cancer treatment Archives - Provision CARES Proton Therapy Center

Provision patients enjoy a little vacation too

By | Cancer, East Tennessee, Knoxville, Patient Experience, Patient Hospitality, Proton Ambassadors, Tennessee, Uncategorized | No Comments

Provision Center for Proton Therapy patient Wayne Mason may have come for cancer treatment, but weeks spent in Knoxville also gave him an opportunity to see the local sights! And he was impressed. Here’s his must-do list of local activities in and around Knoxville and beyond!

In Knoxville

  • Neyland Stadium tour—Great for college football fans! $8. Phillip Fulmer Way. (865)974-1205. Reservation required
  • James White Fort—Awesome historical tour of the homestead of Knoxville’s founder.  The frontier sitting in the middle of downtown (beside the Women’s Basketball Hall of Fame). 205 Hill Avenue Southeast. 9:30 a.m.-5 p.m. (865) 525-6514.

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While you are sleeping…

By | Cancer, Clinical Care, Innovation, Patient Experience, Technology, Uncategorized | No Comments

At 9:45 pm, when only the guard keeps watch over the empty lobby and a few therapists tie up loose ends at the end of a long day, they arrive—mostly young, jeans-clad, ready to do the behind-the-scenes, after-hours work that keeps Provision treating cancer patients.

Tonight’s four-man night crew is among 12 total IBA employees responsible for the treatment gantries, cyclotron, and larger proton therapy system—manufactured by Belgium-based IBA—that make proton therapy possible. They work in three shifts, starting at 5:30 a.m. and 1:30 and 10:00 p.m., rotating crews every three weeks. They are little seen behind the closed doors of their control room and in the bowels of the facility’s equipment rooms, but the team is crucial to ensuring patients receive treatment on time and at the correct dose.

Tonight’s night shift is made up of Jake Storey, operator technician; Micah Veilleux, software systems engineer; Jeremy Cheatham, beam physicist; and Troy Brown, systems engineer specializing in robotics.

On this particular evening, Veilleux has preparations for a software system upgrade on his to-do list, while Storey reviews scheduled maintenance tasks such as blowing dust out of the control units, greasing hinges and checking or recalibrating various pieces of equipment.

The big job at hand, though, is dealing with recent challenges presented by IBA’s decision to change out the deflector in the cyclotron. The component, which helps channel protons to the patient target, was acting up at some other IBA sites, so the company chose to upgrade the part in all of its machines. That has resulted in a shutdown and a significant problem to solve in the coming hours. Read More

New website focuses on survivor experience

By | Breast Cancer, Cancer, Patient Experience, Patient Stories, Pediatric Cancer, Prostate Cancer, Proton Therapy, Survivors, Uncategorized | No Comments

Cancer may change your life. It shouldn’t define it.

On any given day, the lobby at Provision Proton Therapy Center is full of patients awaiting their turns in the treatment room.

Young and old. Homemakers. Students. Business owners. Musicians. Factory workers. Teachers. Pilots. Engineers. Doctors. From all over the country. All over the world.

Cancer, the great equalizer.

But at Provision, we don’t celebrate cancer. We celebrate life.

Meet Emma, whose journey brought her from China to a new family in Kentucky. Meet Patty, a make-up artist who frequents local TV sets and is on a first-name basis with Peyton Manning. Meet Mary, whose proton therapy treatment allowed her to easily resume her active life as an antique finisher and volunteer. Meet James, who claims martial arts, the military and music in equal measure. Meet Ryan, who’s bravely fighting a brain tumor with quiet grace and humor. Meet Walt, who faced cancer like any other adventure in life—from flying helicopters to ice hockey to road biking.

Not cases. Not charts. Not charge numbers. What we treat at Provision are people.

ProtonStories.com tells their stories. Check it out today—and there’s much more to come.


Proton therapy on the cusp of major expansion

By | Cancer, Innovation, Insurance Coverage, Market, Proton Therapy, Technology, Uncategorized | No Comments


Proton therapy is in growth mode worldwide because of the rise in cancer and protons’ effectiveness in treating it.

