Proton Therapy on First Coast !!(Florida)

[RandyW]

JACKSONVILLE, FL -- Some cancer patients are looking into alternative treatment options. Proton therapy is a unique form of radiation with fewer side effects and better tumor control. Doctors are able to treat a tumor precisely by directly hitting it with the proton treatment.

This cancer treatment is offered at the University of Florida Proton Therapy Institute (UF PTI). It opened in August 2006. Since then, 850 patients have been to the institute.

People can get treatment for brain tumors, prostate cancer and the head and neck. Recently, health professionals at the Proton Therapy Institute treated their first lung cancer patient. Children diagnosed with cancer can get proton treatment too. Stuart Klein, Executive Director at the UF PTI, told First Coast News the youngest person to ever receive treatment was 4-months-old.

The Proton Therapy Institute in Jacksonville is one of five centers in the country. It is the only one in the Southeast. It has been open two years, but it is making history. Klein says it is the fastest start up of any proton facility.

Health care professionals see about 100 patients a day. The center is open from 6:30 a.m. - 10 p.m.

Klein says it is making an economic impact on the community. Many of the patients come from out of town to get the treatment. It's usually a 2 month process. So, they temporarily live in the community. They eat and shop. Research done by the center has found the out-of-town patients brought an estimated $2.5 - $3 million in room, board and entertainment revenue to the First Coast in the first year.

©2008 First Coast News. All rights reserved. This material may not be published, rewritten, or redistributed.

[RandyW]

Proton therapy debated

As state gets center, cancer treatment, cost split experts

Christina Rogers / The Detroit News

A pricey and controversial cancer treatment that blasts tumors with concentrated bursts of radiation is setting the medical community in Metro Detroit abuzz, with the chance the state could land not one -- but two -- proton centers in the coming years.

The therapy is drawing interest not only for its potential to improve treatment for thousands of patients each year, but for the hefty price tag attached to the machinery used to deliver the care, which includes a 220-ton accelerator used to speed up subatomic particles and turn them into tumor-targeting beams.

Beaumont Hospitals has received state approval to build a $159 million proton beam center on its Royal Oak campus.

Advertisement

And it's possible the state could approve plans for additional facilities before the year's end -- the result of Gov. Jennifer Granholm striking down a state regulatory commission decision to require the state's largest cancer hospitals to collaborate on a shared center. Granholm said she believed mandating a collaborative would only delay bringing the technology to the state and violate antitrust laws.

Beaumont plans to launch operations at its center by 2010 and will treat about 1,500 patients a year with the new therapy.

"We anticipate it will become a referral center for people out of state," said Dr. Frank Vicini, chief of oncology services at Beaumont, noting that many other proton facilities have waiting periods for patients in need of treatment.

The technology is an upgrade over traditional radiation, known as photon or X-ray therapy, in that it targets cancerous tumors with better precision and avoids damaging surrounding healthy tissue. Like radiation therapy, protons kill cancer by interfering with the DNA of its cells and preventing them from dividing and growing. The difference is that proton beams release the bulk of their energy when they reach the cancerous area and then stop, so there is no exit dose. X-rays, by comparison, leave a track of radiation damage as they enter and exit the body.

Medical experts see possible benefits in using protons on pediatric cancers, so growing young patients don't absorb large doses of radiation early in life, and on tumors in delicate areas, such as near the base of the skull and in the eye.

Only five medical centers in the country offer proton therapy. Another eight are in the works in places such as Virginia, Illinois and Oklahoma City.

Not everyone in the cancer treatment community is a fan of proton beam therapy. Some medical experts question the treatment's overall effectiveness and whether the benefits outweigh the expense of building and operating a proton facility.

In some cases, such as prostate cancer, standard X-ray therapy has become so sophisticated as to match the precision of proton beams, said Dr. Paul M. Busse, clinical director of radiation oncology at Massachusetts General Hospital, which opened a proton treatment center in 2001.

"Can we adequately treat these patients with other modalities and is it worth the cost?" Busse said. "That's the debate that is going to go on for years and is raging on now in our community."

Proton centers profitable

To be sure, there's plenty of profit and prestige for Beaumont in this endeavor.

Proton centers are increasingly in vogue among top-notch hospitals across the country and the treatment itself tends to bring in higher reimbursement rates than X-ray therapy. Medicare, for example, pays about $24,497 for a six-week course of proton therapy, compared with the $10,429 it reimburses for X-ray treatment, according to 2008 rates.

But Beaumont says above the financial considerations, the technology offers the possibility of better cancer treatment, fewer side effects and reducing the chances of patients developing secondary tumors later in life.

"I think there we're just at the beginning of learning about the potential of protons," said Vicini, of Beaumont. "If you look at the physical properties of photon versus protons, there is no question that you can focus the radiation better."

To build the facility, the hospital system is teaming up with ProCure Treatment Centers Inc. Beaumont will sink about $13 million into the for-profit venture.

At first, Beaumont says it plans to use protons only for cancers where the technology shows promise. The center could branch out to treating more common types of cancer such as lung, breast and prostate cancer, Vicini said, but for now, medical evidence is lacking on whether for these particular illnesses protons deliver better results than standard X-rays.

Proton therapy began in '50s

Doctors first began experimenting with proton therapy in the mid-1950s. It was not until 1990 that the nation's first proton facility opened at Loma Linda University Medical Center in California. A decade later, Massachusetts General Hospital followed suit, opening its own such center in 2001.

The centers are expensive to build and operate, requiring a site nearly the size of a football field and a two-story, 65,000-square-foot building with concrete walls measuring eight to 14 feet in thickness. A proton accelerator alone can cost upwards of $65 million.

Staffing the center is also a challenge. ProCure officials estimate they'll need about 80 to 100 workers to run the proton operation, including a number of employees with backgrounds in physics.

"It's a very complex and highly engineered project," said Hadley Ford, CEO for ProCure Treatment Centers, based in Bloomington, Ind.

It's that complexity that has prompted some medical experts to question whether proton therapy is cost-effective.

"The reality there is very little data in most situations to suggest an advantage to protons over X-rays," said Dr. Joel Tepper, a professor in the department of radiation oncology at University of North Carolina's School of Medicine. "There is a large capital cost of the building and there is a large operating cost of running these facilities. Whether those costs are justified in the incremental benefits from the use of proton therapy is not clear."

Because of the immense upfront investment, Tepper said, hospitals who build these centers have little incentive to refute the benefits.

Rather, Tepper said that medical community needs better comparison studies to determine the value of protons over standard therapies or they risk needlessly contributing to rising health care costs.

Beaumont officials acknowledge there is a need for more research, arguing that its center will help achieve that by giving hospitals a valuable tool for furthering study the use of protons. The financial benefits, however, are harder to predict, Vicini said.

"It's pretty hard to say that it's going to end up being lucrative," Vicini said. "We've only begun to learn about the potential for use of protons. That's one of the big reasons we wanted to be one of the leaders at this."

You can reach Christina Rogers at (313) 222-2300 or cvrogers@detnews.com.