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Could proton beam therapy help cure the UK's toughest cancers? | Could proton beam therapy help cure the UK's toughest cancers? |
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It is not just a UK and an NHS first. The start of building work on the high-energy proton beam service at Manchester’s Christie hospital marks a significant point in the institution’s transformation, from locally loved north-west specialist institution to world-leading player on the cancer stage. | It is not just a UK and an NHS first. The start of building work on the high-energy proton beam service at Manchester’s Christie hospital marks a significant point in the institution’s transformation, from locally loved north-west specialist institution to world-leading player on the cancer stage. |
The £125m five-floor proton beam therapy centre opening its doors in 2018 will be able to treat 750 of the most complicated cancer patients every year, many of them children – such as Ashya King, whose parents triggered an international police hunt when they took him to the Czech Republic to receive proton beam therapy. | The £125m five-floor proton beam therapy centre opening its doors in 2018 will be able to treat 750 of the most complicated cancer patients every year, many of them children – such as Ashya King, whose parents triggered an international police hunt when they took him to the Czech Republic to receive proton beam therapy. |
The government has invested £250m in building and equipping two NHS sites. The second, at University College London hospitals, will open a few months after the Christie. | The government has invested £250m in building and equipping two NHS sites. The second, at University College London hospitals, will open a few months after the Christie. |
The Christie is already the biggest centre in the UK delivering conventional electron-based radiotherapy (as well as the biggest chemotherapy centre), but the advantage of proton beam therapy is that it allows the use of higher doses of radiotherapy, precisely targeted to within millimetres (rather than centimetres) of the tumour and, crucially, without damaging surrounding tissues. | The Christie is already the biggest centre in the UK delivering conventional electron-based radiotherapy (as well as the biggest chemotherapy centre), but the advantage of proton beam therapy is that it allows the use of higher doses of radiotherapy, precisely targeted to within millimetres (rather than centimetres) of the tumour and, crucially, without damaging surrounding tissues. |
A cyclotron weighing the same as a Boeing 747 will generate a proton beam capable of treating three patients at a time, five days a week. Treatment can take as little as a minute at a time, although positioning a patient correctly can take up to 45 minutes. | A cyclotron weighing the same as a Boeing 747 will generate a proton beam capable of treating three patients at a time, five days a week. Treatment can take as little as a minute at a time, although positioning a patient correctly can take up to 45 minutes. |
The UK currently has a low-energy NHS proton beam facility at Clatterbridge cancer centre, in the Wirral, suitable for treating rare cancers of the eye, but complex cases need high energy proton beam therapy. | The UK currently has a low-energy NHS proton beam facility at Clatterbridge cancer centre, in the Wirral, suitable for treating rare cancers of the eye, but complex cases need high energy proton beam therapy. |
Other groups to benefit from this NHS facility will be people suffering from advanced prostate, ocular and spinal cancers. Currently NHS patients have to travel to the US or Switzerland. The cost of overseas treatment varies according to its complexity, but the average is approximately £75,000, whereas the Christie expects the average cost of on the new NHS service to be less than £40,000. The figures in both cases include accommodation. | Other groups to benefit from this NHS facility will be people suffering from advanced prostate, ocular and spinal cancers. Currently NHS patients have to travel to the US or Switzerland. The cost of overseas treatment varies according to its complexity, but the average is approximately £75,000, whereas the Christie expects the average cost of on the new NHS service to be less than £40,000. The figures in both cases include accommodation. |
At the turf-cutting ceremony for the Christie proton beam centre, chief executive Roger Spencer said: “This proton beam therapy facility represents a crucial piece of the jigsaw, which equips the Christie to become the biggest radiotherapy centre in the world as well as one of the top five cancer hospitals in the world.” | At the turf-cutting ceremony for the Christie proton beam centre, chief executive Roger Spencer said: “This proton beam therapy facility represents a crucial piece of the jigsaw, which equips the Christie to become the biggest radiotherapy centre in the world as well as one of the top five cancer hospitals in the world.” |
Big claims, but what of the substance? The Christie has form for world firsts – including therapeutic use of x-rays in 1901, clinical use of the breast cancer drug tamoxifen (1970), use of cultured bone marrow in leukaemia, and umbilical cord stem cell transplant for blood cancers. | Big claims, but what of the substance? The Christie has form for world firsts – including therapeutic use of x-rays in 1901, clinical use of the breast cancer drug tamoxifen (1970), use of cultured bone marrow in leukaemia, and umbilical cord stem cell transplant for blood cancers. |
The world expert on targeted cancer treatment, Marcel van Herk, has left the prestigious Netherlands Cancer Institute after 32 years to take up the chair of radiotherapy physics based at the Christie, but jointly funded with the University of Manchester. Another recent catch is Karen Kirkby, the new chair in proton beam physics, who has left the Ion Beam Centre at the University of Surrey to take up her joint post. | |
What excites me and has brought me to Manchester is the chance to get the whole cancer treatment chain right. | What excites me and has brought me to Manchester is the chance to get the whole cancer treatment chain right. |