Today there are 15 proton therapy centers in the U.S. and 57 centers worldwide with 141 total treatment rooms. By 2018, based on current plans, there will be 119 proton therapy centers around the world.

By 2019, the proton therapy market is expected to reach the $1 billion mark.

In 2012, approximately 14 million new cases of cancer were diagnosed, and there were 8.2 million cancer-related deaths. That number is expected to increase by 70 percent in the next 20 years, according to the World Health Organization.

Radiation therapy is effective in destroying most cancers but can result in serious side effects and long-term health issues due to the healthy tissue it also affects. Unlike conventional radiation, proton therapy provides a carefully timed and controlled dose of radiation directly to the tumor. This significantly reduces the levels of radiation exposure to surrounding tissue, sparing key organs and resulting in many fewer side effects—both during treatment and long-term—and less risk of secondary cancer due to radiation damage.

Today, proton therapy is available to just 1 percent of the population with about 14,500 patients treated in 2014, according to the “Proton Therapy World Market Report,” produced by MEDraysintell, a market research firm.

By 2030, the world market for proton therapy is expected to be between $3.5 billion and $6.6 billion and an anticipated 300,000-600,000 patients will receive treatment, the report said.

As a relatively new treatment modality, proton therapy’s growth has progressed slowly since the first U.S. center was opened in 1990. The equipment needed to generate and deliver protons for treatment has, historically, been expensive and cumbersome to transport and install. Although Medicare allows proton therapy for many cancer indications, many private insurers do not. And recent decades have been spent gathering data to support protons’ efficacy in treating most types of cancers.

A new generation of smaller, lighter proton therapy equipment—such as a system now in development at ProNova Solutions, Provision Healthcare’s sister company—along with improved efficiency and the ability to deliver therapy in less individual treatments will reduce the cost of proton therapy and make it more available to patients.

Additionally, mounting evidence of proton therapy’s effectiveness in curing most types of cancer and improving quality of life for cancer patients has resulted in helping the technology finally come into its own, according to MEDraysintell.

For example, one report from the nation’s oldest proton therapy center has shown that less than 1 percent of men treated with proton therapy for prostate cancer suffered from major rectal and urinary side effects.

“The absence of such risks associated with other radiation treatments or surgery is a major driving factor driving the demand for proton therapy among patients,” state another marketplace report focused on proton therapy, recently released by Kuick Research.

More proton therapy centers, in turn, will result in more clinical research, better clinician understanding and greater patient awareness of its benefits—which will only help encourage further growth.

Provision & Raysearch: A look at proton therapy treatment planning

By | Cancer, Clinical Care, Proton Therapy, Technology, Uncategorized | No Comments



Provision Center for Proton Therapy is the star in this movie produced by RaySearch and featuring the company’s software system, RayStation. The system allows physicians create custom and adaptable treatment plans for proton therapy patients.

Provision has been utilizing RayStation for treatment planning since the center opened last year. The result? World-class cancer care.

Tennessee among states in cancer peril

By | Breast Cancer, Cancer, East Tennessee, Exercise & Nutrition, Screening, South, Tennessee, Uncategorized | No Comments

Tennessee has made its mark on the nation’s cancer map, and it’s not a pretty picture.

The state is among a handful (all in the South) that rank higher, or lower, than the rest of the country when it comes to leading risk factors for the disease, according to a recent report of the American Cancer Society (data illustrated by National Public Radio.) An estimated 1.6 million people will be diagnosed with cancer this year, according to ACS.

Tennessee leads the nation in rates of obesity and smoking, while trailing in measures that reduce the risk of cancer including exercise and eating healthy foods.

Here are how the statistics break down for the state:

• 24.3% are smokers

• 33.7% are obese

• 37.2% don’t exercise regularly

• 17.6% eat fruit twice daily

• 11.2% eat three vegetables daily

Compare this with Vermont, for example, in which 16.6 percent of the population smokes, 24.7 percent are obese, and just 20.5 percent don’t exercise or California where nearly one-quarter of the population eats the recommended services of vegetables and nearly 40 percent the recommended servings of fruit. (Truth is, there’s room for improvement across the country.)

