & Girls Club of Northeast Florida

By Theresa Edwards Makrush

A group of fifth grade students from the Boys & Girls Club of Northeast Florida stopped by with a special delivery for patients: pink envelopes with letters of encouragement and pink candies. The children each carried a pink balloon as they walked several blocks from their building to the Institute. Brad Robbert, director of patient services, welcomed them and thanked them for their act of kindness.

Parent volunteer Natasha Owens said she was inspired to coordinate the community outreach because of a friend who was being treated for breast cancer at the Institute. She said the project would teach the children about community service and they hoped to bring a smile to the patients.

Executive Director Message


StuartKlein.pngOur local community and our vendors go above and beyond for our patients. There are many Jacksonville area businesses, nonprofits, and cultural groups that provide discounts or donations year-round for those being treated at our facility. Last month we received a surprise gift of a new shuttle bus from THE PLAYERS Championship. The timing couldn’t be better since our original van, in service since 2011 and rolling over nearly 200,000 miles, is starting to show its age. The original van was a donation organized by proton alum Markus Mittermayr. His Kiwanis chapter raised funds to help defray the cost of purchase from Nimnicht Chevrolet. Over the years, many proton alumni, patients and other donors have contributed to the maintenance and staffing of the transportation service. Patients frequently remark that the proton van, thanks in large part to driver Mitch Kubaki, makes their lives much easier during a difficult time. I am grateful for the community’s support of our mission to provide exceptional care to cancer patients.


Stuart L. Klein

Executive Director

New Proton Therapy Equipment Heading to Jacksonville

PROTEUS® ONE proton therapy system
The journey begins in Belgium for the Proteus®ONE proton therapy system destined for the UF Health Proton Therapy Institute in Jacksonville.

By Theresa Edwards Makrush

The cross-Atlantic voyage is underway carrying the new cyclotron and gantry to the UF Health Proton Therapy Institute in Jacksonville. The equipment left the IBA factory in Louvain-La-Neuve, Belgium, on Sept. 24 and was loaded onto a ship in Antwerp for departure Oct. 13. Its estimated arrival date in Jacksonville at Jaxport is Oct. 25.

Together, the cyclotron and the gantry are the largest components of the new Proteus®ONE compact single-room proton therapy system. They will be housed in the 10,000-square-foot expansion, adjacent and connected to the original UF Health Proton Therapy Institute building.

The cyclotron is the accelerator that speeds up the protons used in proton therapy. According to IBA, it is a specially designed superconducting synchro-cyclotron – a new technology that reduces the accelerator weight and energy consumption by a factor of four. It weighs 55 tons, roughly the weight of 3.5 standard school buses. In comparison the cyclotron used in the existing facility since 2006 weighs 220 tons, roughly the weight of a 757 airplane.

The gantry is the 100-ton machine that rotates around the patient in the treatment room to deliver the proton beam. The Proteus®ONE delivers the proton beam to the target using Pencil Beam Scanning (PBS). PBS delivers Intensity Modulated Proton Therapy, a technique that conforms to the size and shape of the treatment area and heightens dose uniformity, especially for complex tumors. It is equipped with Image Guided Proton Therapy, a technology used for accurate patient positioning and rapid detection of anatomic changes throughout the course of treatment.

“Once the equipment arrives and is installed in mid-November, we will have completed about 70 percent of the expansion project,” said Stuart Klein, executive director of the UF Health Proton Therapy Institute. “The majority of time leading up to completion will be spent assembling the equipment, conducting quality assurance and commissioning it for patient treatment.”

The addition is phase two of a $39 million, three-phase upgrade and expansion project announced in early 2016. Phase one was completed in mid-2016 and included upgrades to the existing facility: rolling floors under the treatment tables in two gantries, a new imaging system and a new treatment planning system. Phase three involves retrofitting one treatment gantry in the existing facility with a dedicated PBS nozzle.

When completed, the facility will have five treatment rooms – four gantries and one fixed beam – and two cyclotrons. It is estimated the addition will increase patient capacity by 25 percent.

