Should We Be Building Proton Therapy Centers?
Cancer treatment is seeing a newcomer joining the ranks of more traditional approaches like surgery, radiation, and chemotherapy—proton therapy.
In fact, as part of a recent trend report I wrote on cancer center design, sources told me they’re seeing growth in the niche on their end, too, as more institutions consider adding treatment facilities that today are still few and far between (See "Proton Progress"). But whether that’s a good or bad thing is stirring up debate.
According to a recent report from Kaiser Health News posted to NPR, there are just 11 proton therapy centers in the United States, with 17 more underway. But due to questionable returns on investment and largely unproven effectiveness, are more locations necessary?
Dr. Ezekiel Emanuel, a former healthcare adviser to the Obama administration who now works for the University of Pennsylvania, says in the NPR report that there isn’t sufficient evidence to show a need for more facilties. “They’re simply done to generate profits,” he claims.
Proton therapy is used to precisely target tumors with less damage to surrounding tissue than radiation—especially useful for tumors in sensitive areas of the body or those found in children. But the cost of treatment is high, and there's also a sizable price tag for construction of the facilities that not only need to be large enough to house the enormous equipment required, but also to hold the massive amount of concrete shielding necessary for their vaults.
With the cost of construction and operations funneling into the price of care, and subsequently into insurance premiums, it’s easy to see why some might start to demand results. The NPR article states that while proton therapy may be beneficial for some childhood cancers, studies show little promise for it as a better alternative to radiation for most other cancers.
According to a May 2012 study from KLAS, “Proton Therapy 2012: Dollars, Decisions and Debates,” providers reported that there wasn’t enough data on effectiveness because there are so few sites in operation and noted that it does have a place in the treatment landscape.
Regardless of views on its value, one thing is true: These facilities are incredibly expensive and require immediate, efficient, and high throughput to survive.
And while designers and construction firms can do their part to shorten schedules and address smart approaches to operational flow, there also has to be demand. And for now, there is. The treatment method offers a new approach that offers less invasive therapy that's appealing to patients already going through a pretty scary ordeal.
On top of that, the KLAS report offers alternatives like the construction of smaller, single-vault facilities that are lower in cost to build, and therefore require a lower patient volume to support them.
So as the 17 planned facilities come online, and most likely additional sites join them, more centers will mean more cases to compare and treatments to potentially serve effective. It will be interesting to see where the industry lands on the debate.