Blog

Proton therapy is an advanced radiation therapy that uses protons to treat cancer rather than x-rays. Protons deliver the majority of their energy directly into the tumor and stop, minimizing exposure to adjacent healthy tissue. X-rays used in standard radiotherapy continue through the tumor, exposing patients to unnecessary radiation that can result in both short-and long-term side effects and secondary tumors. 

Proton therapy was approved for cancer treatment in 1988, but was not commonly used due to the high cost of developing proton centers. Development costs have been greatly reduced, and today there are 29 centers across the country. The technology is evolving as more research is conducted and we discover more and better ways to use the therapy. During my several decades of working with proton therapy, I have had the opportunity to play a role in some of the advancements that have occurred. One such development that holds great potential for cancer treatment is pencil-beam scanning. This technology provides greater conformality in tumor treatments compared to traditional proton beam therapy, enabling us to treat patients today that we previously had to turn away. In spite of the promising advancements being made and the decreased development costs, proton therapy remains controversial because treatment costs are higher than conventional radiotherapy. 

A closer look at the benefits

Critics often contend there is little evidence to support the cost of proton therapy, but there are many credible clinical studies that show substantial benefits to patients. Additionally, when considering the value of proton therapy, there is more to examine than just the initial cost of treatment. Ongoing expenditures for treating side effects, as well as the patient’s quality of life, must be considered. Managing toxicities, both short-and long-term, is expensive and can be a financial burden to patients and other stakeholders. Patients also want the best quality of life possible so they can enjoy their survival. Proton therapy addresses both of these concerns, minimizing costly side effects while improving quality of life.

Another issue to consider is that lifespans are increasing and many patients are living several decades beyond their treatment. During that time, many experience another episode of cancer. Approximately one in 12 adults diagnosed with a common cancer will eventually develop a second cancer unrelated to the first.1 Patients eventually reach a point where they cannot tolerate any more treatment in their lifetime, so managing the second cancer becomes problematic. Proton therapy can control the initial cancer while minimizing treatment toxicities, offering an avenue to more effectively treat a second cancer if one occurs.

Finally, as more cancers are cured, we will have many more survivors. The increasing number of these patients and the potential costs of treating side effects on a larger scale will dramatically impact our limited healthcare resources. It will be essential to minimize the consequences of cancer treatment while still supporting optimal outcomes. Proton therapy can play a vital role in achieving that objective.  

Investing in optimal outcomes and quality of life

While we are all concerned about costs, we shouldn’t invalidate a treatment that may initially be more expensive but can provide substantial cost savings, improved outcomes and a better quality of life in the long run. It is time to recognize the many benefits proton therapy provides over the long-term, rather than just focusing on the here and now. 

 

1. https://www.medscape.com/viewarticle/866433