UF Health Proton Therapy Institute Receives Two Donations from THE PLAYERS Championship

Donations Delivered: THE PLAYERS Championship 2018 Red Coat Ride Out at UF Health Proton Therapy Institute. Group from left to right: Adam Campbell, Tournament Chairman of THE PLAYERS Championship; Stuart Klein, Executive Director of the UF Health Proton Therapy Institute; Leon Haley, M.D., CEO of UF Health Jacksonville; Jack Garnett, Captain of the Red Coats and member of the UF Health Jacksonville Leadership Council; Jared Rice, Executive Director of THE PLAYERS Championship.

A new 14-passenger shuttle bus for patient transportation and a $5,000 donation to enhance the social programming for adolescents and young adults who are being treated for cancer was received by the UF Health Proton Therapy Institute from THE PLAYERS Championship during the annual Red Coat Ride Out.

THE PLAYERS volunteer leadership – the Red Coats – presented the gifts on Sept. 25 as part of its record $9 million charitable outreach in Northeast Florida, funds generated by the annual professional golf tournament held in Ponte Vedra Beach.

The UF Health Proton Therapy Institute has a van to transport patients and their caregivers, primarily children and their families, who stay in nearby housing or at the Ronald McDonald House, to and from their daily treatments. “Many of our patients are from other countries or cities, and navigating unfamiliar roadways is an unnecessary stress for them,” said Stuart Klein, executive director of the UF Health Proton Therapy Institute. “The shuttle service is part of the comprehensive social support we have in place to help patients cope with their treatment,” he said.

THE PLAYERS Championship 2018 Red Coat Ride Out
THE PLAYERS Championship 2018 Red Coat Ride Out

The UF Health Proton Therapy Institute has treated more than 650 adolescents and young adults and 1,600 children. It has the largest pediatric proton therapy program in the world, treating on average 25 children per day.

“In the United States, cancer is the leading cause of disease-related death in young people age 15-39,” said Daniel J. Indelicato, M.D., the William and Joan Mendenhall Endowed Chair of Pediatric Radiotherapy and associate professor at the UF College of Medicine. “For many cancers, this age range has seen little improvement in survival over the past four decades. Some of this is related to poor understanding of patient and tumor biology that distinguishes cancers in this population. But adolescents and young adults also have unique needs and often feel out of place in an oncology network designed for children and older adults. If we can create a supportive environment more tailored to adolescents and young adults, it will improve their ability to cope with treatment, and ultimately, we hope, improve their outcomes,” he said.

Proton therapy is an advanced form of radiation therapy that can effectively target tumors and reduce side effects. For young people whose bodies are still growing and developing, proton therapy offers the advantage of reducing the amount of radiation in healthy tissue which may reduce the incidence of health complications and secondary cancers later in life.

“We are deeply grateful to THE PLAYERS and the Red Coats for your generosity,” said Klein. “Your gifts will make a positive impact on the patients entrusted to our care.”

THE PLAYERS was among the early donors who made the UF Health Proton Therapy Institute possible. Since opening in Jacksonville in 2006, more than 7,700 patients have walked through THE PLAYERS Championship lobby at the UF Health Proton Therapy Institute.

Alumni Spotlight: Robert Davis

By Theresa Edwards Makrush

Alumni Robert Davis
Friends and family who drove Robert Davis to his proton therapy appointments gathered last March as he rang Aud’s Chime after his last treatment.

You could call it a volunteer caravan. If you lined them up bumper-to-bumper they would make quite an impressive parade. About 40 people, and their vehicles, volunteered to bring Robert Davis for his twice-daily proton therapy over a seven-week period. Davis credits his friends Dan and Lauri Dieterle with organizing the driving tree and arranging food deliveries, too. They used a free online service called LotsaHelpingHands.com

Davis, a resident of Jacksonville’s Southside, was treated last January for a melanoma in his sinus. Davis said that while his wife Sharon drove him to all of his doctor appointments and accompanied him for many of his treatments, his friends wanted to do something to lighten their burden. "I'm fortunate to have a great family and a lot of good friends, " said Davis.

