Advances and investment in modern proton therapy

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Published: 29 Sep 2016
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Dr Hernán Cortés-Funes - HC Marbella, Marbella, Spain

Dr Cortés-Funes speaks with ecancertv at Proton Therapy Congress 2016 about the hurdles to widespread adoption of proton beam therapy (PBT).

Beginning with the high cost and low return of early efforts in America and Europe, he describes how advances in the interim have halved costs and reduced space requirements for modern facilities.

Dr Cortés-Funes also discusses the case of Ashya King, whose parents took him from the UK to receive proton radiotherapy in Europe.

 

Proton Therapy Congress 2016

Advances and investment in modern proton therapy

Dr Hernán Cortés-Funes- HC Marbella, Marbella, Spain


This conference is very interesting because it’s something that’s now achieving the new treatment for cancer and proton therapy is some of the last treatments, it’s very old but the information that we have in our hands for the last studies is very promising. Especially because the technology is more simple and it’s more feasible to use it. And we were discussing, as happened some months ago in Prague, in PTCOG, what is the situation of proton therapy at the present time.

What has your experience with proton clinics been in the last few years?

It is very interesting to see the different programmes of proton therapy units because this starts also in the States, the procurement programme, more than ten years ago they tried to develop ten centres for proton therapy and they failed, the majority, not all. The majority failed because they had not made good calculations of the investment and that reason means that the technology goes very slowly and the price of the technology is very high. That’s happened the same also in Europe because there are some projects that have happened in Germany where they tried to develop a huge programme with only success with one or two centres. In Switzerland they have a large programme in all the cantons to put up around ten proton units but they failed and only have one in Zurich. That is something we have to learn about because in Spain also it has happened, the same as in the UK, that we have no proton therapy units and now we are trying to develop some of them in our centre. They have the most advanced project to install a proton therapy unit in Marbella. The proton therapy today, this delay is very helpful for the success of the project. Why? Because the delay means that you are receiving a new technology, a simple technology in a small space and also much cheaper. Today I could tell you that, probably, the investment of proton therapy is half of five years ago. That means that it is more affordable for a lot of hospitals. In our case our focus is in one small compact unit, one room, but you have to have enough patients to recover the imbursement. It’s hard and it takes some time but we made our calculations and we hoped that we would succeed in a short period of time.

Could you discuss the story of Ashya King?

This is one I know very well because I participated in the history because the guy, this Ashya King, came after finishing the proton therapy in Prague, they came to our clinic to recover and we gave all the rehabilitation due in three months. It was a very risky decision because you know the tumour was at full size, a very aggressive tumour, and needed to be complimented after surgery with chemotherapy and standard radiotherapy to produce a lighter side effect and long term problems. The father of the child decided not to do, to stand away and take the risk to do it only with proton therapy and they succeeded because that was more than two years and a half and now the child is actually close to being fully recovered, he is walking, speaking and going to school. This is one example but this created a situation in the UK because you know some years ago there was approved some budget for developing a proton unit and the budget was moved to other priorities, and now after this history they are running some five or six, I don’t know how many centres; one of NHS, some others private. And while they have a calendar they they will come the next coming years and I hope that we will see it because at the present time all the [?? 4:40] a lot, as soon as happened in Spain, they have to send him far away, no?

What are your thoughts on the conference?

Yes this is a very exciting new field, as I mentioned, because there are very few medical oncologists involved in this situation because we are very… a medical oncologist wants to go immediately to the new treatment. For us, when I was involved in the proton therapy, the involvement for me was like a new drug, because it’s a new drug but it’s a curative drug. I was very happy to see the name of several medical oncologists like Professor McVie involved in the project of proton therapy because our view of the treatment of cancer’s a little bit different from other specialists and also we learn from a new specialist, I just check a new area, physicists. The physicists are the most important specialists in proton therapy development, because they make the calculations, they make all the procedures to put all these beams in the proper place and this takes a long period of time and it’s a very complicated procedure and these are essential for having the success of this treatment.

What is your take-home message?

My conclusion is that I am very happy to hear that there’s a lot of people with interest in proton therapy, I know they still have some who are against that because also under the medical economical point of view they say that the proton therapy, some will say, yesterday I think Karol Sikora said, that proton therapy is the most expensive medical device today.  It’s true, but if you compare with the other cancer treatments that it is more expensive if you are using the chemotherapy, the new agents and the old immunotherapy, that is we could compare. Proton therapy has a lot of future, I am convinced that in less than ten years we will replace totally the standard radiotherapy with photons.