[Dr Yau’s Health Insights] What are the treatment options for cancer? A comprehensive analysis of the principles, applications, and costs of targeted therapy and BNCT (Boron Neutron Capture Therapy)
Health2026-09-08
8 Mins Read
According to the latest data published by the Hong Kong Cancer Registry of the Hospital Authority, 37,953 new cancer cases were recorded in Hong Kong in 2023, representing a 7% increase compared with 2022¹. Cancer remains the leading cause of death in Hong Kong, with 15,368 deaths from malignant neoplasms recorded in 20252. As the population continues to age, cancer incidence is expected to rise further in the years ahead.
Over the past few decades, cancer treatment has undergone remarkable transformation. Traditional chemotherapy's "one-size-fits-all" approach has gradually evolved into an era of precision medicine, offering patients more treatment options than ever before. However, these advances often come at a high cost, creating substantial financial pressure for many patients and their families.
When facing a cancer diagnosis, two questions are often top of mind: What are the latest treatment options available? And how much do they cost? In this article, we take a closer look at the principles, suitability and costs of both targeted therapy and BNCT (Boron Neutron Capture Therapy), helping readers better understand these emerging treatment options.
Quick answers about cancer treatment
Q1: What is targeted therapy?
Q2: How much does targeted therapy cost?
Q3: What is BNCT (Boron Neutron Capture Therapy)?
Q4: Is BNCT available in Hong Kong?
What is targeted therapy and how does it differ from traditional chemotherapy?
Traditional chemotherapy works by attacking all rapidly dividing cells. Because cancer cells grow and divide quickly, they become a primary target. However, other healthy cells in the body also divide rapidly, including hair follicle cells, cells lining the mouth and digestive tract, and blood-forming cells in the bone marrow. As chemotherapy cannot distinguish between cancer cells and healthy cells, it may damage both, leading to common side effects such as hair loss, mouth ulcers and a weakened immune system.
The development of targeted therapy has changed this approach. Targeted drugs are designed to act on specific genetic mutations or protein receptors found in cancer cells. Much like a "lock-and-key" mechanism, they target cancer cells more precisely while causing less damage to healthy cells. As a result, the side effects of targeted therapy are often milder than those associated with chemotherapy, and patients may experience a better quality of life during treatment.
The key difference between targeted therapy and traditional chemotherapy is that targeted therapy only works when a suitable target is present. In other words, the tumour must carry the specific genetic mutation or biomarker that the drug is designed to target. This is why genetic testing is required before treatment can begin. Simply put, patients need to "find the target" before the appropriate targeted therapy can be prescribed.
However, targeted therapy also has its limitations. Cancer cells can adapt and evolve over time. After prolonged treatment with the same targeted drug, new genetic mutations may develop, causing the cancer to become resistant to the therapy. For this reason, some patients may need to switch to a different targeted drug or another treatment approach after months or years of treatment.
Targeted therapy at a glance
- Genetic testing is usually required before treatment to determine whether a suitable target is present.
- Only patients with specific genetic mutations or biomarkers are likely to benefit from targeted therapy.
- Side effects are generally milder than those associated with traditional chemotherapy.
- Drug resistance may develop over time, reducing the treatment's effectiveness.
- Regular scans and blood tests are needed during treatment to monitor response and check for potential side effects.
- Monthly treatment costs can range from several thousand to tens of thousands of Hong Kong dollars
Who is suitable for targeted therapy and what tests are required before treatment?
Targeted therapy is not suitable for everyone. Whether a patient is eligible depends on whether their tumour carries a specific genetic mutation that can be targeted by the treatment. In non-small cell lung cancer (NSCLC), for example, common driver mutations include EGFR, ALK and ROS1. Patients with an EGFR mutation may be treated with EGFR inhibitors, while those with an ALK fusion gene may be eligible for ALK inhibitors.
Before starting targeted therapy, patients must undergo genetic testing or molecular testing. This can be performed using a tumour tissue biopsy or a liquid biopsy, which involves analysing tumour DNA found in a blood sample. The purpose of the test is to determine whether specific genetic alterations are present. The cost of genetic testing typically ranges from several thousand to tens of thousands of Hong Kong dollars.³
The meaning of the test results is clear: targeted therapy can only work if a matching target is identified. For patients whose tumours do not carry the relevant genetic mutation, targeted therapy is unlikely to be effective and may delay other potentially beneficial treatment options. This is why genetic testing is an essential first step before starting targeted therapy.
