UF awarded $11.9 million for prostate cancer research comparing proton and X-ray therapies

Dr. Nancy Mendenhall

A University of Florida research team has been approved for a five-year, $11.9 million award to directly compare the potential benefits and harms of proton therapy to standard radiation therapy when treating prostate cancer.

Nancy Mendenhall, M.D., medical director of the UF Health Proton Therapy Institute, leads the team that received funding from the Patient-Centered Outcomes Research Institute, or PCORI, for a large-scale pragmatic clinical study on prostate cancer — the most common non-skin cancer afflicting men in the United States, according to the American Cancer Society.

Mendenhall, also a professor and associate chair in the department of radiation oncology at UF, and Ronald Chen, M.D., an associate professor in the department of radiation oncology at the University of North Carolina at Chapel Hill, are the study’s principal investigators.

“This is a critically important study that will compare outcomes between proton and conventional radiation in cohorts of 3,000 men with prostate cancer,” said Mendenhall. “It will determine whether there are differences in disease control, toxicity and quality of life in survivors — providing much-needed answers to patients, families, medical teams, hospitals, insurers and policymakers.”

The study will compare 1,500 patients treated with proton therapy with 1,500 patients treated with standard radiation therapy from a total of 42 treatment centers across the United States. The study will collect information on patient-reported quality of life, physician-reported and patient-reported side effects, and prostate cancer recurrence. Some participants receiving proton therapy will also be randomly assigned to receive eight weeks of treatment at a lower intensity or four weeks at a higher intensity, to determine which regimen has a greater impact on cure rates and side effects.

“This large, multi-institutional PCORI-funded study led by Dr. Mendenhall represents a concrete opportunity to move the field of radiation oncology toward the best approaches to reducing suffering and curing this oftentimes devastating disease,” said Paul Okunieff, M.D., a professor and chair of the department of radiation oncology at UF.

Mendenhall’s team collaborated with several stakeholders to design this study, including patients, caregivers, prostate cancer advocacy groups, insurers and minority engagement groups — because, according to the American Cancer Society, the disease occurs more often in African-American men and in Caribbean men of African ancestry than in men of other races.

Mendenhall’s study was selected for funding through PCORI’s Pragmatic Clinical Studies Initiative, an effort to produce results that are broadly applicable to a diverse range of patients and care situations and can be more quickly taken up in routine clinical practice. It was one of 14 studies selected through a highly competitive review process in which patients, caregivers and other stakeholders joined scientists to evaluate the proposals.

“Dr. Mendenhall is a visionary clinician and research scientist who’s a driving force in this country in advocating for less-toxic radiation therapy,” said Jonathan Licht, M.D., director of the UF Health Cancer Center. “This is the type of leading-edge, pragmatic clinical study that we at the University of Florida want to be known for.”

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that provides patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions. The UF award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

UF Health Proton Therapy Institute takes steps to formalize agreement in China for patient treatment and clinical research

UF Health Proton Therapy Institute in China

On January 12, 2018, in Beijing, China, leaders with GlobalMD Network Corporation and the UF Health Proton Therapy Institute, Jacksonville, Florida, signed Memorandums of Understanding (MOUs) to establish a Sino-American Pediatric Neuro-Oncology Program.

UF Health Proton Therapy Institute Executive Director Stuart Klein along with Tim Shi, MD, PhD, Chief Officer for GlobalMD, China Office, represented their respective organizations at the signing, held at the Chinese Academy of Sciences Automation Institute in Beijing. Following the signing, key Chinese opinion leaders and oncologists met with the group from Jacksonville to learn more about proton therapy for children who have cancer.

The initiative will formalize relationships between the Proton Therapy Institute and children’s hospitals across China to enhance and develop new treatments for children for life-threatening brain, skull-base and spinal tumors.

The Sino-American Pediatric Neuro-Oncology Program will include collaboration in:

  • Advanced training of physicians and nurses in pediatric neuro-oncologic and other pediatric health conditions

  • Teleconsultation for pediatric patients in China referred through GlobalMD and the UF Health Proton Therapy Institute

  • Provision of gold-standard treatment protocols for referred pediatric patients, including proton therapy, chemotherapy, neurosurgery and other treatments for these complex disorders

  • Tele-monitoring and evaluation of the outcomes of post-cancer treatment patients once they return home

  • Neuro-oncology research in China and Jacksonville

Dr. Indelicato
Daniel J. Indelicato, M.D.

This program falls under the joint mission of the Sino-American Collaboration Project on Clinical and Translational Medicine, established in 2010.

