From a cancer perspective, the radiation treatment had been a success. Ten years later the patient’s tumor, lodged close to his brain’s memory center, was quiet, stagnant.

But as he examined the man, Arnab Chakravarti, MD, was struck by what he discovered.

Once a math major in college, the patient now struggled with simple arithmetic. He suffered from long- and short-term memory deficits. While radiation likely saved his life, it also damaged the brain tissue surrounding his tumor, altering his future in a number of permanent and unpredictable ways.

That same week, Dr. Chakravarti saw another patient whose tumor was in nearly the exact location. This patient had consented to a different type of treatment: proton therapy, an advanced type of radiation treatment that uses positively charged particles instead of X-rays to kill cancer cells.

Not only was he free of cancer, this patient also had no detectable neuro-cognitive side effects. He remains healthy and unaffected today, nearly 20 years after his treatment.

Scenarios like this cemented Chakravarti’s dedication to expanding proton therapy and offering patients the opportunity to eradicate their cancers while minimizing the harmful side effects of treatment.

“That will be etched in my memory forever, because these patients were juxtaposed right next to each other,” says Chakravarti, chair of the Department of Radiation Oncology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). “It shows you a stark difference.”

Now one of the world’s leading experts in proton therapy, Chakravarti, who holds the Klotz Chair in Cancer Research at The Ohio State University College of Medicine, has built a career that spans decades and institutions, and ultimately led him to Ohio State — where he’s opened central Ohio’s first proton therapy center.

Chakravarti answers frequently asked questions about proton therapy

Dr. Arnab Chakravartii

Launching proton therapy in central Ohio

Here’s what makes proton therapy so special, Chakravarti says: Conventional radiation involves high energy X-ray beams, which have an entrance and exit point. During treatment, everything in between those points is often exposed to high doses of radiation.

“But with the proton beam, you can target the beam just to where the tumor is located, to avoid those entrance and exit points almost completely,” he says. “It avoids the radiation dose and the resulting damage to surrounding normal tissues and organs.”

For complex tumors — and cancers in children — proton therapy has the potential to deliver a potent and incredibly precise treatment with minimal effect on a patient’s quality of life, during and many decades after treatment. Proton therapy also doesn’t require surgery, making it ideal for treating inoperable tumors by painlessly delivering a high-energy proton beam through the skin from outside the body.

“In many ways,” Chakravarti says, “proton therapy is the epitome of personalized care in cancer.”

And yet setting up a proton therapy center is a massive undertaking, requiring a size and scale of resources that most medical centers can’t meet.

For Ohio State, proton therapy plans have been in the works for more than a decade.

“One of the challenges of proton therapy is that it’s very expensive,” Chakravarti says. “But there’s also the technical sophistication that goes into launching a proton center — you need to have a team of expert radiation physicists, radiation biologists, dosimetrists, engineers and physicians working hand-in-hand.”

“It's really a team effort, and at Ohio State, it’s been in the works for a while. We’ve been waiting for the right technology, the right collective expertise, the right partners.”

Finally, it’s all coming together. In 2023, Chakravarti will realize an institutional dream by opening the doors to the world’s premier proton therapy center at Ohio State, a $100 million facility that will occupy 55,000 square feet of the new 340,000-square-foot outpatient facility taking shape on Ohio State’s west campus.

The proton therapy center promises to transform patient care at the OSUCCC – James — but in many ways, it represents just the next step in Chakravarti’s plans to evolve and improve the way we treat cancer.

“What brought me to Ohio State was Dr. Chakravarti and his vision,” says Joshua Palmer, MD, a radiation oncologist at the OSUCCC – James who specializes in the treatment of cancers within the central nervous system. “The growth in our radiation oncology department, both in patient number but also in technological advancements over the past 10 years, has been phenomenal. It’s probably one of the best trajectories out there.”

Proton therapy machine ProBeam 360
A view inside the new proton therapy system. Image courtesy of Varian Medical Systems, Inc. All rights reserved.

