TerraPower Isotopes, part of a nuclear power company founded by Bill Gates, plans a $450 million plant in the Bellwether District to make radioactive molecules for cancer research and potential treatments, Gov. Josh Shapiro announced Tuesday.
Bellwether’s developer HRP Group will build a 250,000-square-foot facility for the Bellevue, Wash., company at the former refinery site. TerraPower Isotopes is expected to employ 225 people in Philadelphia to meet anticipated demand for a type of molecule that can be used to kill tumors without damaging surrounding tissue.
TerraPower’s material, an isotope called actinium-225, is ultimately derived from weapons-grade uranium. Researchers are exploring precision cancer treatments that involve attaching actinium-225 to an antibody that is targeted to specific cancer cells. The isotope then emits high doses of radiation at close range.
“This new facility is a testament to the demand for actinium-225 as part of the growing industry, which is transforming how cancer is treated,” TerraPower Isotopes President Scott Claunch said in Shapiro’s announcement. “Our team is proud to be building a large-scale manufacturing facility in Philadelphia, which will play a pivotal role in expanding global access to this rare isotope.”
Pennsylvania government is supporting the project with $10 million in grants. The Bellwether District is in a Keystone Opportunity Zone that has tax benefits through 2043. That means TerraPower Isotopes won’t have to pay many state and local taxes, though it will remain responsible for city wage taxes.
TerraPower Isotopes, part of a bigger nuclear sciences company called TerraPower, is the second radiopharmaceutical company to announce a factory in the region. In 2024, Nucleus RadioPharma, which counts Fox Chase Cancer Center among its investors, shared plans for a 48,000-square-foot facility in Spring House, Montgomery County.
TerraPower’s move to South Philadelphia is the third significant life sciences development announced this year by Shapiro and his economic development team.
TerraPower is the second tenant in the 1,300-acre Bellwether District, which HRP is trying to develop into a new industrial and life sciences hub. Late last year, it announced that California-based canned beverage manufacturer DrinkPAK will build a 1.4 million-square-foot factory that will product 3 billion cans a year.
Paul F. Engstrom, 89, formerly of Ambler, Montgomery County, celebrated pioneer in cancer prevention, education, and treatment, former chair and professor emeritus of the hematology and oncology department at Fox Chase Cancer Center, retired vice president of cancer control and senior adviser to the president at Fox Chase, Army veteran, and mentor, died Friday, Dec. 26, of Parkinson’s disease at Normandy Farms Estates in Blue Bell.
The son of a small-town doctor, Dr. Engstrom accompanied his father on house calls in Minnesota when he was young and assisted sometimes on routine procedures. Later, after earning his medical degree at the University of Minnesota, he excelled at identifying cancer-related health problems and creating solutions.
Starting in the 1960s and ’70s, Dr. Engstrom noticed large gaps in cancer prevention programs and treatment strategies. So he compiled comprehensive clinical care guidelines for cancer doctors and hospitals around the world, forged sustainable oncology research networks and community education partnerships, and established one of the country’s first cancer prevention and control programs at Fox Chase.
“Most doctors and oncologists in the 1970s were training to treat cancer, not necessarily to prevent it,” former Fox Chase colleague Carolyn Fang said in a 2018 story for Fox Chase’s Forward magazine. “He was one of the first to recognize that prevention was important.”
In 1991, Dr. Engstrom told the Daily News: “Changing the behavior of the public is only part of my job. We must change the physicians, too.” In 2000, he told The Inquirer: “Nowadays, the trend is toward identifying high-risk individuals and treatments we can give to prevent cancer from ever starting.”
Dr. Engstrom was adept at organization and collaboration, former colleagues said in online tributes. He recruited other cancer experts to Fox Chase and established cutting-edge programs for cancer screening, smoking cessation, and education at hospitals, schools, private companies, and other organizations.
He taught clinical science classes, secured vital grants from the National Cancer Institute and other groups, and made seminal clinical trials available to many more patients. “He was really aware of the need to integrate the community into this work.” Fang said in 2018.
