• Precision in proton therapy reduces unwanted side effects on patients, especially children
• Patients can expect better treatment outcomes for certain types of cancers
• NCCS is the first in this region to acquire this technology for cancer treatment

Thursday, 19 Jul 2012

Singapore, 19 Jul 2012 – Cancer patients in Singapore will benefit from an advanced form of radiation therapy when the National Cancer Centre Singapore (NCCS) sets up its state-ofthe-art Proton Therapy Centre within its new building in the Outram Campus in 2017.

This will make the NCCS and Singapore the first to offer proton therapy in this region. Among other countries in Asia which are offering this treatment protocol are South Korea, Japan and China.

Proton therapy is a form of radiation therapy that destroys cancer cells using positively charged subatomic particles (protons) instead of the x-rays used in standard radiation therapy. The energy of proton beams can be controlled to precisely release their cell-killing energy directly in the tumour with minimal exposure to nearby healthy tissues.

Patients who undergo proton therapy treatment will potentially see a reduction in treatment-related side effects, and minimal damage to healthy tissues. This is because proton beams can precisely deposit high doses of radiation in the tumour to kill the cancerous cells with much reduced collateral damage to normal tissues.

NCCS Director, Prof Soo Khee Chee said: “This is a major milestone for Singapore as proton beam therapy is the cutting edge in radiation treatment. Certainly it can bring a lot of benefit to cancer patients because of the precision with which proton treatment can treat tumours whilst significantly reducing the harmful exposure of radiation to normal tissues and organs.

“Proton therapy will enhance our ability to treat tumours in difficult areas of the body and especially in children. It can also be used to treat recurrent cancers that standard x-ray radiation therapy may not be able to. With our strong research base and the team of experienced medical specialists, proton therapy will give NCCS a great boost in her efforts to combat cancer and participate in the research that is ongoing to optimise proton therapy use. There have been encouraging treatment outcomes from other cancer centres in the US, Europe and Japan, which have been using this technology for some decades.”

As NCCS is a national referral centre, Prof Soo said it is also exploring collaborations with other cancer institutions in Singapore so that they too can use the proton treatment.

The acquisition of proton technology for cancer treatment was first brought up in public in 2006 by Dr Tony Tan, the then chairman of the National Research Foundation (NRF) after he visited the Paul Scherrer Institute in Switzerland, which is a leading institute in proton therapy. He felt that tapping on proton therapy would give Singapore an edge in its development as a medical hub besides the benefit of treating cancer patients in the local community. He was quoted by the media as saying he would discuss with the then Health Minister Khaw Boon Wan and the NCCS as well as with the Ministry of Education and the Ministry of Trade and Industry to establish a proton therapy centre in Singapore.

Since then NCCS embarked on studying and understanding the use of proton therapy and teams of doctors have visited various medical institutions in the US, Europe and Japan over the past years to gather first-hand information on the effectiveness of the proton beam treatment.

The NCCS arrived at its final decision only earlier this year when it presented its findings to the Ministry of Health for approval, taking into consideration that the NCCS is going to build a new building. The new NCCS Proton Therapy Centre will be located at the basement levels of the new building, scheduled for completion in 2017.

Dr Fong Kam Weng senior consultant and deputy head from NCCS Department of Radiation Oncology explained: “A typical proton treatment centre consists of an accelerator which releases protons at two-thirds the speed of light into a beam feeding system. The ‘beam line’, as it is known, directs the protons to the patient in the treatment room.

The appropriate anatomy is positioned so that the proton beam can be aimed at the tumour. The patient does not feel any unpleasant sensation.

“The delivery of the proton beam to the patient lasts only several minutes. The total time spent in the treatment room is in the order of 15 to 30 minutes, as the patient needs to be positioned and adjustments have to be made to the equipment settings,” said Dr Fong.

Dr Michael Wang, senior consultant with NCCS Department of Radiation Oncology, said that proton beam therapy has many clinical benefits compared with conventional radiation therapy. It is currently being used in major hospitals and cancer institutions in the US, Europe and Asia. There are other centres which will soon be introducing this treatment to their patients such as Mayo Clinic in Rochester, Minnesota and at its centre in Phoenix, Arizona.

Proton therapy will require a team which includes a radiation oncologist, radiation physicist, dosimetrist, radiation therapist, and a nurse.

“Patients will be assessed by a team of radiation oncologists to determine the appropriateness of proton therapy. Once that is done, the primary radiation oncologist will work with the radiation physicist, dosimetrist and radiation therapist to establish the best way to deliver the prescribed treatment.

“The procedure is performed on an outpatient basis. The average course of treatment is usually five to seven weeks for most tumours. The length of treatment will vary depending upon the tumour type and the stage of the tumour,” added Dr Wang.

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