UF Health Proton Therapy Institute’s Executive Director Stuart Klein said the program, when fully executed, will build on successful agreements with other countries, including the United Kingdom, Norway and the Canadian Provinces of Quebec and Ontario.

“Since opening in 2006, the Institute has seen patients from more than 30 countries, including China, and is the largest pediatric proton therapy program worldwide,” said Klein. “In the past two years since organizing a symposium on radiotherapy in China, the number of patients from China has grown to the point that we have added a staff person who helps Chinese families with communication, transportation and housing needs.”

New research from UF sheds light on pediatric patient outcomes following proton therapy for ependymoma.

Dr. IndelicatoEpendymoma is one of the most common brain tumors in children under 10 years old. Proton therapy can reduce the low and intermediate radiation dose delivered to uninvolved brain tissue in children with intracranial tumors, which may improve functional outcomes and reduce second malignancies in survivors. Based on this rationale, ependymoma is the most common pediatric tumor treated with proton therapy in the United States.

The authors from the study Outcomes Following Proton Therapy For Pediatric Ependymoma, published last month in Acta Oncologica, report a 3-year survival exceeding 90% in the first 178 children with ependymoma treated with proton therapy at the University of Florida. This series represents the largest single-institution report of intracranial pediatric ependymoma outcomes treated with any radiation modality – proton or x-ray therapy. Therefore it contributes useful information for overall disease management, patient and family counseling, and surveillance guidance for pediatric radiation oncologists worldwide. Moreover, this cohort provides the foundation for continued follow-up studies quantifying the reduction of late toxicity with proton therapy.

“These are encouraging results,” said lead researcher Daniel J. Indelicato, M.D., who holds the Mendenhall Endowed Chair of Pediatric Radiotherapy and serves as associate professor in the UF Department of Radiation Oncology. “We demonstrated that protons are at least as effective as X-rays, in the short term, at reducing the risk of tumor recurrence. Our data further validates the experience reported in smaller groups of patients at other proton therapy centers.”


Red Coats Grant fuels rides for patients

Patient TransportTHE PLAYERS Championship is one of Jacksonville’s premier events. It features the PGA Tour’s top talent in a high-stakes golf tournament, not only for the competition in the field but also for the challenging course at TPC Sawgrass including the famed Island Green on the 17th hole. It attracts avid golf fans and casual spectators alike from the local community and beyond.

Each year, THE PLAYERS gives back to the community through charitable donations. A portion of sales, including event tickets and sponsorships, is distributed via a program called Red Coat Grants. The grants program is named for the distinctive red jackets worn by the volunteer chairmen of the current and past tournaments who are called Red Coats. Thanks to the efforts of the UF Health Proton Therapy Institute’s friend and supporter Hugh Dunn, we prepared and submitted a successful grant request to help fund our patient transportation program.

Our driver, Mitch Kubaki, and van transports 25-30 patients and their families to and from treatment each day, traveling approximately 650 miles each week. The fuel costs alone average $100 per week, and the Red Coat Grant will help defray this expense.

“We are grateful to THE PLAYERS and the Red Coats for this generous grant,” said Stuart Klein, executive director of the UF Health Proton Therapy Institute. “The transportation program eases the burden for many of our patients and their families. Having access to a free, safe and comfortable ride for doctor appointments, errands and group outings is one less worry.”

Executive Director Message

StuartKlein.pngEven as we prioritize our attention on day-to-day patient care and clinical research, we continue to push the boundaries towards improvement. We are seeing progress on many fronts.

Expansion Project

Site prep is underway for the 10,000-sq.-ft. addition of a single-room proton therapy gantry and cyclotron. We have relocated a water main to accommodate the expansion, and construction of the foundation will begin shortly after all site work is completed.

Pencil Beam Scanning

System upgrades are progressing and pencil beam scanning (PBS) is now being used on a limited basis. We anticipate that we will be using PBS on a full-time basis in one of our gantries within the next two months. PBS is a method of delivering the proton beam that will enable us to treat more types of cancers.


We recently refinanced our debt and secured municipal bonds that will help reduce our annual interest expense and provide the funds needed to cover costs of the expansion.

Ad Campaign

Be on the lookout next month for a new advertising campaign. Radio commercials will begin this month and television ads in November.


Stuart L. Klein

Executive Director

Survivor Spotlight: Jerry Lambert

Jerry Lambert, a UF Health Proton Therapy Institute alum patient, was recently featured in a story on Fox News Channel for his extraordinary years of service as a lifeguard. The 73-year-old native New Yorker has watched over swimmers at his local beach for 50 summers. He moved to Ocala, Florida, several years ago, but he said he hasn’t spent one summer in Florida in order to maintain his lifeguard duties.

