A non-surgical option for cancer treatment
Heavy ion therapy, or hadron therapy, is a type of cancer radiation therapy that uses carbon beams to directly target cancer cells and destroy them. Hadron therapy is increasingly popular because it is more effective than conventional radiation treatments and has fewer side effects.
Yamagata University’s Heavy Ion Therapy Center (Yamagata East Japan Heavy Ion Center, hereinafter Yamagata Center) is the only institution in northern Japan that offers this therapy. Satô Hiraku, director of the carbon ion radiotherapy center, explains in simple terms: “Heavy ion rays are about three times more effective from a biological point of view than standard X-rays (…) making them a promising option for non-surgical treatment and cancer control.” Taking prostate cancer as an example, he explains that five years after irradiation, in the case of heavy ion radiotherapy, the rate of no recurrence and disease control in patients is 90%. “For lung and liver cancers as well, the rate is between 80% and 90%.”
Sato Hiraku
The mechanism by which heavy-ion beams destroy cancer cells is the same as that of X-ray or proton therapy, but the beams, which are accelerated to 70% of the speed of light, are more effective at cutting both strands of DNA. Unable to repair the damage, the cells die. The technology is gaining much attention as a new approach to treating radiation-resistant cancers, such as osteosarcoma.
Targeting cancer cells with increased precision
Heavy ion beams can focus radiation on specific areas of cancer, limiting damage to surrounding healthy cells and reducing the risk of side effects. This effectiveness and efficiency allows for shorter treatment cycles than more traditional approaches. A single treatment lasts between 10 and 30 minutes, so patients do not experience the pain associated with other types of radiation therapy.
The treatment control room at Yamagata Center
Japan leads the world
As the first country to achieve clinical application of heavy ion therapy, Japan has been a pioneer in the use and advancement of this cancer treatment. In the United States, research into heavy ion therapy began in the 1970s, only to be discontinued 20 years later. In comparison, it would take until 1984 for the first research to be carried out in Japan, with the first clinical use of the technology occurring ten years later in 1994. Research and development has continued unabated ever since, making the archipelago a leader in the field.
To date, there are 15 institutes worldwide that offer heavy ion radiotherapy, 7 of which are in Japan.
Coordination with a university hospital
The Yamagata Center is the newest facility in the archipelago for this type of treatment.
The entrance to the Yamagata Center
The Yamagata Center is affiliated with Yamagata University Hospital, the only facility in the world that offers this type of radiotherapy connected to a general medical hospital. This partnership provides access to all the resources available at the medical university, giving patients the greatest peace of mind. Iwai Takeo, director and professor of the center in the Department of Heavy Particle Medical Science at Yamagata University, explains that this connection helps provide a wider range of treatment options. “With heavy ion therapy, we sometimes use surgery or chemotherapy based on the type or location of the cancer. This location within a general hospital makes it easier for doctors to communicate and develop better treatment strategies.”
Iwai Takeo, Director of the Yamagata Center
Better comfort for patients
The center is equipped with a rotating gantry treatment machine. There are only three in the world. Conventional equipment can only irradiate in a horizontal or vertical trajectory, so adaptation to the patient’s position is necessary to focus the beams on the tumors. But a rotating gantry allows the beam emitter to rotate 360 degrees during irradiation, for greater comfort for patients when they are lying down.
The center’s rotating gantry is more compact and lighter. But still, it is 10 meters long and weighs 200 tons. The price of the machine is in line with its size; the center invested 15 billion yen (over 90 million euros).
The Center’s rotating gantry
The center has been offering radiotherapy treatments since 2021. And research has made progress in the meantime, allowing for the development of new therapies as the safety of treatments has been confirmed. The center now offers most cancer treatments covered by the public health insurance system and the subsidiary program for advanced medical procedures.
Ion therapy, however, remains an expensive option, costing patients tens or even hundreds of thousands of yen in co-payments for radiation treatments under the public insurance system.
Therapies not covered by Japanese social security cost more than 3 million yen (19,000 euros). Patients from countries other than Japan who receive this treatment can pay up to 4 million yen (25,000 euros). Despite these high costs, the center is receiving more and more requests from abroad, explains Satô Hiraku.
“Of the nearly 1,500 patients treated at our center so far, only three were medical tourists, but we received more than 60 requests through an overseas medical care coordinator.” He added that the facility was unable to accept the majority of these requests, particularly because of the patients’ general condition.
However, he said this situation is set to change. “Once we have an admission system in place, I think we will be able to provide more care to international patients.”
The lobby of the Yamagata Center
Treatment, onsen and gastronomy
The government has supported the Yamagata Center under its Japan International Hospitals program, an initiative that recognizes medical facilities that welcome medical tourists.
In order to be able to admit more patients, the center has entered into agreements with medical coordination companies, and Professor Iwai is already looking forward to collaborating with different groups and establishing a specialized department within the center. “When it was established, the center received funding from the Japanese government, prefectural authorities and local companies,” he explains. “The travel and hospitality industries also gave us their support, with the hope that the center would help develop inbound tourism in the region. We hope to live up to their expectations.”
Located just over three hours by Shinkansen from Tokyo Station, Yamagata Prefecture is full of tourist attractions to explore, including over 130 hot springs and natural landscapes such as Mount Zao and the Mogami River. The area is also known for its food lovers, who will enjoy Yonezawa beef, cherries and local sake.
In March 2023, Yamashin Kanko, a major brand in the tourism sector, began offering tailor-made trips for foreign visitors who wish to receive treatment at the center. The company took care of aspects such as arranging accommodation, purchasing plane tickets and arranging visas.
Prefectural and municipal organizations in particular, as well as companies, have come together to offer tours that include, in addition to patient treatment, visits to various tourist sites, in order to breathe new life into the local economy. It is a safe bet that this initiative, which seems to appeal to many local stakeholders, will help develop medical tourism in the region and thus revitalize local communities.