Some patients may need to undergo repeat testing. For example, if resistance develops after a period of targeted therapy, additional testing may help doctors determine whether new genetic mutations have emerged in the tumour and identify a suitable next-line treatment.
Understanding the cost of targeted therapy
The overall cost of targeted therapy includes several components, such as the medication itself, genetic testing, regular imaging scans, and outpatient or hospital treatment costs. Among these, drug costs are typically the largest expense.
The monthly cost of targeted therapy can vary significantly depending on the type of medication, dosage and patent status. For example, third-generation targeted therapies for lung cancer can cost approximately HK$40,000 to HK$50,000 per month4.
In addition to medication costs, regular monitoring can represent a significant expense. During targeted therapy, patients typically need to undergo regular imaging tests, such as CT or PET-CT scans, to assess how well the treatment is working. Depending on the type of examination, each scan may cost anywhere from a few thousand to tens of thousands of Hong Kong dollars. Regular blood tests are also required to monitor liver and kidney function and ensure the treatment is not causing serious adverse effects. The longer the treatment continues, the higher the overall cost is likely to be.
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Medication assistance in public hospitals
Eligible patients may apply for medication assistance through the Samaritan Fund and the Community Care Fund. At present, the Samaritan Fund covers around 100 medications5. Patients must first be referred by a doctor, undergo a financial assessment, and obtain approval from the fund before receiving support.
In 2025, the Hospital Authority announced relaxed eligibility criteria for the Samaritan Fund. As part of the changes, the proportion of income taken into account when calculating a patient's "annual disposable financial resources" was reduced from 100% to 80% for new applicants, and from 80% to 60% for existing applicants6. However, patients may still need to pay out of pocket for certain targeted therapies, particularly newer drugs or those that have not yet been included in the Hospital Authority's drug formulary.
Paying for targeted therapy in private healthcare settings
In private hospitals and clinics, patients generally need to cover the cost of targeted therapy medications as well as related tests and investigations themselves. Costs can vary considerably depending on the drug prescribed and the treatment plan, and the cumulative expense of long-term treatment should not be overlooked.
As targeted therapy often continues for months or even years, patients should consider not only the potential treatment benefits but also the associated medical costs and their personal financial circumstances. For those who have health insurance that covers cancer treatment, targeted therapies or private hospital care, there may be greater flexibility when choosing treatment options and healthcare providers, allowing patients to discuss and select a treatment plan that best suits their individual needs in consultation with their doctor.
How does BNCT work?
BNCT is carried out in two stages.
- Step 1: A specialised boron-containing compound is administered to the patient. The compound selectively accumulates in cancer cells, while healthy cells absorb much smaller amounts.
- Step 2: The treatment area is then exposed to a low-energy neutron beam. When the neutrons interact with the boron accumulated in the cancer cells, a nuclear reaction occurs, releasing high-energy alpha particles and lithium particles. These particles travel only a very short distance, approximately the diameter of a single cancer cell. This allows BNCT to destroy cancer cells from within while minimising damage to surrounding healthy tissues.
Key features of BNCT
The main advantage of BNCT lies in its high level of precision. Unlike conventional radiotherapy, BNCT is designed to concentrate its effects on cancer cells while preserving as much surrounding healthy tissue as possible, which may help reduce treatment-related side effects.
In addition, BNCT typically requires fewer treatment sessions. In many cases, treatment can be completed with just one or two irradiation sessions, which may be particularly beneficial for patients who would otherwise need to make frequent hospital visits.
At present, BNCT is mainly used for selected cancers that may respond less favourably to conventional treatments, including recurrent head and neck cancers, brain tumours and melanoma. However, BNCT remains a relatively new treatment modality, and its clinical applications and approved indications are currently more limited than those of conventional radiotherapy and targeted therapy. Not all cancers are suitable for BNCT, and patients should undergo a thorough assessment by a specialist before determining whether it is an appropriate treatment option.
The development of BNCT in Hong Kong
At present, BNCT has not yet been incorporated into routine clinical services in either public or private hospitals in Hong Kong. Patients interested in BNCT generally need to travel to Chinese mainland or other regions where the treatment is available.