Dr. Engstrom joined the old American Oncologic Hospital in Philadelphia in 1970 and oversaw its merger with the Institute for Cancer Research in 1974 to become the Fox Chase Cancer Center. He was named vice president of cancer control and continuing education in 1984, and head of community cancer program activities in 1989.
Dr. Engstrom (center) earned many awards over his long career.
He was also vice president for population science and held the Samuel M.V. Hamilton endowed chair in cancer prevention. He specialized in treating gastrointestinal cancers and neuroendocrine tumors. Heretired in 2018 but continued as a special adviser to the Fox Chase president.
He cofounded the National Comprehensive Cancer Network and was a fellow of the American College of Physicians and longtime member of the American Association of Cancer Research and other groups. He served on many boards and earned a clinical care achievement award in 2013 from the Association of Community Cancer Centers.
Dr. Engstrom edited, wrote, or cowrote hundreds of research papers and lectured around the world. He was drafted into the Army in 1967, rose to the rank of major, and served three years as head of hematology and oncology at Tripler Army Hospital in Honolulu.
Dr. Engstrom (left in the photo) appeared in many print advertisements for the Fox Chase Cancer Center, such as this 1995 ad in The Inquirer.
“Medicine is a great career,” he said in 2018. “It is still the most satisfying and the best opportunity to do well, but most importantly to do good.”
Paul Frederick Engstrom was born May 28, 1936, in St. Cloud, Minn. He played football and basketball, ran track, played trombone in the high school band, and sang in the school chorus.
His father was the only doctor in Belgrade, Minn., and Dr. Engstrom knew early he was going to be a doctor, too. He earned a bachelor’s degree at St. Olaf College in Minnesota and completed a public health fellowship at the California Department of Health during medical school.
He met nurse Janet Johnson during a procedure in a Minnesota hospital in 1960, and they married in 1961. They lived in Hawaii while he served in the Army and in Ambler until recently, and had daughters Karin and Maria, and a son, David.
Dr. Engstrom met his wife, Janet, when she was an intensive care unit nurse.
Dr. Engstrom and his wife enjoyed the orchestra, ballet, and theater in Philadelphia. He liked to garden, read, and travel. He was thrifty, his wife said.
He followed many of the local college and professional sports teams, especially the Eagles, and sang in the choir at Christ’s Lutheran Church in Oreland. He survived prostate cancer and remained a lifelong learner.
Conditions were rough when staff and students arrived at Penrose Elementary in Southwest Philadelphia — some paths they needed to access to get inside the school were untouched by shovels or plows.
Some buses could not open their doors to let students out at their usual spot because snow banks were so high, according to multiple people who work at the school and teachers union officials. A ramp that students with disabilities use to get into the school was blocked.
And the heat was on the fritz for part of the day as outside temperatures were barely in the double digits.
“It’s about 45 degrees inside this classroom,” one Penrose staffer said Thursday morning. The staffer was not authorized to speak to the media and asked not to be identified. “We’re all in jackets and hats.”
After Monday’s snow day and virtual learning Tuesday and Wednesday, Philadelphia schools reopened Thursday, but for many students, it was anything but an inviting return. The combination of accumulated snow, days of subfreezing temperatures, and a clutch of old buildings — many of which have maintenance issues — made in-person learning challenging across the district.
The rocky return came just hours before a planned rally to protest the district’s proposed $2.8 billion school facilities master plan, which is necessary, officials say, because of poor building conditions and other disparities.
Around some schools, crosswalks were covered by giant piles of snow, forcing children to walk in streets. Elsewhere, there was no place for staff to park.
At Vare-Washington Elementary, in South Philadelphia, pipes burst, rendering six classrooms, the cafeteria, the gym, and the entire basement unusable, according to the Philadelphia Federation of Teachers. There was a strong chemical odor throughout the building.
At Mitchell, another Southwest Philadelphia elementary, “it’s a mess,” said a staffer who asked not to be identified for fear of retribution.
A pipe broke at the school, and Mitchell had no running water for most of the day, with just one brief window where students could use the bathroom. And Mitchell’s student lunches were never delivered, so kids were fed cereal for lunch.
