19 February 2019

During a year of operation, the first and to date the only clinical proton therapy center in Russia and the CIS countries, the Berezin Sergey Medical Institute (MIBS) in St. Petersburg has treated almost 200 people, more than 45% of whom are children.

The majority of the Center's patients - 100 people - are residents of St. Petersburg. About 20 people came to St. Petersburg for treatment from other countries: Belarus, Kazakhstan, Estonia, Ukraine, the Republic of Serbia, Bosnia and Herzegovina, and Israel.

"We are satisfied with our results - they match and even exceed those of the best proton centers in the United States and Europe in the first years of their operation. After all, proton therapy involves submillimeter precision of radiation dose delivery and very thorough verification of treatment plans, which requires doctors and medical physicists to develop relevant skills," says Arkady Stolpner, Chairman of the Board of the Berezin Sergey Medical Institute (MIBS).

According to Stolpner, already in 2020 the specialists of the Proton Therapy Center will be ready to reach the planned capacity and treat up to 800 people per year. The only limitation to the patient flow may be the issue of treatment funding.

Pictured: Proton Therapy Center in St. Petersburg

Matter of national importance

Proton therapy is the most advanced, effective and sparing type of radiation treatment of cancer today, distinguished by high precision targeting of malignant cells and minimal side effects that occur with traditional radiation therapy due to the inevitable irradiation of healthy organs and tissues. Proton therapy is indicated for tumors near critical organs (brain, spinal cord, heart, liver, kidney, etc.), radiation exposure of which can lead to their dysfunction. Proton therapy is recognized worldwide as the best method of radiation treatment for children whose growing bodies are especially sensitive to radiation. Protons, unlike X-rays, can prevent such severe consequences of radiation exposure as impaired physical and mental development and reduce the risk of secondary cancers by an order of magnitude.

However, with all the advantages this treatment method has one downside - high price. Proton therapy, due to the high investment costs for building and equipping centers, is one of the most expensive treatments in the world. For example, the MIBS invested 7.5 billion rubles of its own money in the construction of the private proton therapy center in St. Petersburg which is estimated to pay back in 15-17 years. The cost of setting up and maintaining the facility and training the staff dictates the cost of treatment which is about 1.8 million rubles ($30,000). However, the price in the closest European center in Prague starts at 50 thousand euros, and in the USA it comes to 150 thousand dollars.

But if in the US, Germany, UK and other countries cancer patients receive treatment at the expense of national health systems and insurance companies, in Russia, as the Ministry of Health promises, proton therapy will be included in the program of high-tech medical care and will be paid for by the state only starting the next year. In the draft budget of the Federal Compulsory Medical Insurance Fund (CMI) for 2019 - 2021 published last fall, the Ministry of Health of the Russian Federation for the first time mentions proton therapy for cancer, which in 2020 should be added to the list of high-tech healthcare not included in the basic program of CMI. It is planned to allocate 5 billion rubles for it in 2020 and 5.5 billion - in 2021, which is enough to annually treat 2 thousand people in two proton centers - MIBS in St. Petersburg and the state-funded center in Dimitrovgrad in Ulyanovsk region, which shall open this summer. As Chairwoman of the Federation Council Valentina Matvienko said after visiting the MIBS proton therapy center, "the state is able to pay for the treatment (with proton therapy) of all children with cancer.

Based on the current Western standards, about 1,500 children a year require proton therapy in Russia.

Pictured: Valentina Matvienko and Arkady Stolpner

Regions and funds

So far, regional budgets and charitable foundations come to the aid of patients. In 2018, charitable organizations raised funds for the treatment of 44 children. Rusfond, the Khabensky Foundation, Gift of Life, and Light were the most active collaborators with the new center.

"Last year, we were excited to learn that a proton therapy center had opened in our city. Because for ten years we had been paying for this treatment abroad, in America, in Europe, and finally this high-tech healthcare became available here. And another reason why were happy to hear this news is the price of the treatment. While here it costs about two million rubles, we had to pay 3-5 times as much to send the children abroad to undergo the treatment course," said Rusfond project coordinator Yevgeniya Zabelina.

The treatment of several patients was paid for from the budgets of Russian regions and other countries. But it was only in 2018 that the treatment became truly affordable for St. Petersburg cancer patients, the region's budget allocated 1.8 billion rubles for proton treatment of 100 people.

"St. Petersburg is the first region in the Russian Federation, and, I think, the first in the world, where absolutely all children eligible for proton beam therapy can receive it for free - at the expense of the city budget," says Arkady Stolpner.

In St. Petersburg about 150 new cases of cancer are diagnosed every year among patients under 19 years old. About half of them have leukemia and the other 70-75 have solid tumors. According to current treatment protocols, more than half of these patients, i.e. 35-40 young residents of St. Petersburg, require radiation therapy. And in almost any case, proton radiation therapy for children will be more beneficial than photon radiation therapy.

Pictured: Katya from Belarus undergoing treatment at the proton center in St. Petersburg

Good prospects

In 2019, the number of children and adults receiving high-tech proton therapy may be much higher. St. Petersburg and Moscow have already placed orders on the state procurement portal for proton therapy treatment for 100 people from each region, and tenders will be held in the coming weeks. The Moscow region followed suit and is ready to allocate funds for the treatment of 10 people in 2019. According to Arkady Stolpner, the Leningrad region officials have also promised to fund quotas for 8-10 people. "We talked to the governors of Altai Krai, Novosibirsk Oblast, Tomsk Oblast. That is, the regions where we are now opening our nuclear healthcare centers. The governors said they would be happy to join the program," Stolpner notes.

Agreements on sending patients for treatment in the first proton therapy center in the CIS have been signed with the largest insurance company in Israel and with the government of the Republic of Armenia. Similar agreements are being prepared with Kazakhstan and Belarus.

Source: MIBS Press Service

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