State-of-the-Art Particle Radiotherapy for Cancer in Japan: Lessons and Opportunities
The author with Professor Dr. Tadashi Kamada, the Director for the Centre of Charged Particle Radiotherapy, NIRS
Last week on the 25th May 2015 I had the opportunity to be in the team to accompany the Yang Amat Berbahagia Datin Seri Rosmah Mansor for a visit to the National Institute of Radiological Sciences (NIRS) in Chiba, Japan. The NIRS is one the 5 centres in Japan offering heavy particle radiation therapy for cancers. In fact it is the leading institution in the world at the moment in this field and has treated more than 9000 cancer patients including from other countries. The heavy particle used is carbon (which is 12 times heavier than protons) and it differs from the conventional radiotherapy which uses photon beams (X-rays and gamma rays) which may have side effects. The difference is that heavy ion have the superior ability to travel in a straight line and hence it can be targeted to the cancer cells alone with greater accuracy and not damage the surrounding normal cells. It is indeed a form of radiosurgery. The cost of building the accelerator device and also the set-up is expensive. We were told that the capital cost can easily reach USD100-150 million. The average 5-year survival rate for all cancers treated at the centre is about 80% which is very impressive.
We can learn a few keys lessons here. The Japanese as we know are very innovative and focused. When they believe that something needs to be done, they embark on it and invest in training the necessary human resource, infrastructure and the research required. This centre was built in 1957 and it took them many years to reach where they are now. The government continues to provide support and funding until now. In fact for two and a half months per year, the NIRS does not accept patients as the radiotherapy devices are used for research and development (patients are directed to the other 4 centres in Japan). The Japanese are also willing to share. In fact, they offered to train our oncologists and radiation physicists and also those who are interested to do research at their institute. These are opportunities which the government should take up if Malaysia wants to plan to build a similar centre as we need to skilled radiation oncologists and physicists plus other key staff members. The survival of cancer not only depends on the stage of cancer but also on the types of treatment one will receive. Many of the new targeted therapies for cancers including inhibitors, and also the radiosurgery mentioned here, are expensive but to me it is money worth spending on as it will help save more lives.