ROCHESTER, Minn. — Mayo Clinic is expanding its proton beam therapy program by spending $200 million to build a new 110,000-square-foot facility in downtown Rochester.

The announcement was made Monday morning, Aug. 16, that the expansion will be built on the east side of the Eisenberg Building and attached to the south side of the Jacobson Building, where the proton beam program began in 2015. It was built for $188 million with $100 million coming from donor Richard O. Jacobson.

This is latest of major Rochester projects announced by Mayo Clinic following the $60 million tower on the Saint Marys Hospital campus to be named after the late John Nasseff and the $120 million Anna-Maria and Stephen Kellen research building in downtown Rochester.

The proton beam expansion will add two new treatment rooms to the four Mayo now uses to treat patients dealing with prostate cancer, breast cancer, neck and throat cancers as well as pediatric cancers. Work on the massive project is expected to begin in November.

The 110,000-square-foot expansion will also feature a single lobby and check-in desk. An estimated 117 new jobs are expected to be added to Mayo’s payroll to staff the expansion.

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Map of downtown Rochester. Created with Datawrapper
Map of downtown Rochester. Created with Datawrapper

If construction goes as planned, Dr. Nadia Laack said the hope is to be able to start treating patients in the new facility by late 2025.

Laack, the chair of the Department of Radiation Oncology, said her department has been advocating for an expansion of the proton beam program because of the benefits it provides cancer patients.

Proton beam therapy delivers radiation treatment via a “pencil” beam to specific areas of the body much more precisely and with more power than traditional photon radiation treatment. That means other organs are not unintentionally exposed, reducing negative side effects and the occurrence of secondary cancers.

Mayo Clinic’s proton beam program has been operating at maximum capacity, treating 1,200 patients a year, since October 2019. That was more than a year earlier than planners expected.

The Jacobson proton facility currently treats patients from 7 a.m. to 11 p.m. throughout the week. However, Laack says they do sometimes operate past midnight or on Saturdays to accommodate emergency cases.

Mayo Clinic’s proton beam treatment wait-list is about a month for most patients. The expansion means an additional 900 patients a year can be treated.

Dr. Nadia Laack
Dr. Nadia Laack

Mayo is planning to spend $1.3 billion in capital expenditures in 2021, which equals the 2019 and 2020 capital expenditures combined. However, requesting $200 million for a project is still not a small ask. Why does Laack believe the proton beam expansion deserves this funding over other Mayo Clinic departments and projects?

“I like to think that it's not a zero sum game. It is an investment ... it's not something that takes away from the other projects,” she said.

Specifically, this project will give a boost to Mayo Clinic’s cancer treatment programs.

“From a cancer perspective, we don't have enough space to take care of our cancer patients, so this actually gives us an opportunity to grow the foundation for more of a multi-disciplinary cancer practice and fill the needs that we have for growth,” Laack said.

From the start in 2015, Mayo Clinic’s proton beam program faced criticism due the limited amount of clinical research into proton beam treatment versus less expensive options. Mayo Clinic leaders say that is one aspect that has changed in the past five years.

Mayo researchers have published an estimated 300 articles studying the effects of proton beam treatment that have found it less toxic than traditional radiation as well as more cost effective with fewer treatments required.

While the equipment is more expensive, Mayo Clinic has kept the patient cost of proton beam radiation treatment equal to the cost of intensity modulated photon radiotherapy cancer treatment. The per-treatment cost of proton beam treatment, according to Mayo Clinic’s online cost estimator, was $5,904 at the end of 2020.

Jacobson’s $100 million donation covered much of the cost of launching the program, so that made it easier for Mayo Clinic to keep the cost down. Despite no donors or other external financing source for the $200 million expansion, Laack said Mayo intends to continue the practice of pricing proton beam treatment at the same level of traditional radiation treatment.

“The plan is still to keep the pricing equal, so that the cost is not a consideration, either for the Mayo physicians or the insurers. We want to be able to choose the right treatment for the patient, because it's the right treatment for the patient, regardless of the cost or reimbursement,” Laack said.

Most insurance plans do not automatically cover proton treatment. Mayo Clinic is required to make a special request for each patient. Since the price tag is the same as the covered photon treatment, Laack said about 95% of insurance requests are approved.

Given that radiation is involved in this treatment facility and that safety rules require 6 feet of concrete surrounding the equipment, does the proton beam radiation facility pose any sort of health risks? Laack said this is not reason for concern.

“There are no radioactive materials in the building,” she said. “It's not like a nuclear reactor where there's something that is constantly on that could explode or leak. Basically it's a machine that you turn on and off, like an X-ray machine.”