PROTON THERAPY
CMS should not reimburse proton therapy for
prostate cancer until further research proves the
results are superior.

Protons are a proven modality, with better results
than standard photons for pediatric malignancies
and certain malignant and benign neurological
diseases. However, there have been no randomized
studies showing any benefit of the much more
expensive protons over present day modern photon
therapies in the treatment of diseases such as
lung cancer, breast cancer or prostate cancer. If
one looks at the dose distribution of protons
compared to photon therapy there is a small
additional amount of radiation given with photons
that has no clinical significance and does not
produce enough dose to damage or kill surrounding
normal cells.

Proton therapy is not new and has been available
for over 30 years. Newer photon modalities have
evolved allowing the treatment of tumors with
great precision while sparing normal tissues.
These modalities include intensity modulated
radiation therapy, image-guided therapy, and
robotic driven stereotactic surgery. Although
expensive, the $6.8 million dollar cost for this
latter modality pales in comparison to the $120+
million expense of protons.

Organizations hoping to turn proton centers into
profit centers are not counting on the proven
cases (pediatrics, etc.) to turn a profit. They
are counting on the general application of protons
to all tumor sites without regard to a sound basis
in proven research. More importantly, they are
counting on CMS to be the cornerstone of these
profits.

CMS must act responsibly with the taxpayers'' money
and deny payment for unproven proton treatments of
prostate cancer.