When he was diagnosed with prostate cancer he considered his options and settled on proton therapy. He is five years post-proton therapy, has no sign of cancer and has no plans to slow down his active lifestyle.

See his story here:

Welcome Lindsay Carter-Tidwell, Director of Development

We are pleased to introduce Lindsay Carter-Tidwell as our new Director of Development at UF Health Proton Therapy Institute. Lindsay officially joined us on September 6 after relocating with her husband and two children to Jacksonville from the Athens, Georgia area.

Lindsay most recently served as Senior Director of Gift and Estate Planning at the University of Georgia working with alumni and friends to help facilitate major outright and deferred gift commitments. Prior to her career in development, Lindsay practiced law in Lake City, Florida, concentrated in the areas of estate planning and probate. Lindsay acquired her Juris Doctorate from Florida State University and holds a Bachelor of Arts in Journalism and Mass Communication from the University of South Carolina.

With upwards of seven years development experience, Lindsay has a strong background in building relationships and boosting an organization’s philanthropic support. In addition to raising funds for research and the facility expansion project, Lindsay will work with alumni, friends and community partners to identify funding opportunities to sustain and enhance the programs and initiatives available to patients and their families.

If you are interested in learning more about ways you can make a gift to support the Institute, contact Lindsay at lcartertidwell@floridaproton.org or 904-588-1519.

Go4TheGoal Grant Launches Child Life Fellowship

The UF Health Proton Therapy Institute received a $66,000 grant from the Go4TheGoal Foundation. Funds from the grant will be used to launch the Go4TheGoal Foundation Child Life Clinical Fellowship, the first Child Life fellowship of its kind. The program will employ two Child Life fellows, each for 12 months over a two-year period.

The Institute’s Child Life program is seen as a model for radiation oncology departments around the world. A dedicated Child Life specialist works one-on-one with pediatric cancer patients throughout treatment to promote effective coping through medical play, preparation and education. The addition of the Child Life fellowship allows the Institute to continue its innovative approach to pediatric cancer treatment.

Micalene SchwartzMicalene Schwartz is the program’s first child life fellow and began her 12-month contract in May. During her fellowship, Schwartz will enhance her skills in assessing child development, understanding and coping. Her responsibilities include preparing children for medical procedures and treatment, communicating with families and advocating for the patient and their families.




Recognizing Excellence in Radiation Oncology Practice and Education

Excellence in Radiation Oncology

Providing excellent patient care is fundamental at UF Health Proton Therapy Institute. This dedication extends to medical education, community education and advances in radiation oncology practice. We are proud of the commitment our employees make every day and applaud those who have recently received recognition for their exemplary efforts.

Julie A. Bradley, MD, was recognized as the 2016-17 Educator of the Year by the Association of Residents in Radiation Oncology for excellence in teaching, enthusiasm, and support for radiation oncology residency training. The award is presented in partnership with the American Society for Radiation Oncology (ASTRO).

Roi Dagan, MD, received the 2017 UF Department of Radiation Oncology Medical Student and Community Education Award. The award recognizes outstanding educational opportunities and mentoring to medical students and/or community education and outreach.

Daniel J. Indelicato, MD, was named 2017 Pioneer of Innovation by the Northeast Florida Pediatric Society. The award recognizes his leadership and development of the pediatric program at the UF Health Proton Therapy Institute.

Maria Mamalui-Hunter, PhD, received the 2017 UF Department of Radiation Oncology Medical Physics Education Award, recognizing a physicist who provides outstanding educational opportunities to graduate and/or postdoctoral students.

Bradlee Robbert, Patient Services Director, has recently become a fellow of the American College of Healthcare Executives

Executive Director Message

StuartKlein.pngAs an academic health institution, we develop and use treatments informed by clinical research. Our clinical research program tracks the outcomes data of thousands of patients treated with proton therapy. In fact, 98 percent of patients treated here participate in an outcomes registry study and 25 percent of patients are enrolled in clinical trials. The national average of participation in a clinical trial is three percent. We use this high-quality data to document the effectiveness of proton therapy and to develop additional cutting-edge clinical trials for future patients. 

This month, several of our physicians will present new research at the Particle Therapy Co-Operative Group’s (PTCOG) annual meeting in Japan, the largest international gathering of scientists, physicists and radiation oncologists who study and use protons. Presentations at PTCOG are often the first step to publishing research in medical journals. Ultimately, the goal of our clinical research is to realize the full potential of proton therapy to improve cancer patients’ lives.


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

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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.