The New York Times is running an article on one of the most cutting-edge—and most expensive—cancer treatments: proton beam therapy. Hospitals are using particle accelerators, which are machines that accelerate subatomic particles to speeds nearly that of the speed of light, to shoot protons directly into tumors. Proponents of this therapy, such as Dr. Jerry D. Slater, the head of radiation medicine at Loma Linda University Medical Center in Southern California, feel it’s much more accurate than traditional radiation therapy using X-rays. Dr. Slater says that “every X-ray beam I use puts most of the dose where I don’t want it,” while proton therapy more directly targets the actual tumor. In 1990, Dr. Slater’s hospital, Loma Linda University Medical Center, was the first hospital to install a particle accelerator and has since treated over 13,000 patients. There are currently five other hospitals around the country using proton beam therapy and more than a dozen others have announced plans to build their own particular accelerators.

The technology, however, is not without controversy.

Installing a particle accelerator is an exceptionally expensive proposition. A large accelerator can weigh over 200 tons, demand 18 feet of reinforced walls to house it and cost over $100 million. While most doctors accept the theoretical model the techniques are based on, many doctors are still concerned with the great costs associated with its use. Studies have yet to definitely establish that it is any more effective than other treatments and the concern is that patients who could be treated equally well with traditional—and less expensive—technology will be directed towards proton beam therapy simply because hospitals needs to recoup the costs of their investment. For example, many centers are using proton beam therapy to treat localized prostate cancer where Medicaid will $50,000 for the therapy, which is double what would be paid for traditional x-ray therapy with similar efficacy.

The great hope for the technology revolves around its ability to more effectively target a tumor, as well as induce less significant side effects due to its greater accuracy. Until more and better data becomes available, the controversy will likely continue unabated, just as construction of more facilities will continue as well. If, however, the therapy does prove to be more effective and exhibit less side effects, patients and their families will have one more modality in their fight against cancer.

Labels: cancer