From the March 2014 issue of HealthCare Business News magazine
Research in proton therapy is also becoming more mainstream. For example, according to Dr. Hartsell, in women with locally advanced breast cancer, the typical treatment includes surgery and chemotherapy. Adding conventional radiation therapy to that treatment improves their chances of cure, and decreases the risk of breast cancer recurrence, but also increases the risk of heart disease, lung problems, and second cancers in those women who have been cured. That is a dreadful trade-off. Proton therapy offers the potential to provide the same benefits as standard radiation while minimizing those long term risks.
HCBN: I’m sure there are still many challenges you’re up against. Are there new reimbursement or regulatory issues people should be aware of?
LA: Yes, it’s been a challenging year with insurance issues. Medicare contractors and commercial payors continue to evaluate the benefits of proton therapy as the clinical evidence continues to evolve. While some insurance companies in 2013 looked to comparative effectiveness research and cost effectiveness of the therapy for certain disease sites (including prostate cancer), others inappropriately denied their members a freedom of choice. This is a high priority and an ongoing issue that we meet head-on almost every day.
Proton therapy centers in the U.S.
the red dots are operation PTCs
blue are under construction
HCBN: This year, ASTRO commented on the debate regarding the use of proton therapy for prostate cancer, saying that it should not be routinely recommended for prostate cancer outside of a prospective clinical trial or registry. What’s your reaction to that?
LA: NAPT responded to ASTRO in 2013 with a press release. In it, we stated that: Patients and physicians have a number of options when approaching prostate cancer. We believe that all options, including proton therapy, should be available through an informed decision making process. The choice of treatment will have an enormous impact on the patient’s health and ability to enjoy his life. Patients have a right to know what is available to them. An expert panel of the American College of Radiology concluded that proton therapy is equally appropriate and as beneficial as IMRT, 3-D conformal X-ray therapy, and brachytherapy in treating Stages T1 and T2 prostate cancer.
