by
Gus Iversen, Editor in Chief | September 30, 2014
From the September 2014 issue of HealthCare Business News magazine
The American Cancer Society estimates that 36,000 people in the U.S. were diagnosed with cancer of the oral cavity and oropharynx last year, (representing a 20 percent increase since 2010). Those cancers primarily affected men in their 40s and 50s and were typically triggered by an infection with human papilloma virus or HPV. “The thing about HPV cancer in the head and neck, specifically the throat, is that it’s highly curable,” says Frank, who described the number of diagnoses as a national epidemic. “Being highly curable means that not only will they survive, but they will have to live with the side effects of the treatment for potentially 40 or 50 years.” With IMPT, Frank says the frequency of those side effects (such as loss of taste and inability to swallow) are being cut in half.
“IMPT uses small spots of radiation that are deposited in a pencil beam fashion. They are stacked in layers on top of the tumor where you can intensify the radiation and the treatment where the tumors are and minimize it where it’s not,” says Frank. With the alternative IMRT treatment, there is the problem of surplus radiation, like the exit dose that continues beyond the tumor and through healthy organs and tissue. Frank described his first IMPT patient as a 33-year-old woman who had a tumor growing around her brain stem. Traditional IMRT physicians refused to treat the tumor for fear the procedure would be fatal. With IMPT however, the cancer was completely eradicated and the patient experienced a full recovery.
Too much of a good thing?
At the 2013 annual meeting of the American Society of Clinical Oncology (ASCO), Dr. Frank H. Saran, from the Royal Marsden NHS Foundation Trust in the United Kingdom, advocated a more economically conservative approach to PBT technology. He acknowledged the treatment’s benefits for pediatric patients with tumors in the central nervous system, (who are at an exceptionally great risk for side effects) but says those patients amount to only about 1,400 patients per year in the United States; about enough to fill the volume of one facility.
The Center for American Progress recently published an article deriding the use of proton therapy on prostate cancer stating, “There is currently zero evidence that proton radiation therapy is more effective for treating prostate cancer than the alternative standard treatment.” Neither Saran, nor the CAP article object to proton therapy itself, just the excessive application of such a costly treatment when there are more economical alternatives for eradicating a tumor.
