Proton
Theraphy
We are an initiative group that wants to build in Bucharest an oncology hospital with proton and carbon ion treatment.
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Ladies and gentlemen
We have carried out a study in which we present the necessity and opportunity of such a project, the impact on the European regions where it is not located and demonstrate the advantage that our country presents in relation to other states in the region. It could serve the entire European area and could also benefit from the support of specialists from the Magurele Physics Institute, known for the high-power laser existing here. There is an EU initiative of this kind that considers that the area must benefit from this type of treatment, because the WHO’s estimated prevalence for the next 5 years is 1,511,981 new sick people.
We also made an analysis of potential clients and the market in Romania, at the current moment and based on forecasts for the next 10 years. We carried out a comparative study of the costs of therapies from similar European centers and the current situation in terms of costs and the degree of success in treating different types of cancer. Also, we did a first cost-benefit analysis and a financial projection with the return of the investment in 10 years, with a grace period of 18 months from commissioning. We have taken into account existing statistical data regarding the situation and evolution of cancer patients at the local and European level and we are aware of the current situation regarding diagnostic and treatment facilities. Also, we had and have various contacts with specialists, doctors, potential investors, decision-makers in the local and central administration, etc. . We are aware of the high value of the investment and the high difficulty of realizing such a project at the Romanian level, but we consider it a well-done project, with the involvement of several factors in terms of consulting, financing, management, design, construction, etc., with the contribution of specialists in the treatment of oncological diseases and with an enthusiastic team aware of the value and usefulness of this project, it will be a successful one. That is why we are trying to co-opt the consulting firm that has the expertise in the field in order to succeed in obtaining advice, first for the realization of the project and then for the realization of the entire investment.
As we thought, a first approach would be to carry out the project in two stages as follows:
- The first stage will consist of the development of a proton and ion-carbon therapy center;
- The second stage is represented by the creation of a diagnostic and treatment center using classical methods.
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A second approach would be to create only the proton and carbon ion therapy center
I present some data from the current project:
The annual capacity of this center is a maximum of 12,000 patients/year.
The land area required for the phased development is 30-40,000 square meters.
The proton and ion-carbon therapy center will be modeled after the MedAustron Gmbh Austria center or similar. The main equipment can provide both proton and ion-carbon therapy at the same time and is the product of the Hitachi company. It is mainly used in oncopediatric therapy, because it does not affect the rest of the growing organs and tissues in any way. This would be unique in Romania and in the Balkans, Turkey, Israel and ex-Soviet space
The cost of this stage is estimated at 80 million Euros.
These equipment makes this clinic a first for the Romanian oncology market.
1. PET/CT DISCOVERY IQ is manufactured in the USA by the General Electric medical equipment division. It is the newest equipment in the range, just appeared in the European Union. It is the best equipment for investigating Alzheimer’s, Parkinson’s and AIDS (FDG is used) and for the prostate, liver, pancreas, bladder, lungs it uses C11. It can also work with the latest generation biomarkers such as F 18 chlorine, F18 dopa and Gallium Dotatol, with which oncogenetic research investigations are carried out. The impact of such an investigation solution with 64 slices can be summarized as follows:
– Reducing the number of deaths due to oncology;
– Reducing the number of days of hospitalization;
– Reduction of disabilities caused by different forms of cancer;
– Reducing the total costs of the national program to fight cancer.
PET/CT can highlight very small malignant cells, ensuring the discovery of various forms of cancer in the early stages.
PET technology is the only investigation at the cellular level that allows a high-level imaging acuity that CT, MRI or any other equipment cannot achieve.
The PET analysis replaces 14 classic analyses, which are currently practiced and last 30 min. , compared to a month and a half as long as the set of classic analyses. These equipments are essential for the preparation of treatment plans
2. RADIOPHARMACY CYCLOTRON ABT BG-75 produced by ABT Molecular Imaging Inc. from the USA. This equipment produces FDG and C11 biomarkers every 30 min. without any loss through the half-life and independent of the number of patients. It was approved in the USA in 2010.
3. NON-INVASIVE SURGERY ROBOT CYBERKNIFE is a robotic radiosurgery system that uses a linear nuclear accelerator with X-rays and Gamma rays for non-invasive surgical interventions. The 4th generation Cyberknife 4 system is the only intelligent robotic radiosurgery system currently available worldwide. The Cyberknife G7 system combines its unique technological capabilities of radiation imaging guidance with computerized robotics control to allow sub-millimeter precision in positioning the beam and irradiation points. The system uses a compact linear accelerator connected to a robotic manipulator, to allow precise targeting of a number of narrow beams of radiation, to irradiate the tumor from several directions, non-coplanar and non-concentric. The technology presented for guiding irradiation through imaging is based on the comparison between intraoperative X-ray imaging and CT images previously obtained for the tumor and the surrounding tissue to allow the most precise targeting of each radiation beam. This approach leads to the concentration of a very high dose of radiation in the tumor, with a very high degree of compliance. Due to the precision of the irradiation, the surrounding healthy tissues are subjected to a minimal dose of radiation (below 10%), being less affected and recovering more quickly.