He was very familiar with the UF Health Proton Therapy Institute well before his diagnosis, he said, through friends and because of his volunteer work with THE PLAYERS Championship, the professional golf tournament held in Ponte Vedra Beach annually. He was the tournament chairman in 2013 following many years of working his way up through the volunteer ranks. He remains involved with THE PLAYERS and recently took part in the 2018 Red Coat Ride Out, the group of former tournament chairs that delivers donations to charities throughout Northeast Florida.

One of the donations THE PLAYERS made this year was to the UF Health Proton Therapy Institute: a $5,000 gift to the Adolescent and Young Adult Program and a 14-passenger shuttle bus to transport patients to and from treatment. Davis was there for the donation presentation. “It was a special experience for me,” he said. “I know I’ve been able to give back.”

He continued, “I’m impressed with the doctors there. The level of care, compassion – the doctors, the nurses, the staff, the people doing the treatments – I always felt they cared about me. They wanted me to get better. They understood what I was going through.”

Davis said he recently had his six-month, post-treatment checkup, and the scans showed no sign of disease. Proton therapy was targeted enough to avoid his optic nerve, sparing his vision, and his brainstem, sparing the vital connection to the spinal cord. During treatment, and in the weeks and months after, he did experience radiation side effects to the sensitive head and neck area such as soreness in the mouth, blisters on the face and in the throat, and a blocked tear duct, but these have improved, he said. “If you’re facing radiation and proton therapy is an option for you, explore it,” Davis said. “I feel that if I had traditional radiation, the aftereffects would have been much worse.”

Carleen Marianek, MSN, RN -- Making Strides Against Breast Cancer

By Theresa Edwards Makrush

Making Strides Against Breast Cancer
Members of the “Pink Proton Posse” from left to right: Barbara Berges, RN, Carleen Marianek, MSN, RN, and Stephanie Saman

The local chapter of the American Cancer Society held its annual fundraising walk, Making Strides Against Breast Cancer, Oct. 13 and UF Health’s “Pink Proton Posse” organized by Carleen Marianek, MSN, RN, was among the top teams. Their donations will help the ACS in the Jacksonville area fund innovative breast cancer research, 24/7 information and support, and prevention and early detection initiatives. For example, the ACS provides breast cancer patients in need with transportation to and from their treatments and organizes the Look Good Feel Better program that arranges hair, makeup, wig and clothing makeovers for cancer patients. Funds will also go towards construction of the Hope Lodge being built in Jacksonville that will provide free, temporary housing for cancer patients and their caregivers who are from out of town.

Marianek is a long-time volunteer with the ACS and for the past five years has been volunteer chair of the volunteer board. She is a strong advocate for cancer patients’ interests at the Florida Legislature. In her work at the UF Health Proton Therapy Institute, she is a nurse case manager for patients being treated for metastatic cancer and cancers of the head and neck and eye. She said her volunteerism with the ACS is driven by her passion for her patients and by the memory of her mother who she lost seven years ago to breast cancer. She is determined to make a difference both for her patients and for all people facing cancer.

Play Golf. Fight Cancer.® Brings Donations for Proton Therapy Research

By Theresa Edwards Makrush

The 14th Annual Play Golf. Fight Cancer.® Classic took place Oct. 8 at the World Golf Village, St. Augustine, Fla., and was organized by co-chairs Judy Taylor Holland and Nancy Seely. The event is the signature fundraiser for the UF Health Proton Therapy Institute’s research program. Presenting sponsors were .decimal, IBA and Shepherd. A field of 110 golfers took part in the tournament held on the Slammer & Squire course.

The honorary chairman was Steve Spurrier, University of Florida Ambassador and Gator Great. He joined the sponsors for an evening reception on Oct. 7 at the Renaissance Hotel. The next morning at the beginning of the tournament he offered words of encouragement and thanks to players as they set off for a shotgun start. A silent and live auction and awards reception closed the tournament with Sam Kouvaris, noted sports media personality, as emcee.

