Change is On the Horizon for Proton Therapy

“To deny (implied “proton treatment”), if it is available, is immoral and barbaric.”

The above is a quote from a California judge from his recusal letter regarding insurance coverage for proton therapy. It is the centerpiece of a new CNN Health Article.

CNN Health Article covering insurance issues and proton therapy availability.

The data and the tide are slowly turning in the world of radiation oncology and proton therapy is slowing gaining acceptance as more people push for improved patient access for proton therapy.

https://www.cnn.com/2019/05/16/health/judge-proton-beam-therapy-recusal-unitedhealthcare/index.html

Overall, it is a well written article and covers both sides of the debate. Simply put the argument against the treatment is too little difference for the price difference or arguing “no data”. The “no data” kind of makes me laugh.

When is more radiation to healthy tissues not obviously worse?

Answer: Only when arguing against proton therapy – the goal is ALWAYS less radiation to patient with high dose to target – why this would be different is losing argument. It is worse with super low doses given in airports or dental x-rays or CT scans. Of course it is worse when delivering 100’s or 1000’s of times more dose than a dental x-ray or CT to normal tissue while treating a cancer.

Closing thought:

If the large consensus statements stated protons were superior, where would that leave us?

This statement is a decade away for good reason. Logistically, it can’t be the answer. We don’t have that capacity and will not for many, many years.

That really is the beauty of the judge’s quote – the caveat of “if it is available”.

Think about it – if Proton Therapy was deemed to be superior even for just one disease like prostate cancer and national committees stated such but basically only 3% of radiation oncology MDs had access to the treatment and less than 5% of the patient population had access to the facilities – how would that look? You simply can’t have the “standard of care” not be deliverable to the vast majority of patients.

Logistically, once you state it is better there is nowhere near the capacity to treat the patients currently so you really can’t begin to make that type of statement until there are well over a 100 proton facilities across the country and access is far greater.
So change will come slowly but…. it is coming.

Dr. Mark Storey MD
Medical Director, Oklahoma Proton Center
OKCProton.com

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