PALO ALTO - "How long will it take you to learn to operate this machine?" asked Dr. Zvi Fuks, a senior doctor in the oncology department of the most important hospital in the world for cancer treatment, Sloan-Kettering Memorial in New York, addressing his staff.
The year was 1995 and the machine - the most sophisticated of its kind for treating cancer with radiation - was made by Varian Medical Systems. The machine could aim different levels of radiation at the tumor itself, while minimizing the radiation to healthy tissue.
The technologists and radiologists replied that it would take them about a year and a half, an answer that was unacceptable to Fuks. The Israeli specialist found it ridiculous that patients should be unable to receive appropriate treatment just because it took so long to become proficient with a new technology. "You have six months," he told the staff.
Within six months, the machine was in use.
Conclusions regarding cancer treatments are usually drawn five years after treatment. Studies conducted five years after treatment with the machine showed that the success rate for curing prostate cancer, Dr. Fuks' specialty, increased from 46% to 92%.
"Dr. Fuks believed in our technology," says Dr. Richard Levy, president and CEO of Varian. "He promoted its acceptance and was a key figure in helping our technology change the world."
Varian, which manufactures radiation therapy machines, is located in Silicon Valley in California, within walking distance of Hewlett-Packard headquarters. In the third quarter of 2002, when many hi-tech companies in that area were collapsing or recording massive losses, Varian remained strong. Its market value on the Nasdaq exchange is about $3 billion and third quarter profits were $22.8 million, up from $17.4 million in the parallel quarter in 2001. Orders for machines peaked at $660 million and Varian has $273 million in its coffers.
Nevertheless, visitors to the company find it difficult to dwell on the financial side of the business. They don't think about profits, options or stocks, but rather about the extensive activities at Varian, the huge complex machines that surround them (production is done entirely in the building in Palo Alto), and the heavy responsibility that rests on the shoulders of the manufacturers.
The machine developed by Varian, which costs about $1 million, makes the entire treatment program computerized. The machine communicates with the diagnostics machines and creates a computerized image of the cancerous tumor. The software program determines from which directions to send radiation and at what levels. The computer arranges a series of metal panels that block radiation to healthy areas and direct the rays to the affected area. The system is called IMRT (Intensity Modulated Radiation Therapy) and is considered one of the greatest medical breakthroughs in cancer treatment in recent years.
Some 3,600 machines made by Varian are in use in hospitals worldwide. "A patient is lucky if he can receive treatment in Israel, the United States or Saudi Arabia," says Levy. "Japan is not well equipped, and someone receiving treatment in Britain is really unlucky. The equipment there is frightfully outdated. The British health care system is aware of this, and has now decided to invest $100 million in upgrading the radiation therapy equipment in hospitals throughout the United Kingdom."
Israel has no such problems. "Israel supplies 90% of the radiation therapy equipment," says Levy. "In the U.S. our machines constitute 60-70% of the radiation therapy equipment. Israel is among the most advanced countries in the world in radiation treatments."
Some 60% of cancer patients receive radiation therapy. Two thirds of them receive the treatments in an effort to completely cure the disease, while the other third is treated as a means of prolonging their lives. Radiation therapy has been common for decades, but the digital age led to significant advances in treatment.
"In 1988 we established a group whose job was to think of ways to increase the radiation reaching the diseased tissues and minimize the radiation reaching the surrounding tissue," explains Levy. "One of the doctors in that group was Dr. Fuks. He made suggestions and we worked to develop them."
The group developed the IMRT system and Varian's challenge is to increase the use of this method. Currently only 10% of the hospitals in the world use the system. Sometimes, even in hospitals that have the machines, they are not used to their full potential.
"As with any new technology, it takes people time to learn how to use it," says Levy, "but the user rate is constantly increasing. The number of institutions using the technology is doubling every year. Our challenge is to increase awareness [of the technology]."
Nowadays people who have been diagnosed with cancer know that they have to find out not only who the best doctor is, but also which hospital is the best for receiving treatment.
While Varian has competitors in the radiation therapy machine market, it commands the greatest market share. Sixty% of new orders are for Varian machines and they are used to treat over 50% of cancer patients in the U.S.
Levy's doctorate is in nuclear chemistry and he reached the medical field via the sales department of Varian Associates' medical equipment department. His nuclear chemistry background helped him advance and he was appointed general manager of Varian's medical division in the late 1990s. Shortly thereafter Varian Associates split into three separate companies, one of which is headed by Levy.
The recession has not affected Varian, and there is even demand for its technology in a new field. The same technology used to scan tumors can also be used for scanning suitcases or other cargo, and a new machine developed by Varian is now being used in ports. Varian now has two sources of business, both of which, unfortunately, will probably continue to grow: cancer and security.