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December 21, 2012

Oregon hospital says "No" to proton beam therapy, cites studies

This is some from an interesting story in The Oregonian by Nick Budnick. The context is, of course, that Mayo Clinic is building a proton beam center in downtwon Rochester as well as one in Arizona.

Gary Schwitzer, former Mayo Clinic executive, pointed out the article on the Healthnewsreview.org website. Schwitzer characterized the trend of hospitals building proton beam centers with the very evocative and provocative phrase -  a "medical arms race."

Here's some from Budnick's article:

In recent years, large medical centers around the country have been building massive proton therapy machines costing $100 million and up, marketing them to men with prostate cancer.

For now, Oregon Health & Science University won't be one of them, with officials saying the treatment's cost and continued debate over its benefit have caused them to scrap a push to build one here.

06112012protonbeammayoconstruction"All of us were interested in exploring it," said Tomasz Beer, deputy director of OHSU's Knight Cancer Institute. But as conventional radiation therapy has improved, "it's not clear today whether proton therapy offers a meaningful and substantial clinical advantage."

University officials have mulled the idea for some time, even hiring an outside consultant about two years ago. Plans to hire another consultant were dropped earlier this year, with officials instead inviting two experts to university leaders, Beer said. Officials made their final decision in the last month or so.

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."

Proton therapy centers can be as big as a football field, but OHSU had been considering a smaller, more recent version that would have cost about $30 million.

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.

Proton therapy center operators have received other bad news this year. 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.

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This is not related to this particular story, but my wife received a letter today from Fred Meyer Jewelers stating that they are closing the Rochester Apache Mall store effective as of January 20, 2013 and we should now go to the Valley View Mall location in Onalaska/LaCrosse for all future inquiries.

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