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University of California San Francisco

Types of Treatments

Proton Therapy for
Ocular Tumors

The UCSF Ocular Tumor Proton
Therapy Program
is internationally renowned for its long-standing excellence in clinical practice and visionary research in proton treatment for eye cancer. 

  • UCSF is one of two major proton ocular centers in the United States and one of 12 worldwide with a dedicated proton eye beam line and specialized program for eye patients for over 40 years.
  • We have successfully treated thousands of eye cancer patients and have decades of experience with particle/proton therapy.
  • The proton beam line we use is designed exclusively to treat eye tumors and employs a finely targeted beam with adjustable penetration, customized for each individual patient.
  • We use specialized eye treatment planning software and image guidance to ensure optimal dose distribution which allows for excellent tumor coverage and avoidance of normal tissues.

This convergence of innovative technology and clinical expertise for ocular tumor patients is only available at UCSF.

Proton Therapy for Ocular Tumors 2020
The UCSF and CNL proton therapy treatment team.

About the UCSF program

UCSF is recognized worldwide as a leading center of excellence for ocular tumor treatment, with tremendous expertise and close collaboration among ophthalmologists, ocular oncologists, radiation oncologists, medical oncologists, pathologists, geneticists, physicists, and related cancer services.

Ocular tumors including melanomas of the eye, choroidal hemangiomas, conjunctival tumors, benign eye disease, and other eye tumors are treated at UCSF. Proton therapy is today considered the “gold standard of care” for ocular melanomas, the most common primary malignant adult cancer of the eye, as well as for other ocular tumors.

UCSF is one of only two long-standing major proton ocular centers in the United States. Patients often travel regionally and nationally from outside of California and internationally from outside of the USA to receive care at UCSF. The proton treatment is generally performed over the course of one week. Our program coordinator can assist in your visit to our program.

Please contact us by phone at (415) 353-9807 or by email at OcularRadOncNP@ucsf.edu

History

The UCSF Ocular Tumor Proton Therapy Program is one of 2 major proton eye centers in the US and one of 12 worldwide using a special dedicated proton eye facility and beamline to optimally deliver treatment to patients. Being one of the first and only programs of its kind, the clinical practice and technical expertise developed over decades of experience is significant.
Lawrence Berkeley Laboratory (left), Crocker Nuclear Laboratory (right)

At UCSF, we have treated uveal melanoma with particle radiation therapy since 1978. Initial treatment in the 1970s was at Berkeley’s synchrotron-based system, and since 1994, therapy shifted to the Crocker Nuclear Laboratory (CNL). The CNL cyclotron produces a pristine 67.5 MeV beam allowing for a uniquely ideal beam for eye treatment, without degradation or manipulation of the beam.

Over the past several decades we have successfully treated and followed thousands of eye patients. We have been in the forefront of exploring the science of uveal melanomas and advancing radiation treatment for this and other ocular conditions.

Why proton therapy

Proton or charged particle radiation is a type of extremely focused radiation therapy and is very effective for treating uveal melanoma and other ocular conditions. With proton therapy, there is minimal radiation dose to the surrounding normal tissues, making it ideal for treating tumors of the eye and minimizing side effects.

Proton radiation treats cancer by using high-energy beams to damage the “blueprints” or DNA of cancer cells, thus preventing the cells from reproducing and multiplying. Melanomas of the eye respond well to proton therapy, which generally spans one week, with once-a-day treatments.

Ocular tumors are in close proximity to critical structures within and just beyond the eye, including the brain. Proton therapy can deliver effective dose to the tumor while minimizing dose to normal tissue, and hence reduce side effects. Ocular proton radiation has very high rates of controlling melanomas of the eye, maintaining the patient’s natural eye, and preserving useful vision in many cases. Due to the complexity of the equipment, planning, and delivery, proton therapy facilities require significant infrastructure, footprint, medical and technical expertise.

Proton therapy is FDA-approved and is considered the gold ‘standard of care’ for uveal melanoma and other ocular treatments. 

What to expect in the clinic

Your care begins with your initial consultation with our proton ocular team led by Kavita K. Mishra, MD, MPH. At that appointment, Dr. Mishra and her team will perform a comprehensive medical examination and take your medical history. She will describe the therapy, its risks and benefits, as well as the alternative treatments as they apply to your case. Following the consultation, if you feel ready, you may proceed directly to the radiation planning session (which is called a ‘simulation’). You will have ample time to discuss your care and have all your questions answered.

Crocker Nuclear Laboratory Treatment Room

Crocker Nuclear Laboratory Treatment Room

During the simulation, measurements and x-rays may be taken and a special immobilization mask and chin rest may be made for your treatment. This helps with your positioning during treatment to minimize body movement and allow for precise targeting.

The proton treatment is performed at the Crocker Nuclear Laboratory in Davis, California, approximately 70 miles northeast of San Francisco (see below). The treatment itself only takes about one to three minutes each day. During the treatment, you will not feel the radiation. You will sit upright in a chair, and the custom-fitted immobilization mask will maintain your position. You will focus your gaze on a small red light; this keeps your eye from moving. This treatment is usually performed once daily over four days. Your follow-up continues with your ophthalmologist, medical oncologist, primary care physician, and our department as appropriate.

Clinical Trials & Research

Open Uveal melanoma Clinical Studies. Please contact us for more information.

Research Highlights for Dr. Mishra and the Proton Program

Contact

Please feel free to call the UCSF Department of Radiation Oncology Proton Ocular Coordinator to discuss any further questions at (415) 353-9807 or by email at OcularRadOncNP@ucsf.edu

Directions

  1. Consults and Simulations done at UCSF Radiation Oncology
    (415) 353-9807 or by email at OcularRadOncNP@ucsf.edu.
    Directions to UCSF Mount Zion in San Francisco, CA
  2. UCSF Team will treat eye patients at Jungerman Hall/Crocker Nuclear Laboratory (CNL)
    (530) 752-1460 Front Desk Jungerman Hall/CNL
    (530) 754-9289 Ocular Back line
    Directions to Jungerman Hall/CNL in Davis, CA
    PDF iconDirections to Crocker.pdf

Lodging

For list of Lodging/Hotel options –

  1. San Francisco – UCSF Radiation Oncology
    PDF iconLodgingSanFrancisco2016.pdf
  2. Davis – UCSF Eye Patients
    PDF iconLodgingDavis2016 PDF.pdf

Redefining Possible