“A lot of our kids rely on those lunches to sustain them throughout the day,” the staffer said.
In addition, Mitchell’s back doors and fire tower exits were blocked by snow, so if there had been a fire or emergency, the only available exits would have been the front doors.
Taylor, also in North Philadelphia, also had burst pipes, with four rooms unusable and most of the school cold. School officials asked for permission to hold classes virtually Friday, but had received no response as of Thursday afternoon.
The Philadelphia Federation of Teachers has called on the district to return to remote learning on Friday in light of “treacherous commutes and dangerous building conditions,” Arthur Steinberg, PFT president, said in a statement issued Thursday afternoon.
Steinberg said in an interview that his office was inundated with reports of heating issues or a lack of snow removal or other problems at schools including School of the Future in Parkside; Farrell, Swenson, Mayfair, and Fox Chase in the Northeast; and others.
“The District must also show respect to students, families, and our members by rectifying the broken heaters, burst pipes, icy sidewalks, and piles of snow in parking lots as soon as possible, so that students and staff can safely resume in-person instruction on Monday,” he said in the statement.
Monique Braxton, a district spokesperson, said “the safety and well-being of our students, staff, and families remains our top priority.”
Staff worked long hours inspecting boilers and buildings, restarting heating systems, clearing snow and ice, and more, Braxton said.
“Across the district, teams are responding in real time to heating concerns, snow and ice conditions, and other weather-related issues as they arise. When conditions do not meet District standards, we work closely with school leaders to take appropriate action and communicate directly with our families,” she said in a statement. “We will continue to closely monitor building conditions throughout this bitter cold period and make adjustments as needed, while temperatures remain below freezing.”
Both Thursday and Friday had long been scheduled as half days for students, with parent-teacher conferences planned. Those would be held virtually.
John Bynum, a former building engineer who is now an official with 32BJ SEIU Local 1201, the union representing 2,000 Philadelphia school building engineers, maintenance workers, and bus drivers, said the going was rough for many schools in terms of building condition.
“Most of these buildings are operating with the original boilers,” Bynum said. “We know with antiquated equipment, there’s going to be problems.”
In some cases, snowblowers that school staff were using to attempt to clear parking lots and sidewalks failed, Bynum said.
And like other school staff, his members often coped with trouble getting to work themselves, he said.
“There were challenges regarding SEPTA not running at a full schedule and the anxiety of getting to work without a robust transportation system,” Bynum said. “Street conditions weren’t the greatest. However, they made the best of it, and they showed up.”
Conditions like Thursday’s, Bynum said, highlight why the district needs more resources to address its buildings — and students’ learning conditions.
On weekdays from 9 a.m. until 2:30 p.m., buses will serve Fox Chase, Ryers, Cheltenham, Lawndale, and Olney stations. Trains will run to and from Center City between Wayne Junction Station and 30th Street Station.
Passengers headed inbound should plan on an additional 30 to 35 minutes of travel time.
An outbound trip toward Fox Chase Station will take an extra 35 to 40 minutes during the midday hours, SEPTA advises. The connecting shuttle bus is scheduled to depart Wayne Junction Station five minutes after a train arrives.
Fox Chase Cancer Center was not cited by the Pennsylvania Department of Health for any safety violations between November 2024 and October of this year.
Here’s a look at the publicly available details:
Feb. 21, 2025: Inspectors came to investigate a complaint but found the hospital was in compliance. Complaint details are not made public when inspectors determine it was unfounded.
March 17: Inspectors came to investigate a complaint but found the hospital was in compliance.
April 15: The Joint Commission, a nonprofit hospital accreditation agency, renewed the hospital’s accreditation, effective January 2025, for 36 months.
Philly is getting ready to dress itself up — with Liberty Bells. Lots of Liberty Bells.
Organizers of Philadelphia’s yearlong celebrations for America’s 250th anniversary in 2026 gathered in a frigid Philadelphia School District warehouse in Logan on Tuesday, offering a special preview of the 20 large replica Liberty Bells that will decorate Philly neighborhoods for the national milestone.
