Maribel Gallardo Fuentes
Researcher in the Department of Atomic, Molecular and Nuclear Physics at the University of Seville.
Proton therapy is a very precise technique that is significantly better than conventional radiotherapy for the treatment of a number of tumours, including most paediatric tumours. However, there is a large proportion of cancers that respond very well to X-ray radiotherapy, and a third group for which there is not yet a consensus opinion among specialists, although in principle it seems that the use of protons would be beneficial for them.
Four treatment units in Spain would be sufficient to treat all patients in the first group. Let us remember that there are two private units already in operation; if we add the ten units whose equipment will be financed by the Amancio Ortega Foundation, and one more in Cantabria, also public, that makes 13.
With this number of units, in a very short space of time we are only behind the USA in terms of the number of proton therapy rooms per inhabitant, well ahead of Germany and Japan, all countries with long experience in this type of therapy.
This provides a unique opportunity to not only treat those patients in the first group, but also to conduct clinical trials to shed light on the possible benefits for patients in the third group mentioned at the beginning, and also to carry out research into innovative treatments and the development of new equipment linked to proton therapy.
The dark side of having such a large number of units is that such an ambitious programme requires detailed planning, including a realistic needs assessment (for scaling up); a training programme (since new technology and protocols are involved); and a rigorous estimation of the associated operation and maintenance costs (which may represent a considerable fraction of the total expenditure).
In the absence of these circumstances, the returns to the public health system would fall far short of expectations. Or the wards may even be left empty.