Doorstop interview, Adelaide
Turnbull Government’s $68 million commitment to establish Australia’s first Proton Beam Therapy facility

Steve Wesselingh, Executive Director, South Australian Health and Medical Research Institute: I’d like to welcome you here today for a fabulous announcement, and that is the support from the Federal Government for $68 million to build a proton therapy unit. This will be the first proton therapy unit in Australia, and in fact the first in the Southern Hemisphere, and will enable us to treat really difficult cancers, particularly in children. And the big advantage of proton therapy is the lack of damage to other tissues; so if you’re treating a cancer on the spinal cord or the brain of a child, you don’t damage the other tissue and therefore the treatment, obviously, is much, much more successful.

And with the $68 million from the Federal Government, we’ll be able to start building our proton therapy unit in the context of a second SAHMRI building and that building, as I mentioned, will house the proton therapy unit but will also house other research capacity, particularly clinical research capacity and public health capacity, and also have additional space available for industry, so for small biotechs or pharma or other industry that might want to join us, and in addition there would be space for expansion from the universities as well, either Adelaide University or Flinders. 

And this is so much more exciting because it’s on this precinct; it’s right next to this amazing 800 bed teaching hospital, right next to SAHMRI, and right next to the new Adelaide University building. So the combination of research, teaching, and clinical service is really the three legged stool that enables us to develop- deliver the very best health care for people in South Australia, but in this case for people right across Australia and right across the region, and really allows us to lead in this area.

So we’re very excited and we’re very thankful for the help from the Federal Government.

Simon Birmingham: Thanks so much, Steve. And it is a real delight for me to be here today as the Minister for Education and Training, but importantly as a Senator for South Australia, to announce and endorse the $68 million that the Commonwealth Government, the Turnbull Government is providing towards SAHMRI 2 and, in particular, towards the new proton beam therapy unit that is going to be at the heart of the new SAHMRI 2 facility.

This is a project that my colleague, Greg Hunt, the Minister for Health, has driven and is delivering on behalf of the Turnbull Government, and he’s doing it thanks to combined and collective lobbying efforts right across party lines. I particularly acknowledge my South Australian colleagues in the Lower House, Nicolle Flint, Christopher Pyne, who lobbied hard for this, as well as other colleagues, Nick Xenophon, and the State Government, who’ve all been on board supporting it, and of course we look to the State Government to now work with us in partnership with SAHMRI and other partners to ensure the full delivery of the full proposal. 

As you’ve heard, the gains and the benefits from this are incredible. This is going to deliver world class cancer treatment, particularly targeting and helping childhood cancers. It’s going to provide a facility for research activity that doesn’t exist anywhere else in the Southern Hemisphere; it will provide treatment services to people not just in South Australia but from around Australia and around our region. It will bring together, in a collaborative sense, researchers, industry, and treatment and patient services, ensuring that we have the best of all outcomes here.

It’s only a few months ago that I was delighted to be in this precinct opening the new University of Adelaide medical school, situated right next door to SAHMRI 2, which is providing yes, world class education and training for our medical profession, but also, with SAHMRI 1, the University of Adelaide is bringing together the best of medical skills, the best of medical research, and in the new SAHMRI 2 they’ll apply that to the best of new, modern, world class cancer treatments and research in the future.

Journalist: Could you tell us how the machine actually works? Is it something you require surgery for? Is it more laser based?

Steve Wesselingh: So this is a form of radiotherapy, so basically we create a proton beam, a very precise proton beam, which is lined up with the cancer and doesn’t require surgery, but the beam damages the cancer cells, but importantly doesn’t scatter and then damage other viable and healthy cells. So for the patient it’s very similar to going to have radiotherapy at any other unit, expect that it’s a much bigger unit surrounded by a concrete bunker. But no surgery, just the beam going into to the- treat the cancer and, depending on the cancer, a variety of treatments will be required, so it might just be a couple of weeks but- or up to six weeks of treatment.

Journalist: Is it stronger than radiotherapy or chemotherapy?

Steve Wesselingh: It … it is not necessarily stronger, but less likely to cause damage and certainly the proton therapy beam is more potent at killing cancer cells, yes.

Simon Birmingham: Steve gave me a really good example before that you might want to elaborate on, in relation to childhood cancers and different spinal cancers and the benefits of targeting that the proton beam provides.

Steve Wesselingh: So, if you imagine a child with a cancer on their spinal cord, with the current radio therapy we could try and kill that cancer, but we would also damage the spinal cord and so in the end you would end up with a very damaged spinal cord and maybe success in treating the cancer, but obviously not- a spinal cord that’s not working. With this case, we can precisely aim the beam at the cancer. The beam hits the cancer cells, doesn’t scatter, so doesn’t damage the spinal cord, and we can kill the cancer cells and the spinal cord still works and the child’s still able to walk around and do everything they want to do.

Journalist: Is it the most effective cancer treatment?

