Study Reveals Proton Therapy for Breast Cancer Is Cost-Effective

Proton therapy at or below cost of other radiation options, study finds

Medicare reimbursement for proton therapy is at or below the cost of other irradiation therapies.

A study using Medicare reimbursement codes to compare the cost of proton therapy versus eight different types of partial and whole breast irradiation therapies and treatment schedules for early-stage breast cancer patients has shown that proton therapy is at or below the cost of other therapies.

The study, conducted by MD Anderson Cancer Center, reports that the cost of proton therapy when used for accelerated partial breast irradiation to decrease overall treatment time and toxicity, was estimated at $13,833. Comparatively, whole breast irradiation using intensity-modulated radiation therapy (X-ray) resulted in the highest Medicare charges at $19,599. The average charges across all of the eight treatment regimens investigated were $12,784, suggesting that the cost of proton therapy is similar to other types of radiation.

Further validation of value

“We’ve known that proton therapy for breast cancer patients is an effective treatment that minimizes the impact of cancer therapy on patients’ daily lives, as well as the promise it holds for a healthier future for patients compared to other radiation treatments,” said Huan Giap, MD, PhD, of the Scripps Proton Therapy Center “That it offers such advantages for patients at a cost that’s at or below the cost of other radiation treatments is further validation of proton therapy’s value.”

Compared to other partial breast irradiation therapy techniques that use implanted catheters, proton therapy is much less invasive (requiring no surgery or implant of catheter) with little or no risk of infection, pain, or bleeding. Proton therapy is much more versatile and can adapt to almost any patient anatomy and geometry. The overall course of treatment is shorter because there’s no need for surgery and related recovery. Proton therapy also provides a superior dose distribution that avoids a hot spot or high dose area in the breast and skin. The overall cost of treatment is similar.

Compared to whole-breast radiation treatment with 3-D conformal or IMRT, proton therapy treats much less normal tissues such as heart, lung, and breast. And at one to two weeks, the accelerated course is more convenient than the typical extended course of five to seven weeks.

The findings were presented at the recent North America meeting of the Particle Therapy Co-Operative Group, held in Houston, Texas. A manuscript detailing the study findings is under way.

Benefits of proton therapy

Proton therapy is a form of radiation treatment that kills cancer cells while preserving healthy surrounding tissue. Conventional radiation treatments use X-rays, which penetrate into normal tissue around the tumor and increase the probability of side effects and secondary cancers. But a proton beam can be controlled to stop where the tumor stops.

This is important for breast cancer patients, who may face the risk of secondary cancers, lung injuries and major cardiac events later in life due to previous radiation exposure.

About Scripps Proton Therapy Center

Scripps Proton Therapy Center uses pencil-beam scanning, the latest advancement in proton therapy. Pencil-beam scanning sweeps a narrow proton beam across the tumor in fine strokes, building up the dose layer by layer. The result is a dose of cancer-killing radiation that conforms precisely to the unique shape of the tumor.

A non-invasive treatment, proton therapy has been shown to be highly effective for adults and children who have solid, deep-seated tumors that have not spread to distant parts of the body. Proton therapy has been used in the United States since the 1950s but is only recently becoming more available. Scripps Proton Therapy Center opened earlier this year for adult and pediatric patient care. It is just the 15th proton center in the United States and fourth west of the Rockies.

Advanced Particle Therapy is the developer and owner of the Scripps Proton Therapy Center facility. Scripps Health provides the center’s clinical management services and Scripps Clinic oversees the medical services. Varian Medical Systems of Palo Alto, Calif., developed and installed the center’s ProBeam proton delivery system.

Cancer Care at Scripps

Scripps Health is a nationally recognized leader in cancer care, providing comprehensive care at its five hospital campuses and various Scripps Clinic locations. Scripps recently opened two regional cancer care facilities: the Scripps Proton Therapy Center and the Scripps Radiation Therapy Center. With more than 300 affiliated physicians, Scripps Cancer Care seeks to provide the best possible treatment and cutting-edge research trials for patients by coordinating medical expertise in the areas of clinical cancer care, community outreach and clinical, translational and basic research.

Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.

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Stephen Carpowich
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