Designed by 16 local artists selected through Mural Arts Philadelphia — and planned for commercial corridors and public parks everywhere from Chinatown and South Philly to West Philly and Wynnefield — the painted bells depict the histories, heroes, cultures, and traditions of Philly neighborhoods.
As part of the state nonprofit America250PA’s “Bells Across PA” program, more than 100 painted bells will be installed across Pennsylvania throughout the national milestone, also known as the Semiquincentennial. Local planners and Mural Arts Philadelphia helped coordinate the Philly bells.
“As Philadelphia’s own Liberty Bell served as inspiration for this statewide program, it makes sense that Philly would take it to the next level and bring these bells to as many neighborhoods as possible,” Mayor Cherelle L. Parker said in a statement. “We are a proud, diverse city of neighborhoods with many stories to tell.”
Kathryn Ott Lovell, president and CEO of Philadelphia250, the city’s planning partner for the Semiquincentennial, said the bells are a key part of the local planners’ efforts to bring the party to every Philly neighborhood.
Local artist Bob Dix paints a portrait of industrialist Henry Disston on his bell.
“The personalities of the neighborhoods are coming out in the bells,” she said, adding that the completed bells will be dedicated in January, then installed in early spring, in time for Philly’s big-ticket events next summer, including six FIFA World Cup matches, the MLB All-Star Game, and a pumped-up Fourth of July concert.
Planners released a full list of neighborhoods where the bells will be placed, but said exact locations will be announced in January. Each of the nearly 3-foot bells — which will be perched on heavy black pedestals — was designed in collaboration with community members, Ott Lovell said.
Inside the massive, makeshift studio behind the Widener Memorial School on Tuesday, artists worked in the chill on their bells. Each bell told a different story of neighborhood pride.
Chenlin Cai (left) talks with fellow artist Emily Busch (right) about his bell, showing her concepts on his tablet.
Cindy Lozito, 33, a muralist and illustrator who lives in Bella Vista, didn’t have to look for inspiration for her bell on the Italian Market. She lives just a block away from Ninth Street and is a market regular.
After talking with merchants, she strove to capture the market’s iconic sites, history, and diversity. Titled Always Open, her bell includes painted scenes of the market’s bustling produce stands and flickering fire barrels, the smiling faces of old-school merchants and newer immigrant vendors, and the joy of the street’s annual Procession of Saints and Day of the Dead festivities. Also, of course, the greased pole.
“It’s a place where I can walk outside my house and get everything that I need, and also a place where people know your name and care about you,” she said, painting her bell.
For her bell on El Centro de Oro, artist and educator Symone Salib, 32, met twice with 30 community members from North Fifth Street and Lehigh Avenue, asking them for ideas.
“From there, I had a very long list,” she said. “People really liked telling me what they wanted to see and what they did not.”
Local artist Symone Salib talks with a visitor as she works on her bell.
Titled The Golden Block, the striking yellow-and-black bell depicts the neighborhood’s historic Stetson Hats factory, the long-standing Latin music shop Centro Musical, and popular iron palm tree sculptures.
To add that extra bit of authenticity to his bell depicting Glen Foerd, artist Bob Dix, 62, mixed his paints with water bottled from the Delaware River, near where the historic mansion and estate sits perched in Torresdale, overlooking the mouth of Poquessing Creek.
“I like to incorporate the spirit of the area,” he said, dabbing his brush in the river water. “I think it’s important to bring in the natural materials.”
Local artist Bob Dix displays waters he collected from the Delaware River and Poquessing Creek to use in his painting of one of 20 replica Liberty Bells representing different neighborhoods Tuesday, Dec. 9, 2025.
Planners say they expect the bells to draw interest and curiosity similar to the painted donkeys that dotted Philadelphia neighborhoods during the 2016 Democratic National Convention.
Ott Lovell said organizers will install the bells around March to protect them from the worst of the winter weather.
“I don’t want any weather on them,” she said with a smile. “I want them looking perfect for 2026.”
Wistar Institute scientist Maureen Murphy wants to solve a decades-long mystery: Why is ovarian cancer often resistant to hormone therapy?
