Friday, October 28, 2005

Proton Therapy, Boon or Bust?

There are really two issues when discussing MD Anderson's new $125 million proton therapy treatment center scheduled to open in the Spring of 2006. A recent article in the Houston Chronicle touches on both of these issues. The first issue, a clinical one. Is proton therapy worth the enormous costs of providing it? The second is the controversial method to used to finance this behemoth.

At one time, it was believed that proton therapy was the holy grail of Radiation Therapy. But with the advent and introduction of new technologies in Radiation Therapy such as IMRT (Intensity Modulated Radiation Therapy) it may no longer be considered such. Proton Therapy deposits its dose in the planning tumor volume without exposing surrounding healthy tissues to high doses. IMRT, implemented in most areas of the country 4 years ago, accomplishes the same effect at a MUCH lower cost. There are no comparative randomized studies comparing the two technologies. But, the name of the game in cancer care today is differentiation from your competitors. You're always looking for that edge that will gain marketshare by offering a service your competition doesn't have. MD Anderson, the cancer center above all cancer centers, is taking this concept to a new level. It's occuring in our area with CyberKnife, GammaKnife, and MammoSite albeit on a much smaller scale.

The second issue is also becoming an increasing trend in cancer care today; joint ventures. Most often these ventures are between a health system and physicians but, in this case it is between MD Anderson and many outside investors. MD Anderson stands to make a seven figure benefit if the investors make enough money. Part of the agreement states MD Anderson has to promote this type of therapy. This type of arrangement causes many concerns. One of which is will this incentive consciously or inconsciously cause patients to be steered toward Proton therapy rather than the cheaper and more efficient IMRT? You would hope that the Hippocratic oath and strong ethics would come into play here but, after experiencing similar situations myself, I know better. Just like in everything else, its ALL about the money. I report, you decide. Posted by Picasa

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