From the beginning, Dr. Slater believed that a heavy-charged-particle facility should be designed specifically for patient use and be based at a hospital, where patients would have ready access to supporting services necessary to deliver high-quality care. It quickly became apparent that 1970 was too early to develop a hospital-based, patient-dedicated treatment facility. A medical particle accelerator and its control system must be highly reliable, with very little “downtime,” and greatly increased computing power must become available, affordable, and sufficiently competent to deliver complex treatment plans and operate complex charged-particle systems. Imaging capabilities must also be improved greatly.

Throughout the 1970s and early 1980s, Dr. Slater and his colleagues studied with other colleagues at particle facilities in the United States and around the world. As time went on, Dr. Slater became more and more certain that the proton was the optimal particle to use for a clinical heavy-charged-particle treatment center. With the further passage of time, it also became apparent that engineering advances, notably in computer competence and advancing digital imaging capabilities, were making it more feasible to develop a sophisticated proton treatment system in a hospital environment.

In 1984 Dr. Slater recruited John O. Archambeau, MD, FACR, to help the LLU effort in developing a hospital-based proton treatment system. Dr. Archambeau was one of the pioneers of proton radiation therapy; he had formerly headed the proton treatment program at Brookhaven National Laboratory and had written some of the classic early papers about the modality in the early and mid-1970s.

January, 1985 can be regarded as a salient date in the history of hospital-based proton treatment. Dr. Slater and other LLU investigators participated in a symposium held at Fermilab. The meeting revealed much enthusiasm among international investigators for the concept of a medically dedicated proton accelerator and facility. At that time, Daniel Miller, PhD physicist, was recruited from Duke University to become the third member of the LLU team.

As 1985 proceeded, Dr. Slater and LLU investigators intensified their efforts to develop a proton treatment system at LLUMC. During the several meetings Dr. Slater approached Philip Livdahl, Deputy Director of Fermilab, to inquire whether the Laboratory might be able to work with LLUMC to develop and build a proton treatment system for Loma Linda. Dr. Slater was then making inquiries of private industry as to whether they would, or could, build a proton accelerator and delivery system for use in a hospital. All of the major manufacturers declined and National Laboratories do not compete with private industry. Livdahl consulted with others at Fermilab, including the Director, Leon Lederman, PhD, and informed Dr. Slater that the Laboratory could participate under its “work for others” program, which was designed to promote technology transfer. At this time, the support of two people became critical: David B. Hinshaw, MD, FACS, President of LLUMC, and Reverend Neal B. Wilson, Chair of the Boards of Trustees at LLU and LLUMC, played essential roles in supporting the endeavor; their support helped convince other faculty and Board members that a proton treatment facility was feasible and consistent with the basic mission of the University and Medical Center.

In July of 1987, Jerry D. Slater, MD was recruited to the Department of Radiation Medicine, following his training at M.D. Anderson Hospital and Massachusetts General Hospital, the latter in their proton treatment program at HCL. Dr. Slater immediately began to develop protocols for treating patients with protons at LLU.

In April 1988, ground was broken on the campus of Loma Linda University Medical Center for the proton facility. This event helped to highlight the important contributions made by supporters in the U.S. Congress, notably Representative Jerry Lewis (R-Redlands, CA), who believed in the project from an early date. Congress appropriated $8.5 million for the facility and, in another session, granted an additional $11.1 million through the Department of Energy.

In November 1989, George B. Coutrakon, PhD, a physicist from Fermilab, was recruited to the LLUMC staff as lead operator for the proton accelerator. Dr. Coutrakon remained at LLUMC and has helped with technical upgrades and improvements to the synchrotron and its systems, a process that goes on continually.

Installation of the accelerator and support systems was completed in early 1990. Testing of the 250-million-electron-volt (MeV) accelerator was conducted at LLUMC in summer and autumn. By October, the LLU team completed the tuning and commissioning of the accelerator and fixed beam room. On October 20, the first patient, a woman with an ocular melanoma, was treated at the new proton treatment center.