4. TOMOTHERAPY produced in the USA by the ACCURAY company in 2011. It belongs to the category of those who do radiotherapy. During a session, it rotates 360 degrees and is guided by CT to maximize the treatment and reduce the number of sessions.
The cost of this second stage is 50 million Euros.
I saw on your website that you have expertise in various fields of activity, including health, and you can provide consultancy in order to finance and implement some projects in this field. Work with strong partners who could help us complete this project.
What do we want?
1. Consulting in carrying out the feasibility study and subsequently in any of the stages I described previously.
2. Promoting this project to your partners in order to obtain its total or partial financing.
To the extent that this presentation is of interest to you, we are at your disposal with any information that could be useful in order to open a collaboration and we await your conditions.
Regards,
Barbu Catalin – initiator and project coordinator
Doru-Nikolaus Olariu – external relations promoter and consultant
Adrian Kovaci – “Provita et Humanitae” Association – promoter
Victor Patrusca – Financial Manager
Daniel Ursescu – doctor in physics, member of the international project ELI-NP Magurele
Daniel Munteanu – IT Manager
Gheorghe Juravlea – Technical Manager
INTRODUCTION
Provitae & Humanitae Asoc presentation
The Pro vita et Humanitae association was founded in 2015 from the desire to find solutions for treating cancer, especially in children.We are an association that wants to develop an ecosystem that combines the advantages of an organization with a mixed funding system that can ensure a wide range of medical investigations.We address all patients regardless of their financial or social status.We want to be a reference environment in the medical field.The association wants to develop Cancer Center Cybermed-Bucuresti. This is a start-up business, as the field of Oncology requires major investments.
Mission Statement & Strategic Vision
Mission
The Bucharest Cybermed Cancer Center mission is to prevent and cure cancer.
Vision
The Bucharest Cybermed Cancer Center vision is to be the preeminent leader in achieving freedom from cancer by extending and enhancing the lives of individuals regionally, nationally, and throughout the world. We will achieve this vision through creative collaborations, excellence in research, and research driven, multi-disciplinary cancer prevention and patient care programs. The creation and dissemination of our knowledge will be achieved through translational research,
technology development, and novel programs in education and training. Our priority is to assure that all those at risk for and affected by cancer have access to the highest quality care.
In the service of our patients we strive to be:
- A top 10 cancer center in research funding;
- The trusted source for accurate and timely information on cancer prevention and cure; and
- The greatest hope for our patients and their families.
Values
As a place of healing and hope, the Bucharest Cybermed Cancer Center is committed to:
- Fostering a culture of innovation and creativity and encouraging and supporting intellectual curiosity among our members;
- Conducting translational research, clinical trials and therapy to produce evidence-based conclusions and results;
- Achieving creative collaborations and open communication in the complex endeavors of research and treatment;
- – Respecting our people and honoring and welcoming the diversity of our talent, thoughts, experience and
- Acting with integrity and honesty in all matters, with each other, our patients and their families, and our community; and
- Assuring that our efforts and activities are always people-centered, compassionate, supportive and focused on quality of life.
External environmental analysis
Dominant statistic traits
For this chapter we used statistical data used by the World Health Organization through EUCAN system.
Romania, are diagnosed each year, nearly 70,000 new cases of cancer.
About 3,000-4,000 Romanians looking for cancer treatment in countries such as Turkey, Germany, France, Austria or Hungary, where the price of a treatment is around 10,000-15,000 euros.
As a result cancer patients spend about 30 million for treatment abroad, plus travel costs and other expenses.
Nature of competition & strength of competitive forces
The main competitors on the market of medical oncology services are:
- Private medical services market amounted to about half a billion euros, and this year could grow by 8%. From 2013 this market would exceed 20%, if they enter into force some regulations in the field, shows the company’s research data PMR.
- As you notice the private medical services market covers only 10% of the total number of new cancer patients.
- Our cancer treatment would have an annual capacity of 5,000 patients.
