Vancouver Sun

Med­i­cal ex­perts call for pro­ton clinic in Canada

Chil­dren with can­cer must go to U.S. for help


HAL­I­FAX • An ad­vo­cacy group for chil­dren's can­cer re­search says it's time Canada makes an ad­vanced form of ra­dio­ther­apy, called pro­ton beam ther­apy, more widely avail­able.

Canada is the only G7 coun­try with­out a clin­i­cal pro­ton fa­cil­ity — a sit­u­a­tion that forces fam­i­lies to travel to the United States to seek a treat­ment that has been around for about a decade.

Cana­di­ans should have ac­cess to the ad­vanced level of care that comes from pro­ton beam ther­apy, said Chris Collins, chair of Ad­vo­cacy for Cana­dian Child­hood On­col­ogy Re­search Net­work, or Ac2orn.

“This is an im­por­tant and proven tech­nol­ogy and med­i­cal treat­ment,” Collins said in a re­cent in­ter­view.

Pro­ton ra­dio­ther­apy uses a beam of pro­tons to ir­ra­di­ate can­cer­ous tis­sue in chil­dren and adults. In com­par­i­son to con­ven­tional ra­di­a­tion ther­apy, pro­ton ther­apy de­liv­ers a higher con­cen­tra­tion of ra­di­a­tion with­out af­fect­ing nearby or­gans.

Collins is a for­mer speaker of the New Brunswick leg­is­la­ture who lost his 13-year-old son Sean to can­cer in 2007. He said the COVID-19 pan­demic is mak­ing it more dif­fi­cult for fam­i­lies to travel to the United States for treat­ment.

He said the pan­demic is ex­pos­ing an in­equity in the health-care sys­tem that would be largely ad­dressed if there were a Cana­dian op­tion.

“Pro­por­tion­ally, it would be good to have a cen­tre in Van­cou­ver, Mon­treal and Toronto, and to fund fam­i­lies who are trav­el­ling to these places,” he said.

Kim­ber­ley Berger, of Van­cou­ver, knows how dif­fi­cult it can be to ac­cess the treat­ment her 12- year- old son Jonah re­ceived at a pri­vate clinic in Seattle, Wash., last Fe­bru­ary.

While the B.C. health sys­tem funded the treat­ment, the fam­ily was on its own to pay their ac­com­mo­da­tions dur­ing the six weeks her son re­ceived pro­ton ther­apy and chemo­ther­apy fol­low­ing surgery for a brain tu­mour.

“My im­me­di­ate thought when this hap­pened was, ` how are we go­ing to do this?' ” Berger said. “I have an­other son and my hus­band is work­ing, we have to rent a home in an­other city and that is ex­pen­sive.”

She said deal­ing with a for­eign health sys­tem was an added stress.

“You don't know how the sys­tem works and then throw a pan­demic on top of it,” she said in a re­cent in­ter­view. “The pan­demic drives it home that we need to be sus­tain­able in Canada when some­thing like this does hap­pen.”

Dr. Jim Whit­lock, di­vi­sion head of hema­tol­ogy and on­col­ogy at Sick­Kids hos­pi­tal in Toronto, said pro­ton ther­apy is a par­tic­u­larly ef­fec­tive op­tion for chil­dren who have brain tu­mours or other types of can­cer.

Pro­ton ther­apy, he said, is prefer­able for pa­tients who have tu­mours at the base of the skull: “A tricky area to try to ra­di­ate and not cause dam­age.”

Whit­lock said the up­front cap­i­tal costs — es­ti­mated be­tween $75 mil­lion and $250 mil­lion — are the main hur­dle to build­ing a pro­ton cen­tre in Canada.

He said there should be at least one na­tional fa­cil­ity, adding that any prov­ince that de­cides to build one will need the help of the fed­eral gov­ern­ment.

The vi­sion of build­ing cen­tres of ex­cel­lent for ex­pen­sive and un­com­mon ther­a­pies is one “Canada needs to em­brace as a na­tion,” Whit­lock said. “I hope the fed­eral gov­ern­ment will con­sider tak­ing a more ac­tive role in help­ing ad­dress these na­tional needs be­cause some of these prob­lems need to be solved at a na­tional level.”

Ac­cord­ing to Health Canada, pro­ton beam ther­apy sys­tems are rated as Class III de­vices un­der fed­eral reg­u­la­tions, mean­ing they must be li­censed prior to im­por­ta­tion or sale in the coun­try.

“While Health Canada is re­spon­si­ble for as­sess­ing the safety, ef­fec­tive­ness and qual­ity of med­i­cal de­vices, the avail­abil­ity, its use, and the fund­ing of pro­ton ther­apy in Canada fall un­der the re­spon­si­bil­ity of the prov­inces and ter­ri­to­ries,” the de­part­ment said in an email.

Dr. Rob Rut­ledge, a ra­di­a­tion on­col­o­gist at the Nova Sco­tia Can­cer Cen­tre in Hal­i­fax, agrees that money is the is­sue.

Cur­rently, the hand­ful of pa­tients in the Mar­itimes who qual­ify for the pro­ton treat­ment are sent to the United States. But Nova Sco­tia, which funds the treat­ment, is look­ing at re­fer­ring some pa­tients to the Nether­lands, a coun­try Rut­ledge said has “ex­cel­lent tech­nol­ogy at a frac­tion of the cost.”

Pro­ton treat­ment, how­ever, needs to be of­fered to some chil­dren with brain tu­mours in Canada, Rut­ledge said, adding that the non-avail­abil­ity of the pro­ce­dure ex­poses a gap in the health sys­tem.

“Pan­demic aside, we need this treat­ment.”

 ?? HAND­OUT, KIM­BERLY BERGER / THE CANA­DIAN PRESS ?? Kim­ber­ley Berger of Van­cou­ver with son Jonah, who had to go to Seattle for pro­ton treat­ment for a brain tu­mour.
HAND­OUT, KIM­BERLY BERGER / THE CANA­DIAN PRESS Kim­ber­ley Berger of Van­cou­ver with son Jonah, who had to go to Seattle for pro­ton treat­ment for a brain tu­mour.

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