Proton system engineer sees beam from new vantage point

For more than two decades, Mike Notarus has helped guide the design and construction of 17 proton treatment centers around the world.

Last April, he saw protons from a very different vantage point — laying on the treatment couch.

Diagnosed with prostate cancer by his physicians at the LAC+USC Medical Center in Los Angeles, California, Mike knew exactly which treatment he would pursue. And he knew where he would be treated.

Still, as is customary, his Los Angeles oncologist walked him through the various treatment options available for his prostate cancer, their risks and their benefits.

“‘No,’ I said, ‘I’ve been helping build proton therapy centers for 24 years, I’ll do protons and I’ll go to Jacksonville for treatment,’” he recalled. “I was never distressed. I knew I would be treated successfully.”

Mike’s confidence in protons goes back to the mid-1980s and the first center he worked on in Loma Linda, California.

Loma Linda University Medical Center was planning to build its proton therapy center and sought the advice of scientists at the US Department of Energy. Mike was employed by the department’s Enrico Fermi National Laboratory in Batavia, Illinois. FermiLab is home to a particle accelerator that generates proton beams. And Mike found himself advising the architects and construction managers to the Loma Linda proton center on the installation of the cyclotron and beam delivery system. IBA, the Belgium-based maker of proton systems, later hired Mike to provide architectural engineering expertise in preparation for IBA’s proton system installations around the world.

Mike takes pride in the strong working relationships he has developed with medical staff at all of the proton centers he’s helped design and build over the years. “They’re all incredibly knowledgeable, incredibly experienced,” Mike said. “But for some reason I just got to know the staff at the University of Florida so much more. And I just knew I would go there.”

The morning of Mike’s first proton treatment at UF Proton Therapy Institute, “I was super excited,” he recalled. “I laid down on the treatment couch and I looked up at that machine for the first time in a whole new way. And when I was done, I said, ‘Gee, there’s nothing to it.’”

Mike received 39 proton beam treatments in all. “And I worked every day,” he said. “I had no problems. There was never any fatigue. Never any loss of energy. Never any pain. Nothing prevents you from living a normal life. It was exactly as advertised.”

Mike and his wife brought two large cakes into the proton center to celebrate his final proton treatment with his medical team and with other patients undergoing proton therapy. But before they cut the cake, Mike hit the treatment couch for his last fraction of protons. His proton radiation therapists burst into laughter as they eyed two words temporarily tattooed to Mike’s buttocks: “Thank you.”

Mike’s PSA level was 7.1 prior to his first treatment. It dropped to 1.8 with his final treatment. His PSA level will be evaluated in October, and Mike has no doubt it will be lower.