Surrounded by inspiration

Chakravarti was born in Bethlehem, Pennsylvania, where his father — a successful chemical engineer whose pioneering work included collaborations on the automobile airbag and the Kevlar vest — served on the faculty of Lehigh University. The family later relocated to Virginia, and Chakravarti recalls watching his parents, part of one of the earliest waves of Indian immigrants in the early 1960s, navigate their culturally unfamiliar surroundings.

“It was really quite an experience for them,” he says. “There were almost no Indian Americans in that part of the country back in the late ’60s and ’70s. It was challenging in some ways, but on the other hand they got to develop some very close friendships with a wide range of individuals of different backgrounds that really lasted them a lifetime.”

The core principles of diversity, equity, inclusion and a love for all of humanity were deeply rooted within Chakravarti from a very young age.

Chakravarti grew up surrounded by invention and inspiration. He picked up his father’s curiosity for scientific innovation and developed an interest in medicine from his grandfather, who was the president and CEO of a hospital in India. Conversations with both men — as well as with a distant relative who worked as a radiation oncologist — would help Chakravarti chart his own life’s mission. “I think that currently represents who I am — a nice blend of the hard science, which was instilled in me from my father, and my passion for improving people’s lives through medicine, which came from my grandfather,” he says. “It fascinated me that I could potentially pursue my passions in helping others battle the toughest of all enemies.” That enemy, of course, is cancer, and Chakravarti entered the battle with marked dedication. Radiation oncology would arm him with the most cutting-edge weapons against the enemy and a limitless future in the advancement of cancer treatment. 

After graduating from the University of Virginia School of Medicine in 1995, Chakravarti completed his internship in internal medicine at Harvard Medical School and his radiation oncology residency at Massachusetts General Hospital, Harvard’s teaching hospital. He stayed at Mass General for 15 years, where he was a clinician-scientist and well-funded by the National Institutes of Health (NIH). He became director of the Radiation Neuro-Oncology program, and was also director of the Brian D. Silber laboratories for Molecular Neuro-Radiation Oncology and one of the earliest pioneers in translational research in the field of Radiation Oncology. Of note, he has been continuously funded by the NIH since 1999, which is a rare feat given the competitive nature of these grants. Of great relevance, Chakravarti played a role in helping Mass General to launch the world’s very first hospital-based proton therapy center while he was at Harvard.

That’s where he met his two similar brain tumor patients and witnessed the life-altering promise of proton therapy.

Dr Chakravarti looking at the screen

A presidential visit

In 2009, Chakravarti was recruited to Ohio State, in large part to establish proton therapy at the OSUCCC – James. He saw wide-open potential and made quick work of expanding radiation oncology’s reach.

“The department was young at the time — that was one of the most enticing features that brought me here,” Chakravarti says. “That gave me the unparalleled opportunity to build a world-class radiation oncology department from the ground up.”

His efforts gained momentum almost immediately when, in late 2010, Ohio State was named the recipient of a highly competitive $100 million federal Affordable Care Act grant. The award funded the addition of a floor in the new Arthur G. James Cancer Hospital and Richard J. Solove Research Institute dedicated to radiation oncology and exponentially grew the number of patients the department could treat each day. “It’s really remarkable what [Dr. Chakravarti] has done — taking a smaller, almost private practice with just a few physicians and a smaller overall fingerprint in Ohio to then growing 10 to 15 times that size and providing services to several hundred patients a day,” Palmer says. “To become one of the largest radiation oncology centers has just been phenomenal, and it really just keeps growing.”

That growth has captured worldwide attention. In March 2021, Chakravarti hosted President Joe Biden for a tour of the department, a trip that marked both the 11-year anniversary of the signing of the Affordable Care Act and the first time a sitting U.S. president had ever visited the Ohio State Wexner Medical Center.

Chakravarti, no stranger to world leaders — having treated patients referred to him by President George H.W. Bush among other prominent international leaders — embraced the opportunity to show President Biden around and share details about the new proton center opening soon at Ohio State.