In a recently published study, she shared a new theory as to why treatments designed to block or remove hormones, known as hormone therapy, often fail in ovarian cancer — and a potential approach to make them more effective. Such therapies have cut the risk of death from certain breast cancers by a third and reduced the odds of a recurrence by half.
She pinpointed a problem facing hormone therapy — the vast majority of ovarian cancer cases have mutations in a key protein called p53.
Her study, published last month in the medical journalGenes and Development, suggests that mutations in p53, a protein that normally works to stop tumors from growing, drive resistance to hormone therapy and that their effects could be reversed.
“There are very few drugs that treat it,” Murphy said.
Her p53 mutation discovery led to her identifying a drug currently in clinical trials that’s promisingin a small number of cases. Murphy wants doctors to start testing the combination of the drug and hormone therapy in ovarian cancer.
If the approach makes it into a clinical trial, it would still take years to evaluate the safety and efficacy of the combination. Most treatments tested in clinical trials do not become standard practice.
“For ovarian cancer, the treatment hasn’t changed much in the last 20 years, and so we really do need new treatments,” Murphy said.
How does hormone therapy work?
Hormones are like the body’s mail service.
These chemicals carry messages to cells throughout the body, controlling mood, growth, reproduction, and development.
Tumors can co-opt hormones for their own purposes using proteins called receptors, which act like mailboxes to receive the messages.
Breast cancers, for example, often have estrogen receptors so that they can receive more of a hormone called estrogen. Similar to how bodybuilders use steroids to build muscle, tumors use estrogen to grow and divide.
“Breast and ovarian tumors love estrogen. They grow on it,” Murphy said.
Hormone therapy works by either blocking the receptors from receiving the hormones, or reducing the amount of hormones in the body altogether.
One of the first hormone therapy drugs for cancer, tamoxifen, was approved in the U.S. in 1977 to target the estrogen receptor in metastatic breast cancer.
In this study, Murphy looked at fulvestrant and elacestrant, two anti-estrogen drugs approved for breast cancer.
More than 70% of cases of the most common type of ovarian cancer express estrogen receptors, making them theoretically a good target for hormone therapy, if the p53 problem can be fixed.
Solving the mystery
In her first professor job at Temple’s Fox Chase Cancer Center in 1998, Murphy chose to study the tumor suppressor protein p53, with a focus on genetic variants in women of African and Ashkenazi Jewish descent that put them at risk of cancer.
Decades later, Murphy expanded her focus at Wistar to look at hundreds of genetic variants of the protein found in the general population, in an effort to predict people’s risk of cancer.
Murphy started to wonder whether mutant p53 controlled the function of the estrogen receptor, and how it might affect the response of tumor cells to hormone therapy.
That led her team to look atovarian cancer because of its high prevalence of p53 mutations. They used cell lines and a lab model to mimic stage 3 and 4 tumors.
The researchers found that when mutant p53 was bound to the estrogen receptor in these models, it inhibited part of the estrogen receptor’s activity, driving resistance to hormone therapy.
By simply removing the mutant protein, tumors “responded great” to the hormone therapy, Murphy said.
A lab at the Wistar Institute in Philadelphia.
Hope for hormone therapy?
While it’s easy to take away p53 in the lab, it’s not as easy in a patient.
There is, however, a promising drug currently being tested in clinical trials. Called rezatapopt, it can convert mutant p53 into a normal-functioning version of the protein.
It works for one particular mutation, Y220C, found in roughly 4% of ovarian cancers.
Murphy’s team foundadministering rezatapopt alongside hormone therapy led to 75% shrinkage of ovarian tumor models, versus 50% shrinkage when the hormone therapy was given alone.
This finding lined up with rezatapopt’s early data from clinical trials.
“For reasons we didn’t understand, women with ovarian cancer were responding best to this drug,” Murphy said.
Nineteen out of 44 women treated with rezatapopt alone saw their tumors shrink, with one even having a complete response, according to recent interim results from a phase 2 trial.
Murphy hopes this paper will prompt clinical trials to test rezatapopt in combination with anti-estrogen therapy.
