Leading the Way in Proton Therapy Expansion

Henry Tsai’s father had a dream. Not only would his son follow in his footsteps with a career in medicine, but, perhaps, father and son would work together one day.

The first part of that dream came true. Tsai, a pioneer in the field of proton therapy with Princeton Radiation Oncology in New Jersey, says that his father’s work and inspiration in internal medicine were the motivating factors for him to pursue a career in medicine.

“He loves what he does, and he loves taking care of patients,” Tsai says. “That certainly was the initial motivation for me to enter the field.”

The second part of the dream, however, has been elusive — mostly because Tsai’s father made it clear that it was important that his son explore what interested him.

“He told me that my career satisfaction and success would be determined a lot by how much I enjoyed the actual field of medicine that I was pursuing,” Tsai recalls. “So, you know, he certainly was hopeful that I might pursue internal medicine, but, ultimately, I fell in love with radiation therapy and that’s the career path I chose; and I think it’s been a good match for me.”

Drawn to oncology

Tsai served as chief resident at the Harvard Radiation Oncology Program, and earned his medical degree from Harvard Medical School. He says that when he entered medical school he wasn’t sure what area of medicine he was going to pursue. But it didn’t take long before his career path came into focus.

As an undergraduate at Harvard, Tsai majored in biology, and part of his undergraduate thesis examined the genetics of oncology. That foray prompted his interest in the field of cancer — what causes it, and how it’s treated at the molecular level. In medical school he explored different aspects of the disease, but radiation therapy caught his attention. And the encouragement he received from those already in the field solidified his decision.

Tsai acknowledges that for physicians — and oncologists, in particular — becoming emotionally involved with a patient is natural and part of the process. But at some point, he adds, “we need to separate out the emotion and the medicine, and remember that we are trying to help the patients.” And while there are sad stories, to be sure, they’re balanced by stories of success.

“We see young children who are cured of their tumors and we see older patients who may or may not survive their battle,” Tsai explains. “But you know, what I’ve noticed is that no matter which way it ends up, the battle and the journey that the patient undergoes is always an uplifting one. Because not only do you see them face the challenge of a cancer diagnosis, but their strength in pursuing the treatments and surviving treatments and family support that goes along with it, I think that’s very positive.”

An emerging field

While often viewed as a pioneer in the field of proton therapy, Tsai says that’s not necessarily the case, and points out that proton therapy has been used to treat cancer patients for several decades — almost as long as many forms of conventional radiation therapy.

But for years there were only two centers in the country that offered proton therapy. Massachusetts General Hospital, where Tsai received his training, was one of them. The success he witnessed prompted him and his colleagues to build a center in his native New Jersey.

“I wanted to make sure that this very advanced form of radiation therapy was available to this geographic area,” Tsai says. “I think my seeing how proton therapy was effective at the Mass General Hospital and how patients were traveling to get it inspired me and my other physician colleagues to work to procure and make sure that this center was built so that all patients could have access to it.”

But that was no easy task. Tsai explains that building a proton therapy center is a massive undertaking. First, it requires a very large facility, as well as a highly technical piece of equipment called a cyclotron, which produces the protons. Logistics must be able to accommodate all the magnetic beam lines that carry the protons to treatment rooms, and a staff that includes highly trained physicians and a physicist must be in place.

“It’s not something that any hospital or academic center can put up on a whim,” Tsai says. “There has to be a commitment to offer the technology. The size and enormity of the project makes it difficult to build these centers at every street corner. Some of the technology may be changing and may be becoming more accessible, but as of right now there are 11 operating centers in the country. Still, that’s a pretty significant jump from two centers not that long ago.”

Passion and gratification

Tsai acknowledges that spare time for him is a rare commodity. But on those occasions when he’s not seeing patients or managing parts of the proton therapy center, his family — a wife and two young children — occupy most of his time.

“Any free time I have, I spend with them,” he says.

That’s rewarding. And in a different sense, so is the work he does.

“You know, when we give radiation therapy, it’s often several weeks of treatments,” Tsai explains. “We develop a strong rapport with our patients. And just going through their journey with them is immensely rewarding. The personal relationships that develop, the success stories, and, you know, even what people consider to be not successful treatments — you know, patients who are battling with cancer, it’s an ongoing battle, but working with the patients, seeing their strength and being a part of that is a privilege.”