UHN investigates bringing proton beam therapy

TORONTO – The Ontario Ministry of Health announced a $5 million “planning grant” to assess the feasibility and plan construction in downtown Toronto of Ontario’s first proton radiation therapy centre. Proton radiation therapy is considered the gold standard for treatment of difficult-to-treat cancers such as brain and soft tissue cancers in children, and head and neck or base-of-skull tumors in adults.

At present, Ontario patients who would benefit from proton radiation therapy are sent to the United States for treatment.

“What this means is we’ll be able to treat Ontario cancer patients with the most current and best technology without them having to go to the U.S. for this important treatment,” says Dr. Fei-Fei Liu, chief of the Princess Margaret Cancer Centre Radiation Medicine Program and head of UHN’s Department of Radiation Oncology.

The due diligence report on the planning, construction and operational costs of the new facility – the first hospital-based proton radiation therapy centre in Canada – is to be delivered to Ontario’s Health Ministry early next year.

“Proton therapy is a newer form of radiation therapy that better reduces the radiation dose to surrounding healthy tissue than current X-ray radiation therapy, so it is much less damaging to normal healthy tissue, and improves patient outcomes,” says Dr. Jan Seuntjens (pictured), head of Medical Physics at the Princess Margaret Cancer Centre. “That’s what makes it such an advance, especially for children who have been diagnosed with brain or soft tissue cancers.”

Reducing damage to healthy, surrounding tissue is of prime importance as damage to the brain and other critical organs can mean developmental delays and loss of cognitive powers in children being treated using traditional X-ray radiation therapy.

“In adults with head and neck cancer, proton radiation therapy is most useful when it comes to sensitive structures, such as the mouth, lips, tongue, salivary glands, and the eyes and brain,” says Dr. Seuntjens.

The announcement is welcomed by the Proton Therapy Planning Group, a collaboration between Ontario Health – Cancer Care Ontario (OH-CCO), the Pediatric Oncology Group of Ontario (POGO), the Hospital for Sick Children (SickKids) and Princess Margaret Cancer Centre – University Health Network (PM-UHN), as well as UHN’s Facilities Management – Planning, Redevelopment & Operations.

There is also significant input from patient and family representatives across the province.

“In recent years, use of proton therapy has been increasing around the world, and Ontario is now committed to planning for an installation in the centre of Toronto,” says Dr. Liu.

“This treatment centre leverages the built-in advantages of our radiation department, with expertise of the radiation oncologists, medical physicists and radiation therapists at UHN’s Princess Margaret Cancer Centre, as well as the world-class expertise from the pediatric oncologists at SickKids.”

In addition to offering world class treatment that is a first-of-its-kind in Ontario, the collaboration is proposing an innovative model of “shared cared.”

“What that means is a cancer physician in Windsor or Ottawa for example, would be actively participating with the multi-disciplinary care team at the Princess Margaret to deliver high-quality proton therapy for their patient,” explains Dr. Derek Tsang, a radiation oncologist at the Princess Margaret.

“And we think that this is optimal in terms of continuity of care, because the same physician at Windsor or Ottawa would be continuing to look after their patient even while they’re here at the Princess Margaret, and after the patients return home to their local cancer centre.

“This is an innovative model that does not exist elsewhere in cancer, and we think that this would be an outstanding care model that is novel, and ultimately in the best interest of clinical care for the cancer patients of Ontario.”

Once the planning report is approved and the treatment centre is operational, it will be run by PM-UHN in collaboration with SickKids and OH-CCO, which has been working with cancer facilities throughout Ontario to ensure that it is designed and built to fulfill the needs of all cancer patients in the province.

The Proton Therapy Planning Group includes: Dr. Brad Wouters, executive vice president, UHN Science & Research, Rebecca Repa, executive vice president, UHN Clinical Support & Performance, Dr. Fei-Fei Liu, head, Radiation Oncology, Princess Margaret Cancer Centre, Dr. Jan Seuntjens, head, Medical Physics, Princess Margaret Cancer Centre, Dr. Derek Tsang, radiation oncologist, pediatrics, Princess Margaret Cancer Centre, Dr. Jim Whitlock, head, Division of Haematology/Oncology, SickKids Hospital, Jill Ross, president & CEO, POGO, Dr. Jason Pantarotto, provincial head of the Radiation Therapy Program, OH-CCO, Sophie Foxcroft, director, System & Infrastructure Planning, Ontario Health.