Proton accelerators to treat cancer are described as the “most costly medical devices” in the world, and the UK and United States are investing considerable amounts of money in order to build them.

However, journalist Keith Epstein states: “no clear evidence of better effectiveness exists” and that this investment may be premature. The report is published online in the BMJ (British Medical Journal). It is believed that proton beam therapy targets cancerous tissue more precisely than standard radiation treatment, and that it reduces adverse effects, increases survival rates and minimizes harm to healthy tissue. Furthermore, for children with cancer, and for some rare brain cancers, the treatment has been demonstrated to be beneficial and cost effective.

Millions of dollars have been invested in the United states to build ten proton beam centers, and 19 more are currently in development. In the UK, the NHS is to spend up to £250m on 2 centers, according to a recent announcement by the health secretary, despite no appraisal by the National Institute for Health and Clinical Excellence (NICE).

Epstein reveals that the treatment is currently being marketed as a treatment for prostate cancer, especially in the U.S., even though the benefits of the treatment are unclear, and the adverse effects are comparable to standard radio therapy.

In addition, there has been increasing evidence since 2007 that the treatment is less cost effective than standard radiation.

Professor Ezekiel Emanuel, an oncologist at the University of Pennsylvania and former adviser to President Obama described the treatment as “crazy medicine and unsustainable public policy.”

Emanuel explained:

“If the United States is every going to control its healthcare costs, we have to demand better evidence of effectiveness and stop handing out taxpayer dollars with no questions asked.”

However, the first randomized controlled trials to compare proton beam therapy with x rays is only just starting and will not be completed for 7 years.

Anthony Zietman, a radiation oncologist at Harvard Medical School said:

“We rush into treatments before they are proved. In some instances, proton therapy might be inferior to existing treatments.”

In addition, Robert Foote, a radiation oncologist at the Mayo Clinic is concerned that that some centers are adopting the treatment, and maybe for the wrong indications, before sufficient research has been conducted.

Written By Grace Rattue