There’s also another new piece of kit arriving at the Christie – the MR Linac – one of only 10 in the world combining advanced imaging techniques with a linear accelerator. Across the road from the Christie is the newly opened £28.5m Manchester cancer research centre building, a joint venture between the Christie, Manchester University and Cancer Research UK. It brings together 250 researchers and clinicians from across the UK, working to translate new research into treatments as fast as possible. A new Maggie’s centre is also under construction. | There’s also another new piece of kit arriving at the Christie – the MR Linac – one of only 10 in the world combining advanced imaging techniques with a linear accelerator. Across the road from the Christie is the newly opened £28.5m Manchester cancer research centre building, a joint venture between the Christie, Manchester University and Cancer Research UK. It brings together 250 researchers and clinicians from across the UK, working to translate new research into treatments as fast as possible. A new Maggie’s centre is also under construction. |
So what’s the current pull about Manchester? Van Herk (who has a formula named after him defining the margins of treatment around a tumour) is clear that access to the new proton beam therapy centre is part of it because it completes a powerful cancer infrastructure he’s not found anywhere else. He has uprooted his family because of the critical mass of networks and expertise built up between the Christie, Manchester University and Cancer Research UK and beyond, that promises real cancer breakthroughs – and soon. | So what’s the current pull about Manchester? Van Herk (who has a formula named after him defining the margins of treatment around a tumour) is clear that access to the new proton beam therapy centre is part of it because it completes a powerful cancer infrastructure he’s not found anywhere else. He has uprooted his family because of the critical mass of networks and expertise built up between the Christie, Manchester University and Cancer Research UK and beyond, that promises real cancer breakthroughs – and soon. |
He said: “What excites me and has brought me to Manchester is the chance to get the whole cancer treatment chain right. It is about much more than equipment.” | He said: “What excites me and has brought me to Manchester is the chance to get the whole cancer treatment chain right. It is about much more than equipment.” |
Factors he mentions are access to the 3.2m cancer population – Europe’s biggest and not divided as in London’s specialist hospitals – and the excitement of having a new, young team of clinicians and researchers from every aspect of medicine and medical physics. Van Herk has already started a large-scale data-mining project to identify which lymph nodes need treating in high-risk prostate cancer patients, and another to improve image-guided radiotherapy for children. | Factors he mentions are access to the 3.2m cancer population – Europe’s biggest and not divided as in London’s specialist hospitals – and the excitement of having a new, young team of clinicians and researchers from every aspect of medicine and medical physics. Van Herk has already started a large-scale data-mining project to identify which lymph nodes need treating in high-risk prostate cancer patients, and another to improve image-guided radiotherapy for children. |
Knowledge from the proton beam project will also have worldwide support thanks to a recently announced £915,000 grant from the Science and Technology Facilities Council (STFC) to allow the Christie to make links with some of the the world-leading organisations such as Cern. Their advances in detectors developed for the large hadron collider may allow strides to be made in advanced radiotherapy. | Knowledge from the proton beam project will also have worldwide support thanks to a recently announced £915,000 grant from the Science and Technology Facilities Council (STFC) to allow the Christie to make links with some of the the world-leading organisations such as Cern. Their advances in detectors developed for the large hadron collider may allow strides to be made in advanced radiotherapy. |
The transformation of Manchester into a cancer top player represents five years of canny collaboration (including a £30m joint recruitment programme) between the Christie and the university, driven by the fact that Manchester’s population has one of the worst cancer records in the country. | The transformation of Manchester into a cancer top player represents five years of canny collaboration (including a £30m joint recruitment programme) between the Christie and the university, driven by the fact that Manchester’s population has one of the worst cancer records in the country. |
David Scott, Cancer Research UK’s director of science funding, said: “The Cancer Research UK Manchester centre has recently received extra investment, and the additional funding is already attracting leading cancer researchers from around the globe. We have watched it grow into a world class cancer centre, and by uniting doctors and scientists under a single strategy, we hope this will help accelerate the progress of getting beneficial new treatments to patients as quickly as possible. There’s a particular focus on personalised treatments and immunotherapy, which is already showing huge promise for patients with several types of cancer.” The arrival of the proton beam therapy to Manchester is one more piece of equipment in the search for effective cancer treatments. Spencer says: “We are clearly getting something right by this collaborative approach, as Greater Manchester’s one-year cancer survival rates are now [at 70%] the best in the country. We now need to look at the longer term figures and at late-stage presentation.” | David Scott, Cancer Research UK’s director of science funding, said: “The Cancer Research UK Manchester centre has recently received extra investment, and the additional funding is already attracting leading cancer researchers from around the globe. We have watched it grow into a world class cancer centre, and by uniting doctors and scientists under a single strategy, we hope this will help accelerate the progress of getting beneficial new treatments to patients as quickly as possible. There’s a particular focus on personalised treatments and immunotherapy, which is already showing huge promise for patients with several types of cancer.” The arrival of the proton beam therapy to Manchester is one more piece of equipment in the search for effective cancer treatments. Spencer says: “We are clearly getting something right by this collaborative approach, as Greater Manchester’s one-year cancer survival rates are now [at 70%] the best in the country. We now need to look at the longer term figures and at late-stage presentation.” |
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• This article was amended on 27 August 2015 to make clear that Prof van Herk’s position as chair of radiotherapy physics at the Christie is jointly funded by the University of Manchester. | • This article was amended on 27 August 2015 to make clear that Prof van Herk’s position as chair of radiotherapy physics at the Christie is jointly funded by the University of Manchester. |