Steve Wesselingh: It’s the most effect- there are lots of cancer treatments, some of them being chemotherapy, some of them being surgery, but there are- there is a group of cancers, and actually it forms a pyramid with childhood cancers at the top of that pyramid but with other cancers elsewhere in that pyramid, where this is the best cancer therapy, yes. But that’s not to say there aren’t other things like leukaemias, which- where chemotherapy and kinase inhibitors aren’t the best therapy.

Journalist: What are families currently doing and how does this new facility change that?

Steve Wesselingh: So, if you currently had a child with a chordoma, a cancer on the spinal cord, you would need to take your child to the United States or to Europe to get this therapy and you would need to spend, as I mentioned, up to six weeks overseas having that treatment and the costs would also be significant, in the order of a couple of hundred thousand dollars, for the treatment. And that does happen at the moment, and supported by state and Federal government people do do that, but obviously that’s an enormous ask on the family and you’re then dealing with a whole heap of doctors that aren’t part of you treatment group. With this, you wouldn’t have to travel; you would come here and be able to have the treatment in Australia. Much easier, much more accessible, much cheaper, and also wouldn’t have to worry about any of the waits that might be incurred if you were trying to access treatments in other countries.

Journalist: You talk about industry as well, can you just expand on that? I mean, it’s not only patients that are set to benefit from this.

Steve Wesselingh: So, the major point that I was making about industry was in the rest of the building, so that we would have space on the precinct for industry like biotech or pharmaceutical industry, imaging industry, to be here in- with the clinical research we’re doing, with the patient care we’re doing, and so that new products will be developed, new jobs will be developed. And I think that’s an important part of what the precinct should do and at the moment there’s no space for that on the precinct.

Journalist: Fair to say South Australia’s really leading the way in all this?

Steve Wesselingh: I think this is fabulous for South Australia. As I said, this will be the only unit in Australia, and I think also the concept of this precinct, such an advanced precinct with an amazing hospital, amazing university building, SAHMRI with 650 researchers in our building, all coming together. Yes, I think we are leading Australia.

Journalist: How many patient- sorry.

Journalist: What’s the worth of the actual machine on its own?

Steve Wesselingh: So the machine on its own is in the order, not wanting to give it away in the terms of the people we’re purchasing it from …

Simon Birmingham: We’ve got to go to tender, yet.

Steve Wesselingh: We’ve got to go to tender, so …

Journalist: A rough ballpark figure?

Steve Wesselingh: So, $50 to $70 million.

Journalist: And how big is the actual machine? It sounds like it takes up a room, does it?

Steve Wesselingh: Yes, yes. So, basically the building will have three basement floors and the three basement floors will be essentially taken up by the proton therapy unit, so the machine takes up a very large concrete bunker. And then we’ll have three treatment rooms and then, obviously, other rooms for patient care and other things in amongst those three floors. But basically, the proton therapy unit as a whole will take up the first three floors of the building.

Journalist: How long does one, kind of, session of treatment take and how many patients would you treat a day or a week?

Steve Wesselingh: So, we’re anticipating as we ramp up that we’d be treating in the order of 700 patients a year, so you can calculate the number per day. And patients, as I said, would range, depending on the cancer, but the average treatment would be about four weeks, so you would come in every day for a treatment for four weeks, four to six weeks for treatment.

Journalist: And how long in the chair, when they’re getting the laser …

Steve Wesselingh: I’m actually not a radiotherapist, so I can’t tell you precisely. But I imagine each treatment would be in the order of half an hour to an hour, but, you know, I’m honestly not that person.

Journalist: That 700 a year figure, is that just South Australians or is that anyone who might use this?

Steve Wesselingh: No, that we- that’s calculated on the basis of Australia-wide need, and- so we would anticipate that we would service the whole of Australia with this proton therapy unit and people would be working with our radiotherapists in terms of planning their treatments and then they would come to Adelaide for the treatments. And that would be absolutely accessible nationwide, so this is not a South Australian-only treatment facility.

Simon Birmingham: As Steve touched on before, currently we provide funding to support families who need it to go overseas to access these types of treatments in the United States and by having this unit here, families will no longer need to undertake the cost and stress of travelling overseas, they’ll be able to get the treatment they require for their children here in Adelaide; from all around Australia, coming here to get the best technology, the best treatment, and from, of course, the best medical practitioners and researchers, which is going to make a profound difference to the lives of those families, but also has the additional benefit in this research precinct of really driving and lifting the research input and impact that we have in terms of future treatment of cancers and other medical research that can come from a proton beam.

Journalist: How many patients do you predict will travel from overseas to use Adelaide’s machine?

Steve Wesselingh: We’ve estimated over the first two or three years perhaps 100 or so, so that’s in our estimates, but we don’t really know the exact answer to that, and obviously Australian patients would get preference and we would work with the oncologists from around Australia to ensure that all Australian patients who need proton therapy would be able to access it. But at the same time, we want to provide regional leadership and if there is- if it’s accessible, we’ll bring patients from elsewhere in the region for treatment.

Journalist: Is that on top of the 700, sorry?

Steve Wesselingh: No, no, that’s part of the 700.

Journalist: Senator, how much does the Federal Government contribute to families looking to go overseas currently for that treatment?

