In June 2011, Loma Linda University Medical Center held a press conference to announce results of a clinical trial using "proton beam therapy" to fight stage one breast cancer. Doctors at Wheeling Hospital took interest. It's a quality senior doctors encourage.
"As we go into the 21st Century -- between the federal government, attorneys, insurance companies -- all try to 'cookbook medicine.' Medicine is not a science. It's 'the practice of medicine,'" Dr. Angelo Georges, Chief Medical Officer at Wheeling Hospital said. "There is some science, but there's also an art to it, which is a thing that in this world that we live in, everyone seems to forget."
Radiation Oncologist Dr. JonDavid Pollock views proton beam therapy like a mechanic views a tool in his tool box. A proton beam therapy machine employs a cyclotron or synchrotron to shoot positively charged particles at a cancerous tumor in a patient in a tight beam. Those particles deliver the radioactive energy differently, compared with the linear accelerator used for nuclear medicine in many American hospitals.
"They get all their dose shot, it's like a bullet, shot directly into where you need to do it, and then that dose falls off," Dr. Pollock explained. "There are very few cancers in the United States seen in community centers, or even in university centers that meet those criteria."
Dr. Pollock's linear accelerator in Wheeling shoots photon beams or negatively charged electron beams that deliver energy from those radioactive particles over a wider area. It's not an institutional reason he doesn't have a proton beam therapy machine in Wheeling. Dr. Pollock asserts serious clinical issues exist.
"The problem is that no one's clearly shown that protons reduce side effects, compared to photons, because the studies haven't been done," said Dr. Pollock. "And here's the other critically important thing. It costs at most four million dollars to put a photon machine, a linear accelerator into my office. If I wanted a proton machine, the cost is $150 million, $200 million."
Dr. Pollock went on to say that proton beam therapy for cancer proved very useful in cases where doctors could not reach tumors through surgery, or where a tumor was near a eye, or near the spinal cord. He reiterated that many tumors seen in patients did not fall into those categories.
Radiation Oncologists used to think one proton beam therapy machine on each coast could treat those cancers. Now, 10 centers exist, and developers plan seven more. This expense troubles some doctors.
"When you have clinicians that continue to practice at state-of-the-art therapy like Dr. (Gregory) Merrick and Dr. JonDavid Pollock do -- they keep an eye on what's relevant, and what's not. I'll go back to the robotic therapy," said Dr. Georges. "That was the hot topic at most universities, and it turns out, unless you're using them all the time, it really doesn't deliver that more efficient care."
"It is, it is, awful, what's going on," Dr. Pollock said, with some regret in his voice. "That there's a proliferation of an unproven technology, without the randomized studies showing that protons are better than photons, for a device that costs ten to 20 times as much money. And, we don't know if it's any better. And nobody is saying 'No' or 'Boo'. No one is saying, 'Absolutely we have to do the studies,'" Dr. Pollock said.
On July 9, the University of Texas's Southwestern Medical Center announced plans for a 100,000 square foot proton beam cancer therapy center, but didn't announce the price tag. A San Diego-based firm, Advanced Particle Therapy, will handle the planning and funding.