A 12 months and a half has handed because the donation made by Amancio Ortega to put in proton remedy tools in public hospitals It is a really particular kind of radiotherapy, more practical, exact and protected, however it’s only supplied by two non-public hospitals for the time being There are ten public tools already tendered, however its manufacture, set up and start-up could be very complicated: “It takes at the least three years”
Oliver will endure proton remedy on the Clínica Universitaria de Navarra. It is likely one of the solely two hospitals in Spain the place this remedy will be carried out, together with the Quirón Hospital in Madrid. Both are non-public facilities. In a couple of years, it will also be carried out in public well being. There are ten groups already tendered for it. But they aren’t even manufactured but.
“We are on time.” There remains to be no tools put in, however “as a result of there has not been time, not as a result of issues aren’t being carried out effectively,” Carmen Rubio, an oncologist and vice chairman of the Spanish Society of Radiation Oncology (SEOR), explains to NIUS. “The phrases are what they’re, it takes at the least three years to place them into operation.”
The non-public one began a lot earlier, nevertheless it took the identical
Proton remedy will attain public well being due to the donation of 280 million euros made by Amancio Ortega in October 2021. “In Spain, the set up of proton models was not deliberate till this donation was made,” Rubio acknowledges. Ortega donated that cash particularly for this kind of remedy. Nothing to do with the donations he made in 2015 to resume the radiotherapy tools for public well being generally.
In 2015, the SEOR denounced “an amazing obsolescence within the tools, and that was when these preliminary donations from Amancio Ortega have been made,” recollects Rubio, who’s head of the Radiation Oncology service at HM hospitals. “From there, many groups have been renewed in public well being. And within the non-public sector, in parallel, in recent times all of the facilities have additionally made their investments in several models”.
In 2017, in truth, each the Quirón and the Clínica de Navarra determined to guess on proton remedy. “It was a non-public funding, they thought-about that there have been no such groups in Spain and that it was an excellent funding. And it has been, ”explains the oncologist.
The public well being gear was launched final 12 months, after receiving that donation on the finish of 2021. From there, it takes between three and 4 years to finish the bidding, manufacturing, set up, calibration and commissioning course of. staff march.
On December 26, 2019, the primary affected person who acquired proton remedy started his remedy on the Quirón Hospital in Madrid. On April 7, 2020, the identical factor occurred on the Clínica de Navarra. The start-up of the general public well being groups, financed by Amancio Ortega, is estimated for the 12 months 2025. “The solely benefit is that they (non-public well being) began a lot earlier. But they wanted the identical instances as us to get them up and working”, insists Rubio.
Ten groups in seven cities: enormous “radioactive bunkers”
We are particularly speaking about ten proton remedy tools, ten proton accelerators that will likely be put in in hospitals in numerous Spanish cities: one in La Coruña; two in Barcelona; one in Vizcaya; two in Madrid; one in Malaga; one in Seville; one in Valencia; one in Gran Canaria. “They have been chosen due to the quantity of the inhabitants and their strategic scenario, in order that they will simply attain extra folks,” they defined on the time from Health.
And proper now, in keeping with the deadlines made public by the ministry a couple of months in the past, we’re within the second part, which known as “finishing up tasks and works.” It has an estimated period of 18/24 months. Manufacturing has already been assigned to an organization, the multinational IBA, and it’ll manufacture them whereas, in every autonomous group, the works for his or her set up progress. “We docs joined on the finish of the method, within the final part, the final six months.”
The manufacture, set up and preparation of the tools, earlier than its start-up, could be very complicated, as a result of we’re speaking about genuine bunkers. Not all hospitals are price internet hosting them. “Because they’re radioactive services,” warns Rubio. Among many different issues, “they require permits from the Nuclear Safety Council.”
And its measurement is big. “The first ones have been nearly like soccer stadiums, now they’re extra compact, smaller models.” Even so, “they want a really massive area, hospitals the place they’ve room,” warns the specialist. Because, even when they’re smaller, we’re speaking about groups “the scale of a tennis court docket”, roughly. “And very effectively armored.”
Train workers “now”: be prepared when the machine is
The purpose, explains the oncologist, is that, when these ten proton remedy groups are able to function, “we have already got sufficient educated specialists, in order that we will begin with individuals who have already got some expertise, not begin from scratch.” Because “Ortega contributes the cash, however the upkeep of the tools, personnel and coaching is the accountability of the CCAAs”, underlines the specialist.
They wish to put this difficulty on the desk now “in order that, when the machine is prepared, we’re prepared too”. The materials and human tools. That there are a couple of, not solely them: radiation physicists, radiation oncologists, radiation remedy technicians and nursing workers.
And that is vital. Because Rubio warns of 1 factor: “There will likely be many retirements of individuals with expertise.” And not solely that. If, as well as, a lot of those that stay “go to protons, there will likely be locations left unfilled.” For this cause, they are saying, it’s essential to broaden the radiotherapy oncology groups generally.
“From 2025, we anticipate to have proton remedy models working in public well being. We have time to arrange. But we demand that there be extra positions for residents, each radiation oncologist and physicist, in order that, when the time comes, now we have every little thing prepared”. It is a query, he says, of “not shedding this chance” in a discipline as pioneering as this one. “That these groups lead tasks, not that they continue to be at half pace,” he insists.
Important, above all, in pediatric oncology
For little Oliver, the time has come now. And he will likely be handled in a non-public hospital, as a result of right now there is no such thing as a different choice. As of 2025, it’s seemingly {that a} case like yours can already go to public well being.
But there’s something else to bear in mind. Only 2-3% of sufferers recognized with most cancers are candidates for this remedy. Radiotherapy, then again, is acquired by greater than 60% of sufferers with most cancers.
“There are nonetheless few sufferers who urgently want this remedy with protons,” explains Rubio. “Most of the sufferers are being handled very effectively with photons (standard radiotherapy).” She assures the oncologist that “protons present a high quality plus in some very particular circumstances” (resembling Oliver’s). “But not all sufferers are going to profit from it, as a result of not all sufferers want it.”
In kids it’s “particularly vital,” he warns. Because radiotherapy with protons “permits us to present decrease doses than photons”, and in the long run, this may be useful, by way of the toxicity of the remedy.