Portrait and video Coen Rasch: "We are going to make the world's best eye radiation line”

Annually, approximately 60.000 people in the Netherlands undergo radiation therapy for cancer, with proton therapy being a specialized treatment method. Prof. dr. Coen Rasch is dedicated to enhancing the precision of this radiation technique, particularly in treating eye melanoma. "I think that we can establish the best eye radiation chain in the world. Not because our equipment is the best, but our entire chain is."

Coen Rasch, holding the position of a radiotherapy professor at LUMC, has recently been appointed as a Medical Delta professor at Delft University of Technology. In Delft, he works at HollandPTC, an outpatient center where patients can undergo proton therapy, and research is conducted.

You have been appointed as a Medical Delta professor. What does that mean for you?

"I see it as a task and an invitation to strengthen the triangle of LUMC, Erasmus MC, and TU Delft in the field of radiotherapy and oncology. Additionally, I consider it recognition of what I already am doing - collaborating and developing products, especially in the field of physics, with Delft and Rotterdam."

What would you like to strengthen?

"I feel there is more potential in the connection between TU Delft and HollandPTC. I think it would be beneficial to use this momentum together with Remi Nout from Erasmus MC and fellow Medical Delta professor Mischa Hoogeman from TU Delft so that several Principal Investigators from Delft become more involved. Although HollandPTC is located on the TU Delft campus, it has a clear clinical aspect. That is unusual for a technical university. It offers unique opportunities that can be further utilized.

I hope the research lines for the development of equipment progress and are completed, so that we can eventually have the best eye radiation line in the world. It will take some time, but it is truly step-by-step. Several innovations could come from Delft, so those in Delft must be aware of what's happening at Holland PTC and join in where they can."

Can you briefly explain your expertise?

"I am a radiation oncologist. I administer radiation treatment to people with cancer. In recent years, I have focused on eye melanoma, of which there are about 250 new diagnoses in the Netherlands each year. About fifty of them now receive proton treatment at Holland PTC. This is a new treatment. Previously, many in this group had their eyes removed. Our first success is that fifty people per year retain their eyes. However, there is room for improvement because most people experience significant vision impairment after treatment.

Our first success is that fifty people per year retain their eyesAlongside Dennis Schaart from the faculty of Applied Sciences of TU Delft, I am working to gain more certainties, such as real-time measurement of radiation on a proton patient. This ensures that the radiation hits where it should, eliminating inaccuracies. We are developing a detector that allows direct measurement in the radiation room. We have shown that it is possible, but the next step is to determine the actual value so that it can be effectively used. We are not there yet."

To what extent does transdisciplinary collaboration play a role in your research?

"The proton center has a significant societal responsibility and has a strong relationship with the Ministry of Health, hospitals, and patient associations. For example, the Melanoma Foundation is actively involved in our research. They provide input on what patients want and what the research should focus on. It surprised me how strongly patients cling to keeping their eyes, even when they can no longer see through them. In the initial results of our research, they find preserving function less important. This certainty surprises me, but that is how it works. First, ask what the customer wants, and then see what you can achieve."

How is it to start collaborating with someone from a completely different discipline?

"Quite straightforward. Scientists from TU Delft once approached me for something else. Although that collaboration did not materialize, it indirectly led to this. I also only know interdisciplinary collaboration. From my initial research, I have collaborated with physicists and mathematicians. So, working with someone from TU Delft is not a big leap."

I think that we can establish the best eye radiation chain in the world. Not because our equipment is the best, but our entire chain is.

Your goal is to create the best eye radiation line in the world. What does that look like?

"For proton radiation, you used to need significant devices that required a lot of support. These were all within the walls of research institutes. Proton institutes always emerged from these research institutes. This meant they were clinical islands, detached from a larger treatment center. I think that we can establish the best eye radiation chain in the world. Not because our equipment is the best, but our entire chain is. Thanks to collaborations, we have a wide range of good eye doctors, good imaging, effective treatment, and good aftercare. Making the Proton Institute Island part of the rest of the care chain is what we aim for. I expect we can achieve this by 2026. In theory, at least. Then we need to prove it, which will take another five years. By then, we will have the best eye radiation chain when looking at the whole picture."

What do you still miss in your collaboration to achieve your goals? What call would you like to make?

"As mentioned, I miss the overview or involvement of Delft in the broad sense, and I would like to see some improvement in that. I also have a personal interest in making a request. During proton therapy, patients see what is called Vavilov-Cherenkov light. It is the blue light that also appears in a reactor. Patients perceive this as a grid. I understand the light, but not the grid. I am looking for someone from TU Delft who is good at light modulation to help me with this. This is likely not going to directly benefit a patient, but it is interesting to know."

Which scientist from another discipline or institute has surprised you, and why?

"Bert Wolterbeek from the TU Delft Reactor Institute. He is now retired. He used to work as a biologist on lichens, acid rain, and nitrogen at a time when I, studying environmental science, was also working on these topics. It surprised me that a biologist worked at the reactor institute, but it was intriguing."