“We have some of the finest minds in the world,” President Biden would later say during a press conference, “and they’re right here — right here at Ohio State, right here in Ohio, right here in the United States of America.”

Arnab Chakravarti, MD, explains how proton therapy, including FLASH proton therapy, have the potential to transform cancer treatment.

The ‘complicated journey’ of proton therapy

As Ohio State’s radiation oncology department gained prominence and patients, Chakravarti never lost sight of his ultimate goal: to establish a premier proton therapy center in Columbus, and to outfit it with the best and most current technology.

“He always said that you’re kind of a three-legged stool if you don’t have that kind of treatment,” says Julie Sussi, the department’s chief administrative officer.

Chief Medical Physicist Nilendu Gupta, PhD, FAAPM, has been with Ohio State since 1988 — first as a student and later as a faculty member in radiation oncology. He has watched a small program grow into one of the region’s leading cancer treatment centers with the 2014 opening of the new OSUCCC – James.

He’s also witnessed the lengthy and involved process — a “complicated journey,” he says — of bringing proton therapy to Ohio State. The folders on his computer documenting that journey date back to 2007. Setting up an expensive proton therapy center requires buy-in from every level of leadership, Gupta says, and it also can require a significant partner, which the OSUCCC – James ultimately found in Nationwide Children’s Hospital.

Read how Nationwide Children’s Hospital will use proton therapy for pediatric patients

“Thanks to philanthropic partners and Nationwide Children’s Hospital, we have achieved our shared ambition to develop one of the largest and preeminent radiation oncology centers,” says Michael Faber, vice president of advancement at the Ohio State Wexner Medical Center and health sciences colleges. “The foresight, talent and vision that Dr. Chakravarti and his team have brought to this effort are extraordinary. The new proton therapy center enables patients from near and far to undergo life-saving treatments from our renowned cancer program. The OSUCCC – James was already on the map, we just got a little bigger.”

While the process took well over a decade, Gupta and Chakravarti marveled at how neatly — almost serendipitously — the pieces came together.

Beam for the new proton therapy center signed by the team

“One of the things Dr. Chakravarti and I joke about is we generally try to be on the leading edge of technology, but with protons we said it was better that we waited — because now the newer generation of machines are much more powerful, targeted and compact, while the construction costs are much lower,” Gupta says. “Many of the early centers are now struggling to upgrade their equipment, and that’s very expensive to do. We’re actually at the right spot where a lot of the core technology prices went down with quality and precision having increased by leaps and bounds.”

They’re also in the best place to push proton therapy even further. Ohio State’s proton therapy center is the first treatment center in the United States specifically built with a dual-capability system that can deliver both conventional proton therapy and a new technology, FLASH, which could reduce conventional radiation therapy from eight weeks to a single treatment — one that’s over in the blink of an eye.

“This is the most advanced technology that’s available,” Palmer says, “and that’s the really exciting part, both from a research standpoint and from our ability to offer the best treatments to our patients.”

At the proton therapy center, OSUCCC – James researchers will continue to study the safety and efficacy of the new radiotherapy. Although these studies are not yet active in human patients, early preclinical results are promising enough that Chakravarti is able to envision their transformative power. FLASH holds immense promise not only for effective cancer treatment but also the expansion of access to patients who may be unable to shoulder the burden of repeated hospital visits.

“If we can get to that point — where we can treat patients in less than one-tenth of a second, requiring one visit instead of 30 or 40 visits — we can greatly expand access to cancer care,” Chakravarti says.

While this project has a long history, so much more lies ahead. As Chakravarti’s dream becomes a reality, he envisions a future of cancer care that’s speedy, safe and available to everyone.

For a man with decades’ worth of patience, that’s well worth the wait.

“This is an exciting time for us here at Ohio State,” he says. “Everything is before us. The impact that both proton therapy and FLASH will have on the health and well-being of the people of central Ohio and beyond — it’s going to be astronomical.”

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