Simon Birmingham: Look, we can come back to that. I think the- I understand from rough discussions previously there’s around a couple of hundred thousand dollars in terms of the price tag applied for the cost and the support that we give, and we’ll get precise details for you. But there’s no doubt that, in an ongoing sense, there’s a saving to the tax payer in terms of not funding families to go overseas, but far more importantly there’s a saving in cost, time, stress on those families in terms of having to travel to access that treatment; obviously in terms of parents needing to continue working while their child is undergoing treatment, that’s really hard if you’re having to leave the country to access that type of treatment. So it will make a big, big difference to access to treatment, but also, of course, to the stress and circumstances of families who are undergoing those treatments.

Journalist: And is this just the beginning? You’d hope to see more centres like this across Australia?

Simon Birmingham: Well, we’re licensing and funding one right now, and of course it’s a relatively targeted number of circumstances at present where this treatment is applicable and necessary and is the best form of treatment for people, but as medical technology changes, who knows in the future?

Journalist: Could you be more specific about what you’re asking the State Government for and what you’re expecting from them?

Simon Birmingham: Well, this proposal has been around for a couple of years and has undergone very thorough analysis. Now, we’re thrilled that we are- be able to invest $68 million to make sure the proton beam therapy unit comes here, is built here, and established here in Adelaide. Together with that is the proposal for an expanded SAHMRI presence, which I understand- there’s a collaboration that’s part of the discussion there. So the total cost of it might be in the order of a couple of hundred million dollars, but the partnership and partners will include the State Government; it could also include universities and, indeed, research tenants and other tenants in the building, too.

So SAHMRI is of course working on that. We want to make sure that this happens. We were asked to pretty much front up the cash to make sure the proton beam therapy unit could happen and that’s what we’re doing.

Journalist: You must have a figure of what you want from the State Government, though.

Simon Birmingham: Well, it’s not- it’s not our project, its SAHMRI’s project. We’ve received request to provide this level of funding to support the proton beam therapy unit and that’s exactly what we’re doing.

Journalist: Is it not $40 million from the State Government?

Simon Birmingham: As I said …

Journalist: [Talks over] On the land?

Simon Birmingham: … I’ll let Steve- if Steve wants to get into exactly how it might come together, I know he’s got discussions to have with all of the different partners, I don’t want- leave you to deal with how you have those discussions. We’ve dealt with what we’ve been asked to contribute …

Journalist: [Interrupts] But surely you know. Is it $40 million or…?

Steve Wesselingh: So, the- I mean, I think the Premier would probably like to make his own announcement, but there has been preceding discussions which includes $44 million from the State Government and the land, which is valued at around $20 million. So that’s our discussion so far, but the Premier has indicated a- that he’s going to make an announcement and I obviously would wait till that announcement to see what the Premier’s going to say. But that has been our preceding discussions, which would enable us to move forward immediately with the Federal Government’s monies and the State Government’s monies, and the State Government’s commitment towards the train control centre.

Journalist: So you don’t actually know when construction will begin? I mean, you say it’ll be operating by 2020, but sort of waiting and seeing till the Premier stumps up the cash?

Steve Wesselingh: No, no. I think we are comfortable, I just want to give the Premier a chance to make an announcement. So we’re comfortable that we’ve had the discussions that enable us, with the Federal Government’s support today, to move ahead immediately. But I think the Premier has every right to make an announcement about his contribution and be proud of his contribution.

Journalist: So construction is underway, about to get underway?

Steve Wesselingh: Construction is not underway, no, but the- and the first move will be the move of the train control centre off the site, the second move will be to dig a great big hole, and then the third move will be to build a bunker which will enable us to move the proton therapy unit into the bunker. So that- they are the processes and we have a game chart that tells us how we’re going to build that, but that’s the process.

Journalist: And those processes have begun?

Steve Wesselingh: They haven’t begun, no. We’ve got a funding announcement today and there’ll be another funding announcement from the Premier in the next couple of days, and then those processes will begin.

Journalist: Any estimate on how many [indistinct] planning, how many staff could be employed at this facility?

Steve Wesselingh: So, we- we’re thinking, from a SAHMRI point of view and from a proton therapy unit point of view, that there’ll be another 400-odd people in the building, so that’s researchers, clinical researchers in the floors above the ground, and the staff that run the proton therapy unit. I can’t really estimate our engagement with industry, how many staff that would produce. So- but we’re estimating about 400 staff from a SAHMRI and proton therapy unit point of view.

Journalist: Just with the research, can you just tell me how the- you know, how it’s going to bring about research as well, having the machine here?

Steve Wesselingh: So the machine- proton therapy is very clear what cancers proton therapy is really good for at the moment and I’ve described those, particularly paediatric, but then there’s a large number of cancers in which we are struggling to really get good outcomes, and an example would be lung cancer, and so the development, with this proton therapy, of research around the treatment of, say, lung cancer, with protons will hopefully enhance our capacity to treat lung cancer and extend people’s lives with lung cancer, which is one of our very common cancers, but ones which we’re not treating as well as we’d like to.

Simon Birmingham: Thank you very much.