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Kavita Mishra, MD, MPH
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, 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 from outside of California or 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.
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 pure 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. Hence with protons we can deliver effective dose to the tumor, while minimizing collateral damage and side effects. 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 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.
During the simulation, measurements and x-rays may be taken and a special immobilization mask and dental block may be made for your treatment. This helps with your positioning during treatment to minimize body movement and allow for precise targeting.
The 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, as it is painless. 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.
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
- 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
- UCSF Team will treat eye patients at Jungerman Hall/Crocker Nuclear Laboratory (CNL)
(530) 752-1460
Directions to Jungerman Hall/CNL in Davis, CA
 DirectionsCrocker2016.pdf
Lodging
For list of Lodging/Hotel options –
- San Francisco - UCSF Radiation Oncology
LodgingSanFrancisco2016.pdf
- Davis - UCSF Eye Patients
LodgingDavis2016 PDF.pdf
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