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Given the advances in gene therapy, robotic surgery, proton treatment and more it’s possible to imagine the  tide has turned in the cancer battle.  And maybe it has, but those advances usually come with a caution mainly added as an afterthought in most popular media reports.   Progress is being made, but as the last few paragraphs in the stories below indicate the fight will be going for a while yet.


Trans oral robotic surgery saves public hospital patients from disfiguring procedure at Nepean Hospital

(Australia) The cancerous tumour growing at the back of Brian Hodge's tongue was about as hard-to-reach as cancers get. 

The 73-year-old was told he'd need radical, invasive surgery to remove the 50¢-sized tumour. His surgeon would make an incision almost from ear-to-ear and split his jaw in two for the 10-12 hour surgery.

After five days in intensive care, another three weeks in hospital and four to six months recovery, re-learning how to eat and talk Mr Hodge would have been left with disfiguring scars, and a voice that he may not recognise as his own. 

"My kids didn't want me to have it," Mr Hodge said. "But I'm not one to throw in the towel ... Then the unbelievable happened," he said.

Mr Hodge became one of the first public patients to undergo robotic surgery for head, neck and throat cancer at Nepean Hospital, the state's only hospital offering the service to patients who can't afford private healthcare. 

Mr Hodge's surgeon, Associate Professor Ronald Chin, performed the trans oral robotic surgery (TORS) by guiding the robot's arm into his patient's open mouth to remove the cancerous tumour. 

"I went in on Monday morning for the surgery and I was discharged Tuesday night," Mr Hodge said of his surgery performed on June 19.

"It's just amazing. Two days compared to six months recovering." he said.

TORS is available for private health patients in other NSW hospitals, but its use at a major tertiary hospital in Sydney's west – surrounded by suburbs with some of the highest smoking rates and lowest private health insurance rates in Sydney – was significant. 

"It's an enormous step forward to be able to offer this state-of-the-art treatment with such obvious benefits both cost-wise and [avoiding] disfigurement-wise ... to patients who may not have previously had the resources to access it," Dr Chin said. 

"With TORS, patients can go home the next day [with minimal discomfort]," he said. 

More than 400,000 cases of oropharyngeal squamous cell carcinomas are diagnosed each year worldwide. 

The five-year survival rate for head and neck cancer in Australia is 69 per cent, according to government estimates.

Nepean Hospital would see between 10 and 15 patients with head and neck cancers per year who would be suitable for TORS, Dr Chin said.
Robotic surgery costs significantly more than traditional surgeries. But Dr Chin said TORS could save the public health system up to $100,000 per procedure, where patients no longer needed to spend days in ICU, costing more than $3000 per night, or weeks in hospital.

The robotic surgery is primarily indicated for patients with oropharyngeal carcinomas of up to four centimetres in size. Roughly one-third of TORS patients will not need chemo and radiotherapy.

Full story:

Proton Therapy Is Finally Here, Now What? 

(U.K.) IT’S been three years since proton therapy was thrust into the UK’s spotlight, following the case of Ashya King. 

Little Ashya was just five when he came to the Proton Therapy Center (PTC) in Prague for treatment to his aggressive brain tumour.

At the time his case sparked a fierce debate - should parents be given the final say on how their child is treated?

Now, the technology is back in the spotlight. 

But this time it’s as Manchester’s Christie Hospital becomes the site of the UK’s first NHS-funded proton therapy machine. 

The capacity for the new proton therapy centres set to open in England - including one at University College London - will be for less than one per cent of all UK cancer patients.

Their focus primarily will be on paediatric cancers and cancers in the head and neck.

At the PTC, our patient numbers have more than doubled year on year since we opened in 2012.Last year we treated 800 patients, including a large number from the UK and Ireland. The vast majority of these patients funded their care privately as they were rejected for funding on the NHS.

Traditional radiotherapy uses high energy beams to target and kill cancerous cells but in the process surrounding tissue can also be damaged. This can lead to side effects. 

With proton therapy, high-speed particles are targeted at the cancerous cells with pencil-point precision. Once they hit the cells they stop, sparing the healthy tissue surrounding the tumour. 

Despite this, doctors in the UK are still reluctant to acknowledge the benefits of proton therapy over existing radiotherapy techniques in many cases, especially when it comes to reducing side effects. 

In the last three years, the NHS spent £43.4million sending 489 patients to countries including the USA, Switzerland and Germany for proton therapy treatment. 

Almost three quarters of the patients were children - making up 342 of referrals. The technology has proven to be particularly effective in young patients whose organs are still developing and in combating tumours that are close to critical structures. 

Full story.

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  • It would be wonderful to have public access to both these therapies.

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