The transformation of UK cancer care with proton therapy in 2018

Professor Karol Sikora

Chief Medical Officer, Proton Partners International

There is a pressing need to make specialised cancer care more accessible worldwide, and high energy proton therapy can play an essential role in delivering better care.

Proton Partners International Ltd is a company in the vanguard of advancing high-energy proton therapy in the UK and was established on World Cancer Day, 4^th February 2015 by international cancer and healthcare specialists. The vision of Proton Partners International is to create a better future for cancer patients by developing a network of cancer centres, committed to providing innovative cancer care with the most advanced proton therapy and imaging technology on the market.

Latest advancements in proton therapy

Protons deliver the same damage to cancer cells as radiotherapy; however, they can be controlled to stop at a defined point in the body, a technique known as the Bragg peak, which means that there is less collateral damage to surrounding healthy tissues and organs.

The Rutherford Cancer Centre South Wales is the first place in the UK to offer high energy proton therapy and will start treating the first proton therapy patient in April 2018. The network of Rutherford Cancer Centres have been named as such in tribute to the renowned scientist Ernest Rutherford’s contribution in identifying and naming the proton in 1911. Each centre aims to treat up to 500 patients annually. Protons deliver the same damage to cancer cells as radiotherapy; however, they can be controlled to stop at a defined point in the body, a technique known as the Bragg peak, which means that there is less collateral damage to surrounding healthy tissues and organs. The single room Proteus^®ONE proton therapy solution installed and maintained by IBA (Ion Beam Applications S.A.), delivers the latest advances in proton therapy and will be installed at each of the Rutherford Cancer Centres.

The Proteus^®ONE system allows for the most advanced imaging techniques to be carried out at the same time. Tumours are targeted with Cone Beam Computerised Tomography (CBCT), a volumetric visualisation of the tumour and the body. The precise dose delivery is achieved through Pencil Beam Scanning (PBS) which enables a highly precise scanning, layer by layer, pixel by pixel, to perfectly match the shape of the patient’s tumour. This along with the dimensionally accurate imaging of 3D CBCT, enables physicians to truly track where protons will be targeting tumor cells.

Accurate patient treatment

The advanced imaging technologies integrated in the Proteus^®ONE ensures quick and accurate patient positioning by comparing diagnostic CT images, taken during the treatment planning process. Image-Guided Proton Therapy (IGPT) relies on high-resolution and high-sensitivity X-Ray digital imaging systems that provide low-dose stereoscopic and 3D imaging in various geometrical arrangements. CBCT offers soft-tissue contrast, providing much more information than a conventional stereoscopic alignment system, and allowing more accurate patient treatment through anatomical modification assessment, the first step towards adaptive radiation therapy. The system has also been designed to optimise the patient experience by providing a soothing patient environment while enhancing the medical staff work experience and efficiency.

By working with the world’s leading technology partners, Proton Partners International is ensuring that its Rutherford Cancer Centres are equipped with the latest cancer technology and the aim is that the centres will evolve into centres of excellence for cancer treatment.

A network of accessible centres

The ambition is to have a Rutherford Cancer Centre within 90 minutes of the front door of 75 per cent of the UK population by 2021.

Proton Partners International plans to build at least eight centres across the UK within the next four years. In addition to its South Wales centre in Newport, a further three oncology centres are already under construction in Northumberland, Reading and Liverpool, with an additional site under consideration in London. The ambition is to have a Rutherford Cancer Centre within 90 minutes of the front door of 75 per cent of the UK population by 2021, meaning that patients will not have to travel for several hours or abroad for cancer treatment that is best delivered close to home.

In addition to proton therapy, the centres will offer traditional imaging, chemotherapy, radiotherapy, immunotherapy and a range of supportive care services including survivorship and recovery. The centres will be staffed by one clinical team across the multiple sites who will all work from a shared central system. This will allow oncologists to work remotely and treat patients on any of the Rutherford sites. Treatment will be available to medically-insured private patients, self-paying patients and patients referred by the NHS.

Benefits for patients

By offering a variety of cancer therapies, our centres will deliver a fully comprehensive level of cancer care, tailored to fit the different needs of each patient – something which is not available in the UK at the moment. There are more than 150,000 cancer patients in the UK every year who are treated with radiation therapy, of which 90,000 require radical radiotherapy. Around 10 per cent of these patients could be better treated with proton therapy. More patients will benefit from better diagnosis and newer treatments, with a greater emphasis on the quality of life.

The market for proton therapy is rapidly evolving and Proton Partners International, with its Rutherford Cancer Centres, will be at the forefront of this growth and will continue to invest in centres and innovation to maintain its position as a market leader. The next 10 years will be a time of unprecedented change in the ongoing battle against cancer.