However, since rezatapopt only targets one p53 mutation, this approach is limited to a small subset of patients. Murphy hopes that more drugs can be developed thatfix other mutant forms of p53 seen in ovarian cancer.
Murphy’s findings make sense conceptually and present a “promising avenue for future clinical trials,”said Tian-Li Wang, the head of the Molecular Genetics Laboratory of Female Reproductive Cancer at Johns Hopkins University, who was not involved in the Wistar study.
A caveat is that the study looked at a limited number of cell lines, she said.
She thinks the results should be confirmed in cases of ovarian cancer that have other types of p53 mutations to see if it could be applied more broadly.
“[I’m] really interested to see if the approach can benefit patients,” Wang said.
The nation’s top vaccine advisory panel is expected to debate whether to delay the first dose of the hepatitis B shot on Thursday.
The immunization, developed in Philadelphia and long recommended for all U.S. infants at birth, protects against a disease that can do permanent damage to the liver, and for which there is no cure.
The shot is widely considered safe and effective, but who should receive it, and when, has come under scrutiny by President Donald Trump’s administration.
The Advisory Committee on Immunization Practices (ACIP), an independent panel of experts reconstituted this past summer to include several vaccine skeptics, had tabled a vote on this topic in September. It is now scheduled to spend Thursday discussing the vaccine, according to a draft agenda of the group’s two-day December meeting.
Vaccine experts and patient advocates have previously advocated against delaying the birth dose, citing concerns that unvaccinatedchildren could be at risk of contractingthe highly contagious virus.
Starting in 1991, the first dose of the hepatitis B vaccine has been universally recommended for all newborns within 24 hours of birth. Rates of infection among children and teens have since dropped by 99%.
Prior to the universal birth dose recommendation, about half of infections in children were acquired from mothers infected with the virus, the Centers for Disease Control and Prevention found.
The virus spreads through contact with blood and other body fluids.
The virus can be transmitted from mother to baby, as well as through a variety of household sources, such as personal items like toothbrushes and razors that become contaminated with blood.
The virus cannot be spread through casual contact such as hugging, touching, or sharing utensils, but it can be spread through open wounds.
Patients can take antiviral treatments to help control the virus, but there is no cure.
The panel has previously considered delaying the birth dose until one month of age.
ACIPpreviously debated delaying the first dose of the vaccine until one month of age for most babies.
Some members had suggested the dose for newborns should instead be given only to the populations most at risk.
The ACIP considered recommending doctors vaccinate only those newborns whose mothers test positive for the virus, and having the other babies wait a month for their first dose.
Trump separately stated in a news conference, without citing scientific evidence, that he thinks newborns should no longer universally receive the shot and children should wait until age 12. Experts criticized Trump for incorrectly suggesting that hepatitis B is only transmitted sexually.
Experts are concerned about a potential change to the guidelines.
Experts worry that delaying the vaccine could affect its ability to prevent transmission of the virus from mother to baby. “If you wait longer than 24 hours, then the vaccine doesn’t work as well,” Chari Cohen, president of the Hepatitis B Foundation, told The Inquirer in an interview earlier this fall.
Even if the ACIP were to recommend vaccinating only babies whose mothers have the virus, some cases could be missed. Universal testing for the virus has been recommended since the 1990s, but 15% to 16% of women still do not get tested.
Such a policy also would not account for other exposures. Su Wang, a New Jersey physician who treats patients with hepatitis B and herself has the disease, told The Inquirer earlier this year that she likely caught hepatitis B as a child living with her grandparents. Her parents tested negative. “There are a lot of exposures that we aren’t testing for,” she said.
The vaccine is a Philadelphia success story.
The hepatitis B virus was first discovered by Baruch Blumberg, a scientist at Fox Chase Cancer Center, in 1967.
He went on to win a Nobel Prize for that work, and later cocreated and developed the vaccine,which continues to be manufactured in and around the region.
The Hepatitis B Foundation is also locallybased, in Doylestown.