As BNCT is still a relatively new cancer treatment technology, patients considering this option should first consult an oncologist to evaluate their condition, treatment needs and expected outcomes. It is also advisable to check whether their health insurance coverage includes cross-border medical treatment, designated healthcare facilities and related treatment expenses, allowing for more comprehensive treatment planning and informed decision-making.
Your Health Tomorrow. Mastered Today.
AXA's comprehensive healthcare protection spans from prevention and diagnosis to treatment and recovery, with our extensive medical network providing complete coverage across all locations. Whether protecting yourself or safeguarding your loved ones, AXA has prepared the answers for every step of your life journey.
The cost of BNCT
The cost of BNCT varies by region. In Taiwan, BNCT is currently provided as a self-funded treatment, with total costs ranging from approximately NT$550,000 to NT$1000,000, including the boron-containing drug and reactor-related treatment costs7. In Chinese mainland, as domestically developed BNCT systems become more widely available, treatment costs are expected to range from approximately RMB 100,000 to RMB 500,0008. These figures do not include additional expenses such as return travel, accommodation and other related medical costs.
Comparing targeted therapy and BNCT: Key differences and treatment considerations
Comparison | Targeted therapy | BNCT (Boron Neutron Capture Therapy) |
How it works | ||
How it works | Uses drugs to target specific genetic mutations or protein receptors found in cancer cells | A boron-containing compound accumulates in cancer cells and is then exposed to a neutron beam, triggering a nuclear reaction that destroys the cancer cells |
Who it may be suitable for | ||
Who it may be suitable for | Patients whose tumours carry specific genetic mutations, such as EGFR, ALK or HER2 | Patients with locally recurrent disease or certain tumour types, such as recurrent head and neck cancer, brain tumours and melanoma |
Treatment approach | ||
Treatment approach | Oral medication, usually taken daily | Intravenous administration of a boron-containing drug followed by neutron beam irradiation |
Treatment duration | ||
Treatment duration | The duration of treatment varies depending on the individual's condition and treatment plan, and may range from several months to several years. Some patients may discontinue treatment once their disease is under control, remission has been achieved, or the planned course of treatment has been completed. | Short, intensive treatment, typically requiring only one or two irradiation sessions |
Main advantages | ||
Main advantages | Convenient, as patients can generally take the medication at home; side effects are often less severe than those associated with chemotherapy | Fewer treatment sessions; designed to minimise damage to surrounding healthy tissue; generally associated with fewer side effects |
Main limitations | ||
Main limitations | Drug resistance may develop over time | Not currently available in Hong Kong |
Availability in Hong Kong | ||
Availability in Hong Kong | Available in both public and private hospitals | Not part of routine clinical services in Hong Kong; patients generally need to travel to Chinese mainland or other locations offering BNCT |
Key considerations | ||
Key considerations | Genetic testing or molecular testing is usually required to confirm the presence of a suitable treatment target; only appropriate for patients with specific genetic mutations | Suitability must be assessed by a specialist; may be considered for selected patients with locally recurrent tumours that have responded poorly to conventional treatments |
Targeted therapy and BNCT are not interchangeable treatment options. The most appropriate approach depends on a patient's individual diagnosis, tumour characteristics and treatment history. Patients should discuss the available options with their doctors to determine the most suitable treatment plan for their specific circumstances.
Frequently asked questions (FAQs)
Q1: Does targeted therapy cause side effects?
Q2: How long do patients need to take targeted therapy?
Q3: Can targeted therapy be used together with chemotherapy?
Q4: Does BNCT cause side effects?
Q5: How many BNCT sessions are usually required?
Q6: Has BNCT been officially approved for clinical use?
Q7: What types of cancer may be suitable for BNCT?
Q8: Can BNCT replace targeted therapy?
Q9: Can targeted therapy be used if there is no genetic mutation?
Your Health Tomorrow. Mastered Today.
AXA's comprehensive healthcare protection spans from prevention and diagnosis to treatment and recovery, with our extensive medical network providing complete coverage across all locations. Whether protecting yourself or safeguarding your loved ones, AXA has prepared the answers for every step of your life journey.
Preparation is the best protection
Cancer treatment continues to evolve, with emerging therapies such as targeted therapy and BNCT offering patients more options than ever before. These advances have brought new hope to cases that were once difficult to treat. However, as treatment choices become more diverse, decisions about care can also become more complex, often accompanied by higher medical costs.
