The Mayo Clinic is set to open some new digs in Phoenix, which is sure to help it generate some cash. The new facility, Olympian in scope, will be dedicated to cancer treatment with the latest in high-tech medicine. Protons. That's where the action is. Or, actually, that's where the money is.
The news article on it even has the obligatory heart-wrenching story of a child who's parent believes the proton therapy saved her child's life. And maybe it did. We will never know. But we do know that there are strong advocates for widespread use of proton therapy even before it is put through clinical trials to see if it is effective. And the cost?:
The cost of service (not developmental) proton therapy performed in 3–5 gantry centers operating 14–16 h/day and 6 days/week is likely to be equal to or less than twice that of high technology X-ray therapy. [emphasis added]
It seems like we are supposed to be encouraged by that.
Another review of the evidence doesn't seem encouraging:
Existing data do not suggest that the rapid expansion of HT [protons and other charged ios] as a major treatment modality would be appropriate. Further research into the clinical and cost-effectiveness of HT is needed.
And another review:
Conclusion. The present results with protons and heavier charged particles are promising. However, the current lack of evidence on the clinical (cost-)effectiveness of particle therapy emphasizes the need to investigate the efficiency of particle therapy in an adequate manner.
Well, does it work better than traditional radiation therapy? No, it doesn't, at least not according to a recent comparison. So why use it at all?
Medicare pays over $32,000 per patient for proton therapy, compared with under $19,000 for radiation, according to the study.
Let's work some numbers. In 2015 there will be almost 221,000 new cases of prostate cancer in the US. Then lets do a very conservative estimate and say that 1/5th of them get radiation treatment. That's about 44,000 men each year. If each one is a Medicare patient, then the surplus is $13,000/case, or $572 million every year from using protons rather than traditional radiation! Any investor would be crazy not to jump on that opportunity!
I wrote recently about the cash cow that is cancer. Prostate cancer is just symptomatic of the larger problem. Our taxes fund Medicare, which coughs up money to feed the financial appetite of high tech medicine and its endless promises of greater therapies on the horizon.
Here is the final irony. Most prostate cancer diagnosed in men over 50 would have no impact on their life expectancy, even if it is untreated. The treatment that Medicare is paying for is, for the most part and very literally, wasted money:
A lifetime risk of 42% for developing histological [i.e. microscopic] evidence of prostate cancer in 50-year-old men has been calculated. In men at this age, however, the risk of developing clinically significant disease is only 9.5%, and the risk of dying from prostate cancer is only 2.9%.
The most serious harm from testing is being diagnosed with prostate cancer and nearly all those men undergo treatment, yet treatment offers little to no reduction in prostate cancer mortality in the vast majority of those men".
If prostate cancer is a concern and you are thinking about getting tested, please talk to someone who understands these issues and can explain the pros and cons of testing. In a very small number of men treatment can extend their life. In a vastly larger number, treatment will do nothing to extend their life, but may very well lead to complications that last a lifetime.