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How do UK patients access proton beam therapy?

The UK has only one proton beam therapy facility, a small unit at the Clatterbridge Cancer Centre. The Douglas Cylotron can deliver treatment to patients with eye cancers such as choroidal melanoma. Otherwise, proton beam therapy is not available and patients who need it have to travel out of the country.

Plans for treatment centres in the UK

In April 2012, the then Health Secretary Andrew Lansley, revealed plans to build two proton beam therapy centres in London and Manchester, the first in the UK apart from the small facility at Clatterbridge.

The plan will cost £250 million but it will provide treatment for 1,500 patients each year, who will then not need to travel elsewhere in the world to get proton beam therapy.


The two centres, which will start treating patients in 2017, will be located in:

  • The Christie Hospital in Manchester: the Christie is the biggest cancer centre in Europe on a single hospital site and treats over 40,000 patients every year. Proton beam therapy is another first for the hospital – it led the UK in the use of intensity modulated radiotherapy (IMRT) and was the first centre in the world to use image guided radiotherapy (IGRT).
  • University College London Hospital: proton beam therapy will be delivered at the UCLH campus in the centre of London and will be associated with the current radiotherapy facilities. It will also be close to the UCH Macmillan Cancer Centre, which opened last spring.

A third site at the University Hospital in Birmingham may get the go-ahead soon.

This is a positive development that has been welcomed by patient groups. However, because the facilities require a complex set-up, it is unlikely that proton beam therapy will become fully available in within the UK until 2017. Fortunately, until then, UK patients can access treatment abroad.

Going outside the UK for proton beam therapy

The Department of Health (DoH) recognises that proton beam therapy is the best treatment for some patients with some conditions, so has set up a system to allow access to treatment in centres abroad. Since 2008, the National Specialised Commissioning Team (NSCT) has been running this system and has its own specialist clinical panel that looks at all cases individually.

To be considered for proton beam therapy you need to be referred by a consultant, who fills in a detailed referral form and submits to the NSCT panel.  This group of experts then makes the final decision whether they agree that proton beam therapy is the best course of action.

If it is, they confirm this to the patient and their UK medical team and open the way for an overseas referral. The proton beam therapy takes place in one of the many international PBT centres (see below), funded by the National Health Service.

What exactly will the NHS fund?

Going abroad for proton beam therapy is a big step. The treatment is done over several weeks and the patient and their family can be out of the UK for around 10 weeks. As well as the treatment costs, the NHS/NSCT also funds travel costs, accommodation during treatment and some living costs.

Proton beam therapy around the world

The UK is rather lagging behind many other countries that have built proton beam therapies in their hospitals over the last few years. More than 70,000 patients have already benefited from PBT delivered in North America, Asia and Europe.

The biggest single providers are the USA, with around 28% of all PBT centres and Japan, which has 23%. European countries are planning a rapid increase in their proton beam therapy provision in the next few years; Germany, Italy, Sweden and France are all setting up new centres.

 

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