Proton power can work in cancer therapy
ABIG push is on to put tiny particles to work killing cancer in what would be Australia’s first proton therapy facility. Advocates of proton therapy — the next generation of radiotherapy — are rattling political cages and seeking government approvals which would enable them to attract the funding needed to build the facility, estimated to cost $160 million.
This week the Sydney-based firm Proton Therapy Australia (PTA) applied to the Therapeutic Goods Administration to have the procedure approved in Australia. The move follows a preliminary meeting earlier this month between PTA director Sue Bleasel and representatives of the Medical Services Advisory Committee (MSAC), the body that evaluates applications for new therapies to be funded under Medicare.
A Medicare item number is essential if Australia is to have a proton therapy facility, claims Bleasel: We can’t get overseas funding until we have approval from the MSAC.’’ That’s so, she says, because if the Government supports the procedure through the healthcare system, the construction and operation of a private facility becomes attractive to investors.
Upfront construction costs are high because the tumour-busting protons must be stripped from hydrogen atoms and converted into high-energy beams in a particle accelerator, similar to Australia’s new cyclotron in Melbourne. Several NSW hospitals have informally indicated they would provide land to house the warehouse-sized facility.
Despite large and expensive infrastructure, proton therapy is not a high-cost luxury, claims Bleasel. She says that although proton therapy costs are higher than conventional radiotherapy — roughly $25,000 per treatment, compared to $10,000 per course — overseas experience and an Australian feasibility study suggest proton treatment is competitive because there are fewer complications and follow-up procedures.
Most importantly, in some cases it’s the only treatment that extends the life of the patient,’’ she says.
After following advances in proton therapy since the late 1980s, radiation oncologist and PTA scientific adviser Michael Jackson, from Sydney’s Royal Prince Alfred Hospital, agrees: It’s time for Australia to embrace this new technology. Around the world the technology is really taking off now.’’
According to Jackson, proton therapy is a significant advance over conventional X-ray treatment because protons can be targeted far more precisely: ‘‘ You can give more (radiation) to the tumour and much less to normal tissues.’’ The result, he says, is better therapeutic outcome with fewer side effects.
Leading centres such as California’s Loma Linda University Medical Center have successfully treated a wide range of cancers, from head, neck and spine, to lung, breast and prostate. The procedure is particularly effective with children, since tissue and genetic damage produces long-term consequences for their developing bodies.
Proton therapy has proven so successful that 49 proton therapy facilities are operating or under construction worldwide — but currently the nearest to Australia is in China.
‘‘ Radiotherapy in Australia has tended to be behind generally — the way we’re not in surgery and chemotherapy,’’ says Jackson.
That’s why Bleasel, a medical devices specialist, has lobbied hard to raise awareness about proton radiotherapy among politicians and policy makers since she established PTA in July 2006. Previously she worked for Hitachi Australia, which sought to build a proton facility in NSW. But protracted negotiations and a successful bid to build a facility in the US saw Hitachi withdraw from the Australian project, Bleasel says.
Early this month Bleasel, Jackson and Anatoly Rozenfeld — director of Wollongong University’s Centre for Medical Radiation Physics — met advisers to science minister Julie Bishop, industry minister Ian Macfarlane and health minister Tony Abbott. They also discussed the technology with the Prime Minister’s office.
While decisions by the MSAC and TGA are not directed by ministers, a spokeswoman for Tony Abbott said the minister was aware of proton therapy and had received letters of support for it from independent experts not working with PTA.
She added that HealthPACT — a body that scans emerging medical technologies worldwide on behalf of state, federal and territory Governments — has recommend a ‘‘ watching brief’’ on proton therapy.
Liberal MP andWAphysician Mal Washer is already convinced. He’s been a ‘‘ great fan’’ of proton therapy ever since a friend had successful treatment at Loma Linda for prostate cancer. Washer’s so convinced of the benefits of the technology he put in a good word with his cabinet colleagues this month.
‘‘ The feedback I got, from a gut point of view, is that they are very, very enthusiastic,’’ Washer says.