In addition, many Americans fail to get recommended screenings for common cancer types. In Tennessee, just 56.5 percent of women over the age of 40 had a mammogram in the past year. And only 66.4 percent of both men and women had been tested for colorectal cancer. These screenings often result in early detection of cancer, which increases chances of survival.

The good news is, it doesn’t have to stay this way. Changing lifestyle habits such as adding daily exercise and smoking cessation increases your odds against cancer as well as other lifestyle-related diseases. Find out how to take first steps toward decreasing your cancer risk.

Provision’s 400th patient not just a number

By | Cancer, Culture of Care, Dr. Marcio Fagundes, East Tennessee, Patient Experience, Patient Hospitality, Patient Stories, Prostate Cancer, Proton Therapy, Uncategorized | No Comments

James Fulghum’s completion of prostate cancer treatment today was a celebration not only for him but for Provision Center for Proton Therapy as well—the graduation of its 400th patient.

A surprised grin crossed Fulghum’s face as he was presented him with a special certificate before he rang the graduation bell.

The event marks a “huge milestone” for Provision. The center opened last January and celebrated its 100th patient graduation just eight months ago. Since then, Provision Center for Proton Therapy has opened a third treatment room and seen its patient numbers increase significantly in 2015.

Fulghum, who came for treatment for aggressive prostate cancer from his home in Lebanon, Tenn., learned of proton therapy through his nephew. Founder and principal at civil engineering firm, Fulghum, MacIndoe & Associates, Billy Fulghum worked with Provision in its early days as the company made site design plans for the new treatment facility.

When his uncle was diagnosed with cancer, Billy Fulghum approached him about considering proton therapy as a treatment option.

“The first thing he said was, ‘I’m not going to the Bahamas to do some experimental thing,’” Billy Fulghum said.

But after perusing the Provision website and meeting with Dr. Marcio Fagundes and staff at Provision, James Fulghum was sold.

“(Dr. Fagundes has) been in this business for many years. He’s seen a lot of things,” Fulghum said. “He laid it out in simple terms that I could understand.”

At the end of eight weeks in Knoxville golfing, visiting the mountains, making friends with other patients—two of whom attended his graduation—and experiencing the hospitality and warmth of the Provision employees—from radiation therapists to hospitality coordinators to financial services manager Rhonda Turner—James Fulghum said he’s sad to go.

“I feel like when I walked through the front door this was heaven and these people were angels,” he said. “Even though I’m number 400, I’m not a number in this place.”


A Second Opinion is Important

By | Cancer, Clinical Care, Culture of Care, Patient Experience, Patient Stories, Proton Therapy, Uncategorized | No Comments

Provision Center for Proton Therapy is proud to partner with WVLT Channel 8 on the “2nd Opinion, 2nd Chance” campaign.  More than 1.6 million cases of cancer are diagnosed each year in the United States resulting in nearly 586,000 premature deaths.  The Volunteer State sees nearly 36,000 new cancer cases resulting in 14,000 deaths.

By encouraging self-education, preventative screenings and increasing awareness of available cancer treatment options such as proton therapy, we hope to encourage the East Tennessee community to make informed healthcare decisions.  If you or a loved one are diagnosed with cancer, get a second opinion and find out what treatments are available to you.  The goals of this campaign are to:

      • Encourage taking charge of your own health by learning about appropriate cancer treatment options available to you right here in this community, such as proton therapy
      • Promote early detection by encouraging preventive screenings
      • Connect cancer survivors with future survivors
      • Increase awareness of advancements in cancer treatments
      • Share cancer survival stories
      • Encourage participation in the Eddie Check program, a FREE PSA blood test to detect prostate cancer, held every Fall in more than a dozen East Tennessee communities

For more information on proton therapy, Eddie Check or connecting with a cancer survivor through the Ambassador program, please call (865) 862-1600.

What is Dosimetry?

By | Clinical Care, Proton Therapy, Technology, Uncategorized | No Comments

I am a Medical Dosimetrist here at the Provision Center for Proton Therapy in Knoxville.  The reason for this blog post is to answer a question I have been asked by many friends and family. What is Dosimetry?  As I was writing this, I found it amusing that Microsoft Word underlines the word Dosimetrist in red due to the fact it doesn’t recognize the spelling.  To put it quite simply a Dosimetrist is one who measures dose.