When facing cancer, understanding the available treatment options, potential costs and access to medical resources can be just as important as choosing the treatment itself. Beyond the treatment procedure, every stage of the journey, from diagnosis and cross-border medical care to hospital arrangements and post-treatment rehabilitation support, can have a meaningful impact on patients and their families.
As medical technology continues to advance, patients may gain access to more innovative therapies, more sophisticated medicines and a wider range of healthcare resources across Hong Kong, Chinese mainland and other parts of Asia. Establishing appropriate health protection and planning ahead is not only about managing potential medical expenses. It is also about preserving access to more treatment options and having greater flexibility to make informed healthcare decisions when they matter most.
When illness strikes, the most important thing is not simply having treatment available, but having the ability and freedom to choose the treatment that best suits your needs. The preparations made today may help create more choices for tomorrow.
The above content is reviewed by Dr Yau - Chief Medical Officer of AXA Hong Kong and Macau.
Information and materials provided is general in nature and does not constitute medical or health advice from AXA Hong Kong and is on an “as is” and “as-available” basis without representation and/or warranty of any kind, either express or implied. While AXA Hong Kong has taken reasonable care in providing such information and materials, they are not specific to your investment objective, financial situation, health or medical conditions or particular needs. No warranty or responsibility is assumed by AXA Hong Kong and our related or holding companies regarding non-infringement, security, accuracy, completeness, adequacy, reasonableness, fitness for a purpose or free from computer viruses in connection with the information and materials provided. AXA Hong Kong and our related companies and holding companies do not accept any liability for any loss, damage, cost or other expense, whether wholly or partially, directly or indirectly, arising from any error, inaccuracy or omission of the information and materials to the extent that such liability is not excluded by law.
Reference:
- Hong Kong Cancer Registry, Hospital Authority. (n.d.). Top ten cancers.
- Centre for Health Protection. (n.d.). Number of registered deaths by major causes of death, 2001-2025. Department of Health, The Government of the Hong Kong Special Administrative Region.
- Hong Kong Economic Journal. (2025, July 4). 癌症基因檢測費用是多少？一文看清香港醫院、診所檢測地址及價錢.
- Hong Kong Economic Times. (2025). 肺癌｜中大研究證ALK肺癌患者用第三代鏢靶藥 逾半人持續7年無惡化 每月藥費4萬至5萬.
- Hospital Authority. (n.d.). Items supported by the Samaritan Fund [PDF file].
- Wen Wei Po. (2025, April 4). 藥物安全網明年放寬 中產更受惠 肺癌晚期教師每年可減5萬藥費 重燃生命希望.
- Common Health Magazine. (2023, July 20). 癌末新武器，BNCT硼中子治療中心將進駐北榮，復發難治癌友一線生機.
- iTouch TV. (2025). 高效率、短程、費用低！硼中子捕獲療法（BNCT）今年將進行人體臨床試驗.
Other references:
Abdelmonem, A., Bikram Shah, B., Shebli, M.A. and Tabbara, I.A. (2025) “Targeted Therapies in Non–Small Cell Lung Cancer: A Contemporary Review”, American Journal of Clinical Oncology, doi: 10.1097/COC.0000000000001275.
Passaro, A. et al. (2025) “Novel strategies for rare oncogenic drivers in non-small-cell lung cancer: An update from the 2024 Annual ESMO meeting”, Lung Cancer, 204, 108490.
2025 Update: Management of Non‑Small‑Cell Lung Cancer (2025) Lung, 203, article number 53.
Barth, R.F., Zhang, Z. and Liu, T. (2018) “A realistic appraisal of boron neutron capture therapy as a cancer treatment modality”, Cancer Communications, 38(1), p. 36.
Core Clinical Procedures in BNCT (2026) “Core clinical procedures and efficacy-enhancing strategies in boron neutron capture therapy”, Discover Oncology, 17, article number 591.
Porra, L. et al. (2023) “From Nuclear Reactor-Based to Proton Accelerator-Based Therapy: The Finnish Boron Neutron Capture Therapy Experience”, Cancer Biotherapy and Radiopharmaceuticals, 38(3), pp. 184-191.
Zhou, L. et al. (2025) “Clinical application of boron neutron capture therapy for cancer treatment: A systematic review”, Precision Radiation Oncology, 9(4), pp. 304-313.
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