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Improving pediatric access to proton therapy

by John R. Fischer, Senior Reporter | April 06, 2020
Rad Oncology Pediatrics Proton Therapy
From the April 2020 issue of HealthCare Business News magazine

At the Medical Institute of Berezin Sergey, where the majority of patients treated are children, Stolpner said a 60-bed hospital is being finalized this year to house patients and also provide beds to at least one parent of the patient.

In the Netherlands, proton therapy is covered by the government and the costs of travel and accommodation are fully reimbursed, according to Dr. Hans Langendijk, professor and chair of the department of radiation oncology at University Medical Center Groningen. Centers are also required to offer lodging to patients.

“There are countries where proton therapy facilities are not available and only a limited number of patients are referred for proton therapy,” he said. “This is a typical example where cross border healthcare could play a very important role and also to make proton therapy available for pediatric patients that come from other countries. It remains difficult in clinical practice to obtain those referrals for legal, practice and logistical reasons, and discussions with insurance companies.”

While access to proton therapy is limited throughout the world, there are considerably more facilities in the U.S. than anywhere else. At present, there are approximately 30 proton therapy providers across the country, a number which has risen with the emergence of smaller footprint, single-gantry solutions.

Historically, proton therapy centers have been multi-gantry facilities operated by a high-volume academic health system. As the smaller units gain ground, access enters new regions and brings access to new populations.

Reducing the need for anesthesia
A typical proton therapy treatment takes three-to-six weeks and consists of several sessions where the patient must remain still for 15-30 minutes. For young kids, anesthesia is often the only way to ensure they will remain motionless during treatment, but it comes with drawbacks.

“The anesthesia requires that children receive treatment in the morning on an empty stomach, so they end up missing breakfast,” said Washington University’s Perkins. “A procedure that would typically take 20 minutes ends up taking an hour to an hour and a half because kids require sedation and then recovery from sedation. They are sometimes irritable when they wake up from sedation, and they can miss half the day just from recovering from treatment. For the kids who can do it awake, they can actually go to school for the day and receive their treatment in the afternoon.”

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