Doctor projects beams of hope
Herman Suit champions benefits of proton beam therapy
By Neil Osterweil
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Dr. Herman Suit's passion for his work and his compassion for his patients are equally evident.
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BOSTON, Massachusetts (MedPage Today) -- Had he followed in his mother's footsteps, Dr. Herman D. Suit might today be breaking horses. But long ago, he traded the wide open, dusty plains of west Texas for the narrow brick canyons of Boston's West End and Massachusetts General Hospital (MGH).
Here, Suit and his colleagues tame wild, uncontrolled cancers and non-cancerous tumors -- not with bits, bridles and saddles, but with proton beams, cyclotrons and X-rays.
It was Suit -- the former chairman of Radiation Oncology at MGH, along with Andres Soriano, Distinguished Professor of Radiation Oncology at Harvard Medical School -- who virtually willed the Northeast Proton Therapy Center (NPTC) into being.
The NPTC is one of only two hospital-based proton therapy centers in the United States, (the other is at Loma Linda University Medical Center in California). Two more are in the works.
Proton beam therapy is to radiation what a surgeon's scalpel is to a pair of scissors. It's a precise, tightly focused beam that can be shaped to match the depth and contours of a tumor. Proton therapy can deliver its destructive energy to the targeted tumor while largely sparing the healthy tissue surrounding it.
It's particularly well-suited for treating patients who have irregularly shaped tumors in difficult-to-treat areas near critical structures of the body, such as the head, neck, brain, lungs and prostate.
The key to the treatment, Dr. Suit says, is that unlike conventional X-rays, which burn a path through healthy tissue on their way to the target, protons will deposit most of their radiation energy at their point of greatest penetration into tissue (this point is known as the Bragg peak). The energy of the proton beam can be precisely controlled to dump all that cancer-killing power into a confined space.
Over the river
A tall, thin man Suit has courtly manners and a warmth that more than four decades of life in cold climates have failed to suppress. But he's also not afraid to ask for what he wants when he's sure it will benefit his patients.
With boyish enthusiasm, Suit shows a visitor around the NPTC with its three treatment rooms, each served by a proton beam that is generated by a single cyclotron and carried along by a highway of magnets.
Two of the treatment rooms incorporate three-story high gantries weighing 110 tons each that allow the beam to be aimed at the patient in an arc of more than 180 degrees. Patients who are treated in these rooms lie on robotic beds that move in several dimensions to allow for precise alignment of the beam with the target tissues.
The third treatment room contains two specialized beam lines, one for treating cancers of the eye, such as ocular malignant melanoma, and the other for performing stereotactic or 3-D procedures, for treating brain lesions with high precision.
For example, for treatment of tumors of cartilage (chondrosarcomas) the 15-year tumor control rate with proton beam therapy is about 96 percent, and the 10-year control rate for malignant melanomas of the eye, both large and small is about 95 percent, a result similar to surgically removing the eye itself.
Aunt Bill and Aunt Jim
Suit's path to the pinnacle of his profession at MGH started in the west Texas town of Llano. His mother was the daughter of a hard-driving German immigrant who announced to his wife that she would have a male child and that he would be named William Thomas, which is how it read on the girl's birth certificate. She was followed by her sister James.
"You can imagine there was some amusement when people who were not familiar with our family would get together with us, and there would be Aunt Bill and Aunt Jim," Suit says.
With a gender-be-damned attitude unusual at the time, Suit's grandfather made his mother break horses to the saddle, a difficult and often dangerous task that forever engendered in her a disdain for horseback riding.
Her son decided instead to wrangle with textbooks at the University of Houston and at Baylor College of Medicine, also in Houston.
"I learned about radiation and found out that you could cure a patient without loss of anatomy and function in some cases. That was extremely exciting to me, but when I told my friends I was going to do this, people thought that poor Herman had lost his marbles," he recalled with a wry smile.
Neither the blandishments of his professors nor the offer of a position in a prestigious private practice could dissuade him, and he made his way across the pond to the dreamy spires of the University of Oxford in England to study radiology.
"At that time, the Brits were absolutely streets ahead of the United States in radiology," he said.
Upon his return, Suit went to work for the National Cancer Institute and M.D. Anderson and ending up, finally, in the home of the bean and cod.
The cost of a better life
Suit's passion for his work and his compassion for his patients are equally evident. Unlike many senior physicians he'll call patients himself to follow up on their progress, and he wears with pleasure hand-painted silk ties made for him by an artist and grateful former patient.
He also credits the Massachusetts General administration for supporting the NPTC, and insists on recognizinging his colleagues Dr. Jay Loeffler, his successor as chairman of radiation oncology, Thomas F. Delaney, medical director, and physicist Michael Goitein for their work in developing and running the world-class facility.
And he has a ready answer for those who question whether the costs of proton beam therapy outweigh the therapeutic advantages over x-rays, a difference he estimates to be not more than about 30 percent when developmental costs are factored out.
"You also have to consider the costs to society of dealing with patients who have complications from conventional radiation therapy," he said.
"That alone makes any extra costs worthwhile."
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