by John R. Fischer
, Senior Reporter | October 25, 2021
From the October 2021 issue of HealthCare Business News magazine
From New Hampshire to Alabama, more than 20 of the 38 proton therapy centers in the U.S. are scattered across the East coast.
Out West, these cutting-edge cancer treatment facilities are relatively lacking in numbers and patients are at a geographic disadvantage when it comes to accessing treatment.
Meanwhile, many patients throughout the country also face barriers from insurance providers that refuse to cover the treatment, even for indications where evidence suggests protons could yield superior outcomes. This leaves many would-be proton candidates with no option but to receive conventional treatments, which may come with higher risk of side effects and long-term complications, particularly for complex cases.
HCB News sat down with those in the field to discuss these barriers and their impact on outcomes. One expert, Dr. Curtiland Deville, associate professor of radiation oncology in Johns Hopkins School of Medicine and medical director of the Johns Hopkins Proton Therapy Center, said that while unfortunate, challenges like this are to be expected. "Protons are a limited resource. Anything that is a limited resource is going to potentially have a variety of barriers to access and care, from personal to institutional to systemic and at the level of policy."
Reaching patients closer to home
If 38 sounds like a small number of facilities in the U.S., you only need to look back as far as 2010 to a time when there were only seven. Jonathan Weinbach, CEO of New York Proton Center, says America's proton therapy industry was born out of large cities and as a result, has branched out more in areas like the Northeast, compared to Western states. “A lot of it is driven by population density. It’s expensive to build proton facilities. You want to make sure there is a large enough patient population to make use of the market.”
As a result, midwest and western patients may have to travel long distances for treatment. This, however, is often difficult or not feasible due to family commitments, inability to take time off from work or costs associated with relocating. Other potential factors could be the overall climate of medical clinic control and state regulations, according to Dr. Anita Mahajan, radiation oncologist at Mayo Clinic and clinical director for particle therapy in Rochester. “If you’re not living next to a city that has access to proton therapy, then you’re not aware of it and accessing it, and moving yourself to a center, for close to two months sometimes, is challenging.”