Innovative cancer treatment centre in Bulgaria: where will it be built?

In 3 years, Bulgaria is expected to have the first proton centre for cancer treatment, it will be the only one on the Balkan Peninsula.

Funding for it has been secured under the Recovery and Resilience Plan, but it remains unclear where it will be located. The decision will be made at a meeting of a working group of the Ministry of Health next week.

About 600 patients a year in Bulgaria need proton therapy, but no such therapy is available anywhere in the Balkan Peninsula. The key benefit of this therapy is the precision with which the proton beam targets the tumour and spares healthy tissue.

In children this is of great importance because it allows the use of lower doses of radiation. However, the treatment is expensive - EUR 23,000 anywhere in the European Union, compared with EUR 70,000 in previous years. But talks about where to build the centre are still on the table. Sofia is mentioned in the project initially proposed by Brussels, but Varna is also a candidate.

"The group that has been set up has to objectively assess the indications of the place, of the centre, of the staff, of the medical physicists who have yet to be trained. We will overcome the country's 20-year wait to introduce this method," Prof. Vesselina Parvanova, Clinic of Radiotherapy, University Hospital "Prof. Chernozemski" said.

"Varna is also a suitable candidate - we have a lot of experience, we work with children, with anaesthesia," added Prof. Dr. Elitsa Encheva, Radiotherapy Clinic, "St. Marina" Hospital.

Specialists stress that the current methods are also effective and not all types of cancer can be treated with proton therapy. There are only a hundred centres in the world and 31 in Europe.

"This is the best for about 16 localizations of the tumour process and not only the place, but also the histology," added prof. Vesselina Parvanova, Clinic of Radiotherapy, University Hospital "Prof. Chernozemski".

"About 60% of cancer patients need radiotherapy. And those requiring proton therapy are between 12% and 15% according to the latest calculations", commented Prof. Dr. Elitsa Encheva, Clinic of Radiotherapy, "St. Marina" Hospital.

"A large number of adults who have a small residual after linear accelerator treatment cannot be influenced either by drug treatment or radiosurgery, only proton therapy can help," said prof. Vesselina Parvanova, Clinic of Radiotherapy, University Hospital "Prof. Chernozemski".

"The highest priority is given to children up to 3 years of age, because children’s organisms have not reached maturity and they are quite sensitive to radiation and the consequences are serious," said Prof. Dr. Elitsa Encheva.

The total cost of the project is BGN 188 million excluding VAT, of which BGN 157 million is under the Recovery and Resilience Plan.

"With the utmost care, focus and effort to complete this project on time, by the end of 2026, it is of the highest priority to the current management of the Ministry of Health," said Assoc. Prof. Anton Tonev, chairman of the working group at the Ministry of Health.

Public procurement is yet to be announced.