Texas-sized Battlefield Breakthrough hype by Dallas radio station – proton & robots

New technologies such as proton beam radiation therapy and robotic surgery clearly offer some potential benefits to some patients (and to some health care providers who purchase these expensive technologies).  That is not in question.  What we write about on this site are the messages that the public may receive only about potential benefits of such technologies – in the absence of discussion about potential harms, the quality of the evidence, costs, conflicts of interest in those delivering the message, etc.

Yesterday we wrote about an Oregon medical school saying “no” to proton beam therapy, and The Oregonian newspaper offering some context around the decision.  Context like:

Though the technology is considered useful in some pediatric cancers, studies continue to question its benefit for adults. “It is a technology that for adult tumors may have some advantages but those advantages have not been proven in head to head studies,” Beer said. Things could change as the therapy evolves, but “We felt that we couldn’t really justify this sort of investment based on the promise that this technology offers as it stands today.”

…

The treatment costs significantly more than conventional radiation therapy. Supporters say the therapy offers fewer side effects, but that claim has been undermined by studies released this year, most recently in the Journal of the National Cancer Institute. Critics call proton therapy an example of profit-driven medicine gone awry.

That’s one decision, and one way of covering the issue.

Then there’s the KERA Dallas way:  KERA is a public radio station.  Its recent online headline:

In another episode of local journalistic cheerleading, the story talks about “two proton treatment centers in the works for North Texas” with no discussion of how many are needed in the entire US – much less two in North Texas.  But, as we’ve noted before in past posts, proton facilities always seem to pop up in pairs; if one medical center announced plans to build/acquire, a local competitor in the medical arms race pops up to make its announcement quickly.

The story presents not one word of caveats, concerns or limitations.  It was all:

• “zapping with a ray gun”
• “battlefield breakthrough in the war on cancer”
• “provide the biggest blast to the tumor with the smallest radiation spillover to healthy tissue”
• a promotional video courtesy a proton beam device manufacturer
• “looks like something out of Star Wars“
• “Basic cost is about $40,000 per patient; more for certain cancers…most insurance covers it” (Note: The Oregonian reported: ” The federal government recently announced that it will follow through on plans issued this summer to cut Medicare reimbursement for proton therapy by nearly a third. That means centers’ per-patient revenue dropped from an estimated $36,000 to $25,000.”)

There was no independent source, no data about efficacy.  But there was a tease to part two of the series – looking “at how robots are remaking cancer surgery.” And Star Wars was a theme in that one as well. In fact, the formula was the same as for part one with proton – more battlefield breakthroughs.

If I’m not mistaken, Darth Vader’s seemingly invincible flagship The Super Star Destroyer Eclipse was eventually destroyed by Luke Skywalker and friends in Star Wars.  Maybe we need to wait a bit to see how this arms race plays out with evidence and data before proclaiming battlefield breakthroughs just yet. (An arms race, by the way, that Leonard Arzt of the National Association for Proton Therapy denies exists – see his comment at end of yesterday’s post.)

There’s no question in our minds that citizens of Oregon and readers of The Oregonian were better served than were citizens of North Texas and listeners/readers of KERA on the air or online by the stories we’ve highlighted.

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