Interview | Proton Beam cancer therapy is a national asset, says Dinesh Madhavan of Apollo

Dinesh Madhavan heads the oncology and international verticals across Apollo, India’s first corporate hospital group, and has been associated with the group for the last three years. Apollo started the country’s first Proton Beam therapy centre for cancer patients in Chennai three years back.

The Apollo Proton Cancer Centre recently became Asia’s first training institute for radiation oncologists. In this chat with Moneycontrol, Madhavan speaks about the advantages it brings to the country and how a larger number of patients will benefit if more doctors get trained in the technology. Edited excerpts:

What is proton beam therapy and for which kind of cancers does it work?

It is an advanced type of radiation treatment that can precisely deliver a beam of protons to disrupt and destroy tumour cells. When compared to traditional radiation, protons have unique properties that allow doctors to better target radiation to the size and shape of the tumour.

Unfortunately, till now, it was available only in the most developed countries. The therapy is delivered through a far superior form of technology and is very good for certain types of cancers.

It can be used for treating several types of cancers where radiation therapy is indicated with lesser side-effects and high precision rate. For certain types of cancer, like brain tumours, which need more precision, this technology is especially good.

For diseases like brain tumours, there needs to be a targeted therapy without side-effects to the neighbouring organs.

It is also useful for pediatric cancers as kids are undergoing cognitive development.

One of the reasons the technology has not been very accessible outside developing countries is its astronomical cost. Apollo, in order to ensure that the best technologies are available – be it to Indians or other medical tourists who visit India -- acquired this in 2019.

A year later, COVID-19 struck and there were challenges but we have been able to serve 800 patients so far. Looking at the value proposition of the outcomes, the inventors of the technology, IBA (Ion Beam Applications based in Belgium), decided to add us to their global pool of training centres.

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There are only two such training centres in the world so far, and we became the third one, and the only one in Asia. It is a big achievement that a country like ours will now be at par with top institutions in the USA or Germany and people from across the globe can come to us for training.

What is the cost of this therapy for patients and what is the cost of technology? Is there a plan to offer this therapy at other Apollo hospitals too?

The cost of treatment depends on the site of the treatment, the type of cancer and the number of fractions, but, on an average, it would be something around Rs 30 lakh for a patient.

While the patient gets the treatment at this rate, the quantum of investment that Apollo has made is close to about $150 million or Rs 1,200 crore. Because of this cost, it’s not possible to offer it at other centres.

Can doctors from other centres also get trained here?

Since the technology is a national asset, any doctor who is a radiation oncologist in India or anywhere in the world can come and enrol for training. You get the certification. Once you get a certificate, you can bring your patients here and also treat them.

At first, we thought we should master the technology and expertise on the programme, and get recognition by the company which manufactures it. Our training centre now opens the gates for anybody who's a radiation oncologist to get themselves trained, and can later treat their patients, instead of saying I am not able to provide this treatment because I don't have the technology. We believe in being more inclusive and allow even doctors outside of our network to use the technology.

From which centres and countries do you expect clinicians to come and train at APCC?

Apart from doctors from various hospitals in Delhi, we will have doctors from Singapore, Malaysia, Thailand, Indonesia, Vietnam, United Arab Emirates, and Saudi Arabia.

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Many doctors have already expressed interest. We are reviewing the requests. We believe a technology of this nature shouldn't be kept bottled up in one institute, and we, being in the private healthcare space, are opening it up for anybody to use it under strict quality and clinical controls that we will put in place.

Any doctor from BL Kapoor or Max Hospital from Delhi or Fortis or Tata Memorial could come and use the facility once they go through the accreditation process.

Are there any other path-breaking treatment options going to be available at Apollo for cancer patients?

At present, clinical trials related to chimeric antigen receptor cell therapy (CAR T cell therapy- a type of immunotherapy used in case of blood cancers and lymphoma) are underway at our centre and we hope make an announcement related to its commercial availability in November this year.