Panorama After proton therapy in Prague, British prostate cancer patient tells others to check out all the options
Prague’s Proton Therapy Center, which opened a year ago, has had more than its fair share of teething problems. Due to a drawn-out conflict with the country’s largest health insurer VZP one of the most modern cancer treatment facilities on the Continent has had problems letting Czech patients know it is here and offers the most advanced tumor treatment available –highly effective, safer and with fewer side effects. However with only a handful of these therapy centers around the world foreign patients have started knocking on its door.
Peter, from Great Britain, discovered the Prague centre after he was diagnosed with prostate cancer and was considering his options. He underwent treatment there in December and on a visit back to Prague this week told me his story.
“I was on the active surveillance program in London since 2010 and in August of last year when I had further tests it was decided that it would be useful to transfer me from the surveillance program to active treatment. I was offered two kinds of treatments in the UK. One was hormones with a classical radiation program and the other was surgery. The hormone treatment would last for about six months and the classical radiation program for about two months so altogether the treatment would probably take about a year. What I was primarily concerned about was not the efficacy of the program but the side effects associated either with the hormones and old-style radiation or with surgery. And having done my own research I decided that protons were really the way forward and that this was the most modern and most appropriate treatment in my case. I consulted my urologist and oncologist and they agreed to it. Because the proton treatment is not available in the UK – the machine does not exist there – I decided to seek the treatment abroad and I was delighted to find the most modern machine in the world here in the Czech Republic. “
Can you just briefly say what the treatment was like? In terms of how much of a burden it may have been to you?
“First of all the whole treatment took only 21 days, so less than a month. A typical treatment day would consist of me arriving here in the centre, in my own car, parking outside, going in and walking out twenty minutes later to play tennis or golf or going to a gym. My normal life was not at all affected during the treatment and basically throughout the treatment I was able to be involved in all the normal activities, going out in the evenings to restaurants and so on. So basically, there were some minor side-effects during the last part of the treatment, during the last week that related to irritation of muscles in those parts that were being radiated and I was given sleeping pills for example or urological tea in order to make sure that the system worked properly and that basically addressed the problem. So very minor issues, and I lead a normal life with all the minor side effects having gone now six weeks after the treatment.”
“Doctor Kubes said that the result is excellent, that the level of PSA –which is the measure of toxicity – has fallen dramatically to very low levels and will likely continue to fall over the next few months and perhaps a year or so. So one needs to be monitored on a 6-monthly basis, take the tests again and see what happens, but essentially the prognosis is good. According to him, he feels that I have a 90 percent chance there won’t be any recurrence of the problem in five year’s time –which is as high as you can make it. So it is a very good result. I am very pleased and incidentally I got very good treatment here not just in terms of the technology available but also in terms of the service, the friendliness of staff, the involvement of staff and their understanding of patients’ needs so I am absolutely delighted that I decided to come to Prague.”
Is this covered by health insurance for you?
“No, I have paid for it myself and in this case I consider it to be money well-spent.”
Is it affordable?
“Yes, it is, it is affordable. One maybe shouldn’t have so many holidays as an alternative….”
Do you feel that you weren’t given all the options at the beginning –when you were deciding about what treatment to undergo?
“There is a degree of ignorance in Europe about this treatment –I had to do all the research about it myself. Fortunately, I had time to do it because I was on the active surveillance program for three years, so I had plenty of time. Originally I thought I would go to the US for treatment or perhaps to Germany but when I discovered that the most modern machine was actually in Prague I thought well, it would be silly not to come to Prague, and I am delighted to have made the decision.”
So you would advise others in a similar position to check out all the options before making a decision?
“Generally speaking your specialist – at least in the UK – will say you have two options: you either go for surgery or you go for radiation. And so when I said - well, what about this other radiation –they said well, we do not have the machines here so we cannot actually advise you. Having said that, there is a very small number of people who are being sent from the UK to the US for proton treatment, but that is restricted to small children and so I obviously don’t fall into the right category. So I had to basically pursue this venue myself.”
Peter’s doctor, Jiří Kubeš, who heads the proton therapy program, says this is not unusual in Europe.
“This is a problem of European patients. In the US the percentage of prostate patients who get proton therapy is around 60 percent, so this is a typical case of a proton patient.”
And what are the benefits as opposed to other means of treatment?
“A lower dose to critical structures like the rectum, the bladder or the small intestine. Lower doses lead to a lower risk of complications.”
Do patients need a recommendation from their doctor to come to you or can they just come and inform themselves and you will conduct all the necessary tests?
“Patients should have some recommendation for radiation treatment and then we can decide if proton therapy would be beneficial for them.”
How long have you been in operation for?
And what kind of cancer do you treat?
“We have treated prostate cancers, some types of pancreatic cancers, brain tumors, cancers in children and head and neck cancers – those are typical diagnoses for us.”
Is it covered by health insurance and if not, is it affordable for patients?
“Some of these diagnoses are covered, some are not. Generally child patients are covered in all cases, some head and neck – the majority of brain tumors are covered, and prostate cancer in some but not all cases.”
How many patients do you have on average and where are they from?
“About half of our patients are from the Czech Republic, there are maybe 25 from Slovakia and the others are from the UK, Russia, Switzerland, Germany, Turkey, Norway – predominantly European countries. “
To find out more about the Prague Proton Therapy Centre please go to: www.ptc.cz