by
Carol Ko, Staff Writer | January 09, 2014
From the January 2014 issue of HealthCare Business News magazine
HCBN: So if you were to rewrite the script around the argument for proton therapy, what would that sound like?
JC: We’ve been doing a lot of work in advanced cancer of the lung. I think that’s a promising area. If you have a malignant tumor of the lung it’s critical to avoid the normal lung while giving a very high dose to the tumor.
I would rewrite the script starting out with the value and treatment of children. There’s very little dispute around the value of proton therapy in treatment of tumors in children when they need radiation therapy. The ability to avoid late effects is so great that if you look at the costs over a lifetime of a young person, by the time they reach 30 years of age you have saved money with proton therapy — you don’t cost the system money — you’ve saved money. There’s been mathematical modeling by a Swedish group on this.
Then I would go to tumors in the brain. Brain tumors in children are among the most common malignant diseases after leukemia. The ability to preserve IQ and neurocognitive function and preserve the growth of the skull and the normal brain is paramount, so that’s where I would start.
With that recognition then you can say, where else are such issues important? Where there are not really competing strategies for treatment. They tried to treat malignant diseases in childhood with only chemotherapy and when many of those trials were finished they came to the conclusion you can’t do away with radiation therapy. So if you do need it, then proton is of great value.
There are also less common tumors like thymomas, in the central part of the chest. Then there are head and neck cancers. Proton therapy can reduce a lot of the acute side effects that make people suffer while receiving radiation therapy with chemotherapy for oropharynx cancer.
I think back to where we were with high energy X-rays four decades ago or more. We’re still learning about the best things to do with proton therapy. There may be more indications that become more evident as time goes on, and so that’s the future.
HCBN: What do you think is going to be the hottest topic of discussion this year at the conference?
JC: A lot of the people at the conference are going to be talking about cancer of the prostate and as I’ve already indicated to you, I’m not.
It’s hard to say otherwise what the major interest will be. There are certain institutions that don’t see many children with cancer and I think it’s really notable that St. Jude’s hospital in Memphis is installing a proton unit and theirs has to be paid for completely by cash since they don’t charge their kids anything for their treatment.
