Health News Review

Anthony J. Montagnolo, executive vice president and chief operating officer at ECRI Institute, writes in Trustee magazine, “A Question of Value: Proton therapy’s benefits have a big price tag. Is it right for your hospital?

Although this is an article and a publication targeted at directors of hospitals and health care systems, what it says should be of interest to journalists, patients and consumers. Excerpt:

“First question: How well does this really work? An even better question: What objective clinical evidence exists to support using this clinical technology over existing alternatives? Though the first question seems obvious, the corollary question emphasizes that we should compare a new technology to what we currently have; that is, look for its comparative effectiveness. Thus, for proton beam therapy, the question is whether it works better than more conventional therapies, not just that it does what it is purported to do. This isn’t as simple as it seems. Many clinical trials are not true head-to-head comparisons, and much of the clinical literature does not provide conclusive data regarding whether one therapy or treatment is superior to another.

In the specific case of proton beam therapy, the clinical literature has little in the way of direct comparisons that might help us assess its effectiveness if we are trying to answer the corollary question. ECRI Institute’s staff reviewed the literature in 2010 and concluded that no true analysis of the efficacy of proton therapy was possible given that the data available was insufficient.

This conclusion mirrors that of reports issued by the Agency for Healthcare Research and Quality, which similarly indicated that a systematic review of the clinical literature on this technology likely would not yield conclusions on the effectiveness of proton beam therapy.

While this lack of data should not be taken to mean that proton beam therapy does not work, it does mean that there is the possibility that it does not provide much benefit over conventional therapy. Basically, we just don’t know. So, investing in this therapy carries the risk that the technology may not prove worth it–and with a $100 million to $200 million price tag on the line, that is a major risk.”

Comments

Joan Kotun posted on March 28, 2011 at 2:00 pm

I deal with relatively small numbers of patients asking for the care (a psychiatrist in a VA clinic) but their major belief is not that it is any better at tx of the prostate cancer but that it is less likely to produce the dreaded side effects of incontinence or impotence. I have been following this area on your blog and do not see the quality of life aspect brought up as much in the comparisons.

Brian Ganoe posted on April 21, 2011 at 1:02 pm

Joan,
Exactly my situation. I was recently diagnosed with prostrate cancer- T1C, PSA 14.0, and a Gleason of 7(4+3). My wife and I have found info that proton therapy was similar to other treatments but the side effects were either less or much less. I also have been told that it is rather expensive, even with insurance. We are now in the process of talking with doctors and other health specialists to decide with option is best for me. I am a vet also and signed up at the local VA center the day after my diagnoses. I don’t know if the VA can help on such a short notice, but I felt it could not hurt. I hope other who have some info in this matter will share it. Thanks!
………Brian……….

Gary posted on February 2, 2012 at 7:58 am

Would be more than happy to provide first hand knowledge about proton treatment in a more private fashion. Brian, if you have had your procedure I hope everything went well. If you are still researching please feel free to contact me via email.
I’m sorry I found this site so late.

    Gary Schwitzer posted on May 23, 2012 at 7:54 am

    Thanks for your comment.

    As you can see, our site is intended to focus on the quality of health care journalism.

    We do not provide a forum for the exchange of personal experiences or advice.