With almost 98% of the patients at the UF Health Proton Therapy Institute being treated on research protocols, it is generating evidence of the benefits of proton therapy. The support from the tournament is used to perform research that will change the way cancer treatment is handled in the United States and around the world.



Executive Director Message


StuartKlein.pngThe building addition that will house our new single-room proton therapy system has reached several construction milestones. We marked a capping off in May with the final concrete pour. Since then, the exterior walls have been installed and interior work is progressing. Within the next few months, we will receive delivery of the proton therapy system – the cyclotron and gantry. This technology will add to our existing array of proton therapy, conventional radiation therapy and imaging equipment, currently considered the most advanced radiation oncology facility in the Southeast U.S. In the hands of our expert physicians, physicists, nurses and radiation therapists, this advanced technology is used to offer patients the highest quality cancer care and the best chance for excellent results. Our stature as a leading proton therapy facility has never been stronger, and we look forward to continuing to serve the needs of cancer patients in our region and beyond.


Stuart L. Klein

Executive Director

Second-Consecutive ACR Accreditation Earned

The American College of Radiology Seal

The American College of Radiology has awarded a three-year term of accreditation in radiation oncology to the University of Florida Health Proton Therapy Institute. This is the second consecutive accreditation awarded to the UF Health Proton Therapy Institute and is a distinction earned by facilities that meet or exceed national standards in radiation oncology.

Of the 27 proton therapy centers in the U.S., the UF Health Proton Therapy Institute is one of 11, and the only one in Jacksonville, to earn the ACR seal of accreditation representing the highest level of quality and patient safety.

ACR reviewers described the UF Health Proton Therapy Institute as a “high-quality, well-staffed, well-organized facility and operation,” and commended it for its “clear documentation and high safety measures” as well as for following “guidelines for therapy decisions and practice.”

Nancy P. Mendenhall, M.D., medical director of the UF Health Proton Therapy Institute and associate chair and a professor of radiation oncology at the UF College of Medicine, said the accreditation is a testament to the medical team’s commitment to excellence.

“We are a regional resource for proton therapy, and patients rely on us to deliver safe, effective cancer treatment,’’ she said. “It is an honor to earn this recognition from a panel of peers who are tasked with providing a rigorous, impartial review.”

The ACR is the nation’s oldest and most widely accepted radiation oncology accrediting body, with over 700 accredited sites and 30 years of accreditation experience. The ACR seal of accreditation is awarded only to facilities meeting specific practice guidelines and technical standards developed by ACR after a peer-review evaluation by board-certified radiation oncologists and medical physicists who are experts in the field. Patient care and treatment, patient safety, personnel qualifications, adequacy of facility equipment, quality control procedures, and quality assurance programs are assessed. The findings are reported to the ACR Committee on Radiation Oncology Accreditation, which subsequently provides the practice with a comprehensive report they can use for continuous practice improvement.

The ACR is a national professional organization serving more than 36,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.



About This Newsletter

The Precision Newsletter is an electronic-only publication that is distributed by email. Each issue is sent monthly to patients, alumni patients and friends of the University of Florida Health Proton Therapy Institute. As the official newsletter of the Institute, the content is compiled and prepared by our communications representative and approved by the editor Stuart Klein, executive director of UF Health Proton Therapy Institute. Special bulletin newsletters may occasionally be prepared when timely topics and new developments in proton therapy occur. If you would like to send a Letter to the Editor, please click here.


Keep In Touch

It is easy to stay in touch with us online at floridaproton.org . Look at the top right corner of the homepage for Facebook , Twitter and YouTube icons, click and join us in the social media conversation. Also on the right side of the homepage there is a button for VTOC Patient Portal . Click here to open your secure account, view your records, complete clinical trial questionnaires and communicate with your nurse case manager.


Knowing how you are feeling during and after treatment is essential to providing you the best care possible and contributes to the care of future patients.