Oncology Times reports on proton beam radiation therapy

Oncology Times has just completed a five-part series of what appear to be objective and impartial articles on proton beam radiation therapy (PBRT) — as a form of treatment for many types of cancer, not just prostate cancer. However, the role of prostate cancer in the decision to fund recently developed and new PBRT centers is clearly significant.

Here is a set of titles of the articles (in the order they were published) with direct links to each one:

There are now seven fully operational PBRT centers in the US:

An eighth center — the Hampton University Proton Therapy Institute, in Hampton, Virginia — is scheduled to open some time later this year. An additional center is currently planned for Somerset, New Jersey, and is scheduled to be opening in 2012. Other centers are planned or are under discussion, but economic realities appear to have delayed decisions and/or actual plans to proceed. In at least a couple of cases, plans to develop such centers have been canceled.

It is disappointing that at least one major proton beam center and representatives of other proposed centers appear to have been unwilling to speak in any depth to Oncology Times for this series of articles. It is clear that there are issues here that go way beyond the desire to provide the best possible therapy to patients who need such therapy.

The “New” Prostate Cancer InfoLink congratulates Oncology Times and its two reporters for their care and hard work in putting together this series of investigative reports.

4 Responses

  1. It was amazing that Loma Linda did not contribute to this excellent series.

    Apropos your remark “It is clear that there are issues here that go way beyond the desire to provide the best possible therapy to patients who need such therapy,” I thought this conversation with Dr Zietman in Part 3 was telling:

    Many patients come to him with the misunderstanding that proton beam therapy has no side effects, Dr. Zietman noted: “They get this from marketing, and my first job is to disabuse them of all their misconceptions, and let them know that the side effects are not bad, but neither are they zero.”

    He said that proton beam therapy is not new technology, but actually old technology that continues to evolve, and that when patients fly in from all over the world asking him about proton therapy for their prostate cancer they “fall off their chairs when they find out I don’t advocate it.”

    “Rather, I consider it a personal win if they come in wanting protons and go out on active surveillance, because then I know I’ve really done my job.”

    The controversies over proton beam therapy may be more about its use with prostate cancer than about its use as another radiation modality, Dr. Zietman said, noting that almost no one was doing active surveillance until about four or five years ago.

    “Surgeons are interested in treatment and radiation oncologists are interested in treatment because we are incentivized to treat and not to not treat.”

  2. I continue to be amazed at the lack of oversight by the government who is willing to pay perhaps 5 to 10 times more for a treatment that has not one published study on survival at 10 years in men getting proton beam for prostate cancer.

  3. Is there any new evidence on treating Stage I prostate cancer? If it is beyond “wait and see,” the best options seem to be proton therapy or da Vinci robotic prostate removal. To be honest the doctors and studies seem to favor what they do or who paid for the study. The most compelling information I have found is today Mayo leaves your options open, but off the record someone will come in and say do surgery and now I find Mayo is spending $370 million to construct two proton facilities to be complete by 2014, so bet your bottom dollar they will then be recommending proton therapy. However, the patient will still not know if this is the gold standard or just a financial decision. Help.

  4. Chuck:

    There is no “gold standard” for the treatment of Stage I prostate cancer today. The “best” form of management for a specific individual depends on his life expectancy, his clinical stage, his PSA level, his Gleason score, the number of positive biopsy cores he had on biopsy (compared to the total number of cores taken at biopsy), the amount of cancer in each positive core, and the patient’s own attitude to certain definable risks.

    It is also not true that robot-assisted surgery and proton beam radiation are “better” than (say) brachytherapy if all three are carried out by really skilled practitioners. Again, it becomes a matter of the individual patient’s attitude to definable risks in addition to the other clinical factors defined above.

    If you join our social network and give us information in your “profile” answering the above questions when you join we can probably help you to think through your options.

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