Posted: December 12, 2012

Prostate Cancer: How to treat??  The verdict on a new radiation technology is trickling in.  Proton beam therapy for prostate cancer is no better than conventional radiation.  If you live in a city which has a unit you are likely bombarded with TV commercials citing its living-saving benefits.  Recent trials suggest otherwise.  The Dec. 14 Wall Street Journal (subscription required) has the best summary of the state of the art and economics.  The units cost $180 million to build.  The treatments are reimbursed at a much higher level than conventional radiation, and the facility needs to be busy to amortize its costs.   The closest unit to StarkOncology is in Hampton, VA, set up by Hampton University with other investors, and they are trolling for business.  At some point Medicare will likely step in and reduce reimbursement in the absence of outcomes data, or at least medical economists think they should.

Dr. Stark comments:  “Radiation for prostate cancer has been a viable alternative for many men for at least thirty years.  Proton therapy is being touted as the great new technological breakthrough but with computer-assisted radiation treatment plans such as IMRT the toxicity has already been greatly reduced with the efficacy maintained.  Proton therapy was invented years ago to treat rare pediatric brain tumors.  To make a center economically viable radiation oncologists and their investors have had to invent new indications which would capture scores of patients.  This practice in my opinion gives organized medicine in general and oncology in particular a black eye.  As new centers spring up, the economics will become even more daunting, forcing radiation oncologists to create even more indications for treatment.  What’s wrong with this picture?”