Investment in proton beam therapy for cancer may be premature

April 18, 2012

Both the US and UK are pouring money into building proton accelerators to treat cancer. They have been described as the world's "most costly medical devices" but in an article published in the British Medical Journal today, journalist Keith Epstein reports that "no clear evidence of better effectiveness exists" and asks whether the investment is premature.

Proton beam treatment is thought to target more precisely than conventional radiation, minimising harm to healthy tissue while reducing side effects and increasing cure rates. It has been shown to be beneficial and cost effective for children with cancer and for some rare brain cancers.

The US has invested millions of dollars in 10 centres, and 19 more are being built. While in the UK, the recently announced that the NHS is to spend up to £250m on two centres despite no appraisal by the National Institute for Health and Clinical Excellence (NICE).

But proton beam therapy, especially in the US, is now being marketed as a treatment for prostate cancer where, not only is the benefit unclear but, in some cases, the side effects appear to be no better than conventional radio therapy, reports Epstein.

In fact, signs that proton beam therapy is less cost effective than conventional radiation for prostate cancer have been increasingly evident since 2007, he adds.

Earlier this year, Professor Ezekiel Emanuel, an oncologist at the University of Pennsylvania and former adviser to President Obama described proton beam therapy as "crazy medicine and unsustainable public policy."

He said: "If the United States is ever going to control its healthcare costs, we have to demand better evidence of effectiveness and stop handing out taxpayer dollars with no questions asked."

Yet the first randomised controlled trials comparing x rays with proton beams is only just about to begin and won't be completed for seven years.

Harvard Medical School radiation oncologist Anthony Zietman told the BMJ: "We rush into treatments before they are proved" and suggests that, "in some instances, proton therapy might be inferior to existing treatments."

Robert Foote, a radiation oncologist at the Mayo Clinic is also worried that some centres are adopting the proton beam therapy before enough research has been done and, possibly, for the wrong indications.

Explore further: Proton therapy effective prostate cancer treatment

Related Stories

Proton therapy effective prostate cancer treatment

January 5, 2012
Proton therapy, a type of external beam radiation therapy, is a safe and effective treatment for prostate cancer, according to two new studies published in the January issue of the International Journal of Radiation Oncology•Biology•Physics ...

Recommended for you

Microbiologists contribute to possible new anti-TB treatment path

October 23, 2017
As part of the long effort to improve treatment of tuberculosis (TB), microbiologists led by Yasu Morita at the University of Massachusetts Amherst report that they have for the first time characterized a protein involved ...

Major study of genetics of breast cancer provides clues to mechanisms behind the disease

October 23, 2017
Seventy-two new genetic variants that contribute to the risk of developing breast cancer have been identified by a major international collaboration involving hundreds of researchers worldwide.

New study shows how cells can be led down non-cancer path

October 23, 2017
As cells with a propensity for cancer break down food for energy, they reach a fork in the road: They can either continue energy production as healthy cells, or shift to the energy production profile of cancer cells. In a ...

Proton therapy lowers treatment side effects in pediatric head and neck cancer patients

October 23, 2017
Pediatric patients with head and neck cancer can be treated with proton beam therapy (PBT) instead of traditional photon radiation, and it will result in similar outcomes with less impact on quality of life. Researchers from ...

Big Data shows how cancer interacts with its surroundings

October 23, 2017
By combining data from sources that at first seemed to be incompatible, UC San Francisco researchers have identified a molecular signature in tissue adjacent to tumors in eight of the most common cancers that suggests they ...

Symptom burden may increase hospital length of stay, readmission risk in advanced cancer

October 23, 2017
Hospitalized patients with advanced cancer who report more intense and numerous physical and psychological symptoms appear to be at risk for longer hospital stays and unplanned hospital readmissions. The report from a Massachusetts ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.