The University of Pennsylvania Health System, the Philadelphia region’s biggest provider of cancer care and a national leader in developing new treatments, is spending more than $500 million on two new cancer facilities in Philadelphia and central New Jersey to keep growing.
“What we’ve seen pretty consistently is that demand is there to meet any capacity increases,” Julia Puchtler, the health system’s chief financial officer, said in an interview about fiscal 2025 financial results.
Penn is not alone in its push to expand cancer services. Jefferson’s Sidney Kimmel Cancer Center, Temple’s Fox Chase Cancer Center, and the MD Anderson Cancer Center at Cooper are pushing into the suburbs to reach more patients.
The same thing is happening nationally as financially pressured health systems are looking for ways to increase revenue in a growing and lucrative market for cancer care.
Penn stands out locally for the scale of its investment in a strategy to deliver cancer care seamlessly across its seven hospitals and a growing network of outpatient clinics, with the expectation that patients will keep coming back for their ongoing health needs.
Penn sees an opportunity to expand its market share even more, as cancer diagnoses rise. The U.S. is expected to see a nearly 40% increase in cancer diagnoses between 2025 and 2050, according to the Philadelphia-based American Association of Cancer Research.
Experts attribute the rise to a wide variety of factors, from better early detection, to longer life spans, and to environmental exposures that are poorly understood.
Much of Penn’s investment is in outpatient facilities, including a $270 million center being built in Montgomeryville that will have radiation oncology and an infusion center. “More and more patients want to receive care closer to home,” according to Lisa Martin, a senior vice president at Moody’s Rating. “All of that is really what’s behind all of this investment.”
Cancer treatment overall is profitable. At Penn, cancer services account for up to 60% of the system’s operating margin by one simple measure that subtracts direct costs from direct revenue and excludes back-office expenses and other centralized costs.
Puchtler attributed the profitability of cancer care to the prevalence of drugs, such as chemotherapy, that Penn can buy at a discount, while getting the full price from insurers, and the higher percentage of younger cancer patients with better-paying private insurance than is typical for many healthcare services.
The expansion efforts are expensive in an industry where the consumers both benefit from advances and pay ever-rising healthcare costs. Proton therapy, in particular, costs more, but has not yet been proven to have better outcomes across a wide range of cancers.
The intensifying competitive landscape
Penn treats about one-third of adults with cancer in its market area, which stretches from central New Jersey to the Susquehanna, according to Robert Vonderheide, who is director of Penn’s Abramson Cancer Center and leads all of Penn’s efforts in oncology treatment and research.
Penn counted 47,053 new cancer patients in the 12 months that ended June 30, up 40% from five years ago, according to Penn. The system has 14 locations where patients can receive chemotherapy and even more radiation oncology sites.
Competitors are also trying to expand their reach, and Temple’s Fox Chase Cancer Center is succeeding.
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Fox Chase had 21,442 new patients in fiscal 2025, up 148% from 2020, the nonprofit said. Fox Chase has added suburban offices in Voorhees and Buckingham, Bucks County, and is expanding its infusion capacity at its main campus on Cottman Avenue. Fox Chase has a significantly smaller footprint than Penn, with six locations for infusions and four for radiation.
The MD Anderson Cancer Center at Cooper said it had 4,326 new patients last year, up 27% over the last five years. Cooper has taken the MD Anderson Cancer Center brand to the former Cape Regional Medical Center, which it acquired last year and which used to be part of the Penn Cancer Network. Cooper also offers cancer services at its new Moorestown location.
Jefferson Health’s Sidney Kimmel Cancer Center did not respond to requests for patient data, but has in recent years opened cancer center locations at its Torresdale and Bucks County Hospitals. Jefferson’s cancer center also attained the highest designation from the National Cancer Institute last year — the Philadelphia region’s third comprehensive cancer center, matching Penn and Fox Chase.
Lancaster County resident Susan Reese, 56, said she experienced smooth cooperation between her doctor at Penn’s Lancaster General Hospital and the team at HUP during her treatment for non-Hodgkin lymphoma.
“I never had any question in my mind that one doctor didn’t know what the other doctor was doing,” said Reese, who received CAR-T therapy at HUP in September 2022. Penn has since started offering CAR-T at Lancaster General.