So what are the responsibilities of a Medical Dosimetrist in the field of proton therapy?  A Dosimetrist is an individual that is part of a Dosimetry team that has many roles and duties.  Although the duties of a Dosimetrist are numerous, I am going to outline three of the major responsibilities of a Dosimetrist.  They are importation, contouring and planning.


The first of these is to import the CT scan into a treatment planning computer.  After a patient comes in on their first day and gets their treatment planning CT scan, the images are sent electronically to Physics where a Dosimetrist will import those images into a treatment planning computer and, if necessary, will fuse them with any other test they may have had, such as an MRI or a PET/CT.  Fusing is when a Dosimetrist overlays and aligns the treatment area found on a previous PET/CT or MRI with the treatment area on the treatment planning CT images.  Not all cases need to be fused and the necessity of whether to fuse or not is dictated by the Physician.


Once the images are fused, the second responsibility of a Dosimetrist is to contour in the “organs at risk” or as we refer to them: O.A.R.’s.  Organs at risk are defined as organs that are in the path of the beam and/or are in close proximity of the beam and have a low radiation dose tolerance.  An example of these would be the eye when treating the brain, the heart when treating a lung or the bladder when treating the prostate.  To contour these structures the Dosimetrist will use the treatment planning software to trace around the organs that are represented on the treatment planning CT images.  Once these organs and tissues are drawn the physician will come in and contour in the area that needs to be treated to their prescribed dose.   It is during this time that the number of beams and their angles are discussed.


After the Physician has contoured in the treatment area, sometimes referred to as the Region of Interest, and the Dosimetrist has contoured in the O.A.R’s, the Dosimetrist can start the most important part of their job, the planning.  How a patient will be treated is collectively decided by the Physician, the Dosimetrist and the Medical Physicist.  The Physician will let the Dosimetrist know how much radiation they want delivered to the treatment site and in how many fractions or days.  The Dosimetrist will then enter that information into the treatment planning system and create a plan that will deliver that dose to the cancer while sparing as much healthy tissue as possible. After the plan has been approved by the Physician and has passed Physics Quality Assurance testing it is then exported to the treatment console for the Radiation Therapists to deliver daily treatments to the patient until the prescription is fulfilled.

I hope this answers a few of your questions and spurs a few more.  Please feel free to ask me or any other staff members any questions you may have about your treatment.


Jeff Stamper is a Medical Dosimetrist at Provision Center for Proton Therapy.

Provision Celebrates Another Milestone: Gantry Treatment Room Open

By | Clinical Care, Culture of Care, Patient Experience, Patient Hospitality, Prostate Cancer, Proton Therapy, Technology, Uncategorized | No Comments

The Creekside treatment room (pictured above) at Provision Center for Proton Therapy is the first of two 360-degree gantry treatment rooms that can treat patients who have more complex cancers in a variety of disease sites. 

Provision Center for Proton Therapy celebrated yet another milestone this week – the opening of the first of two gantry treatment rooms.   The gantry rotates 360 degrees around the patient enabling us to treat a variety of more complex cancers such as brain, lung, breast, head and neck, esophageal, and pediatric cancers.

Pencil Beam Scanning

This room will also have a precise form of treatment: Pencil Beam Scanning (PBS). Pencil beam scanning uses a beam that is much smaller than those used in more common proton treatments and allows us to “paint” the tumor with protons. It can therefore be used to treat difficult tumors at higher doses and with fewer side effects to surrounding healthy tissue. There are currently less than 10 centers in the United States that have access to this incredible technology.

Third Treatment Room

Our third treatment room is scheduled to open in early fall. Once the third treatment room opens the Provision Center for Proton Therapy will have the ability to provide life-saving cancer treatment to as many as 90+ patients per day.

Grand Opening

The Provision team would like to invite all former, current, and future patients along with friends and family to the official Grand Opening of the Provision Center for Proton Therapy on Wednesday, April 30 at 3 p.m. We will have special guest speakers in celebration of the grand opening. Refreshments will be provided and the center will be open for tours. Please contact us at (865) 862-1600 to RSVP or for more information.