Internal environmental analysis
Assessment of company’s present strategy
In 2010, more than one of every ten deaths will be due to cancer. According to the patterns of morbidity and mortality in the country, nearly every Romanian will have contact with Cancer in their lifetime, either by directly having cancer or through a family or friend. The burden on the society and the economy is large and growing. In 2009, more than 30 percent of all deaths were for people of working age; not the end of life elderly dying alone in a bed. According to WHO nearly thirty percent of these deaths could be avoided with improvements in prevention, detection and treatment. Romania could probably avoid an even higher percentage of the cancer mortality because the current mortality rates are nearly two times the rates of European countries, even after cancer has been detected. This aspect of the performance reflects late detection – in Romania detection by stage of cancer is about half the rates for Canada, for example – and inadequate treatment protocols—5 year survival rates are about 50 percent European levels reflecting the possibility to improve outcomes. The Cancer Optimisation Plan, outlined in this paper sets out the major changes in the cancer services strategy and highlights alternatives for investment plans to develop a health service for the 21st century, offering fast, convenient, high quality care, with patients at the centre. The Government of Romania has identified cancer services as a high priority to benefit the population. While access to services and the effectiveness of cancer care has improved dramatically over the past decade, as resource availability has increased substantially, it is important that future increases in spending for cancer services are targeted to the most cost-effective models of care, driven by evidence and focused on patients. To this extent, this Cancer Optimisation Plan now sets out how these improvements will should introduced. In addition to establishing investment targets, the Plan sets out how this investment will need to be accompanied by reform: strengthening prevention and promotion to reduce the risk of getting cancer; through introducing modern approaches to delivering care on an ambulatory basis; through improving the stewardship role of the Cancer Center to establish and enforce high standards of treatment across the network of providers; by decentralizing services so the patients receive care closer to their homes; and by creating greater support in the communities to care for patients who require palliative care. In summary, the strategic objectives of the Plan aim to make changes that the Romanian people will see and feel.
These changes are:
- To reduce the risk of cancer by improving efforts to reduce smoking, promote healthy lifestyles and promote the vaccination of young girls for HPV;
- To increase early detection of cancers by increasing public awareness, strengthening the integration of screening and early detection programs in the primary healthcare services;
- Faster access to services, closer to your home by strengthening diagnostic capacity for cancer at the regional hospital, including decentralizing chemotherapy and minor surgeries, and expanding palliative care through home-based networks;
- To improve conditions for those patients living with cancer, patients and their families should receive the information, support and specialist care they need to help them cope with cancer, from the time that cancer is first suspected throughout the subsequent stages of the disease. Good communication between health professionals and patients is essential.
- Improve research and evidenced based treatment to focus additional resources on improving research capacity and international collaboration between the cancer programme in Romania and international centers of excellence, to ensure that patients in Romania benefit from the knowledge of international networks and that Romanian oncologist can research how to best treat cancer given the prevailing conditions.
These new commitments will strengthen the fight to prevent cancer; ensure that all who need it are guaranteed fast diagnosis and treatment; and provide increased support for people living with cancer right across the country.
Resource strengths and weaknesses, market opportunities, and external threats
A. STRENGTHS
- Prevention
- GI
- Lymphoma
- Interdisciplinary programs/collaboration
- Productivity- per capita funding
- Strong community support
- Biotech transfer
- Access to diverse populations
- Telemedicine
B. WEAKNESSES
- Outdated accounting systems
- Small clinical program
- Small accrual based for clinical trials
- Limited fixed support/funding
- Relatively small development programs
- Lack of critical mass, particularly of clinical faculty
- Underdeveloped links with community physicians
- Lack of designated inpatient space
- Aging facility
- Underdeveloped marketing/branding
- Underdeveloped multidisciplinary culture among MDs
- Underdeveloped informatics
- Limited outpatient space
C. OPPORTUNITIES
- Statewide /Regional /National /International markets
- One door policy for donors
- Activist Board – Support/assignment of Romanian senior leadership
- Industry/business partnerships
- Bioimaging – Improving access for underserved populations
- Collaborating with other Romanian units, e.g., College of Pharmacy
- New faculty bringing new funding
- State support
- Internal re-engineering
- Outreach – Community medical collaboration
- Development of multidisciplinary MD model
D. THREATS
- Outdated accounting systems
- Small clinical program
- Small accrual based for clinical trials
- Limited fixed support/funding
- Relatively small development programs
- Lack of critical mass, particularly of clinical faculty
- Underdeveloped links with community physicians
- Lack of designated inpatient space
- Aging facility
- Underdeveloped marketing/branding
- Underdeveloped multidisciplinary culture among MDs
- Underdeveloped informatics
- Limited outpatient space
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A Facility for Tumour Hadron Therapy and Biomedical Research in South-Eastern Europe
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Cost Analysis Operational model: base case
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Cost Analysis
Operational model: base case
per patient (inoperable stage I NSCLC)
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Results: cost-effectiveness (all studies)
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Results: cost-effectiveness (all studies)
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Estimated number of new cases from
2020 to 2030, Both sexes, age (0 - 85=+)
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Estimated number of new cases from
2020 to 2030, Both sexes, age (0 - 85=+)
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Estimated number of deaths from
2020 to 2030, Both sexes, age (0 - 85=+)
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Estimated number of new cases from
2020 to 2030, Both sexes, age (0 - 85=+)
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Estimated number of deaths from
2020 to 2030, Both sexes, age (0 - 85=+)
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Estimated number of new cases from
2020 to 2040, Males and Females, age (0 - 85=+)