After she relapsed in early 2023, she came back to HUP for a stem cell transplant. She could have gone to Penn State Health’s Hershey Medical Center for that. It’s significantly closer to her home in Willow Street, but she wanted to stay within the Penn system.
Reese’s experience of integration of services at HUP and Lancaster General is what Penn is aiming for in a territory that stretches from central New Jersey to central Pennsylvania.
Oncologist Robert Vonderheide, director of Penn Medicine’s Abramson Cancer Center, oversees all Penn’s cancer services and research.
Electronic medical records help with the integration needed to ensure the thousands of cancer patients Penn physicians treat annually get the most advanced care possible, according to Vonderheide, whose research focuses on cellular immunotherapies.
“We treat patients’ cancers now in a very precise way; the precise mutation, the precise type of chemotherapy, the precise dose” are the focus for doctors, Vonderheide said. “This is no longer appropriate for the telephone game. This has to be data-driven.”
Reese’s decision to stay within Penn is part of a broader trend of patients tending to receive all their care within one health system, according to Rick Gundling, a healthcare expert at the Healthcare Financial Management Association in Washington, D.C.
That’s particularly important in oncology, which typically involves multiple specialties, such as medical oncology, radiation oncology, and surgical oncology, he said.
“Seamless coordination across all those disciplines really makes it a better patient experience and clinical experience because it reduces delay, improves access,” Gundling said.
Taking advanced treatments from HUP to the network
Part of Penn’s strategy is to begin offering advanced services at locations beyond HUP. That’s where Penn pioneered CAR-T cell therapy, which harnesses the immune system to attack cancer, and for years that was the only place Penn offered it.
HUP still performed the bulk of the CAR-T treatments for blood cancers, 123 inpatient cases and 14 outpatient cases last year, but now CAR-T is also available at Lancaster General and at Penn’s Pennsylvania Hospital in Center City.
Fox Chase was the next biggest center in the region for the relatively new treatment that Penn scientist Carl June and his research teams helped develop. For the fiscal year that ended June 30, 2025, Fox Chase had 21 inpatient cases and 67 outpatient cases, the center said.
In the Penn system, certain kinds of bone marrow transplants also used to be available only at HUP. “Now we do them at HUP and Pennsylvania Hospital,” Vonderheide said.
Even the most complicated pancreatic surgeries are going to be done at Princeton, in conjunction with experts at HUP, Vonderheide said. Penn held a ceremonial groundbreaking Monday for the hospital’s $295 million cancer center.
Remaining only at HUP are bone marrow transplants that use another person’s cells to treat blood cancers, Vonderheide said. HUP performed 118 of those so-called allogeneic bone marrow transplants on the top floor of its $1.6 billion patient pavilion, now known as the Clifton Center.
Pennsylvania’s next-biggest provider of the treatment was Hershey Medical Center, near Harrisburg, with 71, according to state data.
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Penn started offering proton therapy at HUP in 2010, and expanded its availability in the last three years to Lancaster General and Voorhees, through a joint venture with Virtua Health. Those two centers only have one proton machine each, compared to five at HUP.
It’s a type of radiation that is designed to precisely target tumors and do less damage to surrounding tissues. That makes the treatment, which costs more, particularly helpful for children, and it is proving beneficial for treating certain neck and throat cancers.The use of proton therapy for the more common prostate cancer has been more controversial.
Penn’s fourth proton center, with two machines, is under construction and is expected to open at Presbyterian in late 2027. When that $224 million center opens, Penn will have more proton treatment rooms than the entire West Coast, said Jim Metz, chair of radiation oncology at Penn.
Currently about 10% of Penn’s roughly 10,000 annual radiation oncology patients are treated with protons, though it’s a higher percentage at locations with proton machines, Penn said.
Penn officials have noted that some cancer patients come to Penn for proton therapy. Even when it’s not appropriate for them, they tend to stay within Penn. “We have seen, when we build protons, our market share increases, ” Metz said.
Editor’s note: This article has been updated with more recent Fox Chase data.
