Proton Beam Therapy Controversy

At what cost is your health worth when it comes to prostate cancer? That is the fight going on between insurance companies and patients. Health insurers are pushing back against one of medicine’s most expensive technologies amid growing evidence it may not be better for patients than cheaper options. At least three major insurers have recently decided to stop covering proton beam therapy for early stage prostate cancer or are reviewing their policy, saying that while it is an effective treatment, it is much less cost-effective when compared to the price of comparable treatments.

Emergence of Proton Beams

This comes into play as more medical centers acquire proton beam technology since they can charge more and have fewer side effects. The theory behind it is simple. In chemotherapy, the human body is bombarded  with radiation which kills healthy cells along with cancer cells. think of it as carpet bombing an area. Proton Beam targets a smaller area with minimal damage to healthy cells (missile). The therapy is also used for other, generally rarer tumors, including pediatric brain cancer, eye, bladder and spinal cord tumors, where it’s use is less controversial. Eleven proton-beam facilities currently operate in the U.S. At least 15 more are in development.

How It Works

Here is the chemistry behind it. Everything on earth is made up of atoms which are surrounded by electrons. Now for chemistry 101, electrons have a negative charge and protons have a positive charge. When protons or other forms of radiation, pass near orbiting electrons, the positive charge of the protons attracts the negatively charged electrons, pulling them out of their orbits. This is called ionization; it changes the characteristics of the atom and consequentially the character of the molecule within which the atom resides. This crucial change is the basis for all forms of radiation therapy.

Because of ionization, the radiation damages molecules within the cells, especially the DNA or genetic material. Damaging the DNA destroys specific cell functions, particularly the ability to divide or proliferate. Enzymes develop with the cells and attempt to rebuild the injured areas of the DNA; however, if damage from the radiation is too extensive, the enzymes fail to adequately repair the injury. While both normal and cancerous cells go through this repair process, a cancer cell’s ability to repair molecular injury is frequently inferior. As a result, cancer cells sustain more permanent damage and subsequent cell death than occurs in the normal cell population. This permits selective destruction of bad cells growing among good cells.

Cost

So far, assertions about proton beam’s superiority in treating prostate cancer haven’t been backed up by medical evidence. Cost of treatment is the main factor holding back further adoption of proton therapy. There would be no debate if costs were the same as conventional X-ray radiation. For at least a decade, health insurers went along. The federal Medicare program pays more than $32,000 for the procedure, a recent study found, compared with about $19,000 for more conventional radiation options. While the technology is new, the cost is high. Like anything else, once the costs come down, it will be easier for insurance companies to cover the procedure. In the meantime, the debate continues between cost and the value of life.

Have you undergone proton beam therapy?