Proton therapy in Shandong offers hope for childhood cancer

The Proton Clinical Research Center at Shandong Cancer Hospital affiliated with Shandong First Medical University has successfully treated more than 300 cancer patients with proton therapy over the past five months and achieved remarkable results.

Its latest focus is on children as it attempts to improve outcomes in what has become a disturbing trend in China.

Data from the National Childhood Cancer Surveillance Annual Report (2022) sheds light on the state of childhood cancers in China. The upward trend is troubling.

From 2019 to 2020, the average incidence of childhood cancer in the country stood at 125.72 per million, with children age 1 to 4 being particularly vulnerable. Alarmingly, malignant cancer tumors have now become the second leading cause of non-accidental deaths among children.

Proton therapy offers a new dimension of hope. Most patients treated at the Shandong center have experienced relief or even complete remission of symptoms.

The journey to establish the proton center began with Yu Jinming, an academician of Chinese Academy of Engineering, also the hospital president, who studied at Harvard Medical School in the United States in 1995. Reflecting on his time there, Yu recalled patients undergoing proton therapy for cancer and getting extraordinary results.

He determined to bring the advanced treatment to the people of China — a dream that came true in late 2023.

Unlike conventional radiation therapy, proton therapy directs a precise beam of protons at a cancer tumor so that damage to surrounding healthy tissue is minimized. The technique, which also reduces potential side effects, has been used in Shandong to target various types of tumors, including cancers of the head and neck, chest, and abdominal region.

Notably, it has also seen success among children.

"Precision particle therapies, such as proton therapy, can help treat most childhood cancers, including those in the brain stem," Yu said.

To ensure precise and effective treatment plans for patients, the Proton Clinical Research Center has established a multidisciplinary team comprising radiation oncologists, physicists and technicians. The team, led by Yu, conducts comprehensive consultations to consider various aspects of treatment and testing — imaging, pathology, biochemistry and genetics — to tailor treatment strategies based on individual patient needs and medical history.

But Yu conceded that the high cost of proton therapy has discouraged many patients from seeking treatment, despite the fact that it is one of the best radiation therapies available.

With childhood cancer, the problem goes beyond cost. The insidious nature of the disease — coupled with the limited language expression abilities of young children, inadequate public awareness, a shortage of specialized medical facilities and limited social security — has created what has been described as an "invisible time bomb".

Yu said that disparities in healthcare standards across different regions can lead to significant variations in survival rates for children with cancer. Many hospitals lack the seamless coordination required to manage all aspects of cancer treatment effectively, he said.

As a result, a significant proportion of pediatric cancer patients in China seek treatment across regions, underscoring the need for medical institutions to establish specialized teams to provide comprehensive management.

In response to the growing concern, Yu's hospital has taken steps to recruit leading experts and to establish the first pediatric oncology unit. It offers a range of services including surgery, chemotherapy, radiation therapy, targeted therapy, autologous stem cell transplants and immunotherapy. A seamless continuum of care is available for children with solid tumors — a rarity in China.

Another key challenge in addressing childhood cancers is early detection, Yu said. The limited ability of young children to articulate symptoms often leads to delays in diagnosis and treatment, and many parents are caught off guard by the cancer diagnosis. This shows the lack of public education on the subject, Yu said.

He urged improved training for healthcare professionals, standardized diagnostic protocols and enhanced public awareness campaigns to ensure timely intervention for children with cancer.

"With enough attention and timely intervention, 70 percent of childhood cancers can be cured," Yu said, adding that the integration of advanced treatment modalities such as proton therapy and immunotherapy into insurance coverage could alleviate the financial burden on families and improve treatment outcomes for children.

It's possible to make a difference, he said. "By prioritizing the well-being of our youngest generation and fostering collaboration between healthcare providers, policymakers and the public, we can work toward ensuring that every child has access to timely and effective care in the fight against childhood cancer."