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Biotech Science

Hospitals Look to a Nuclear Tool to Fight Cancer 163

Posted by Soulskill from the not-from-orbit-so-dont-say-it dept.
The feed points us to a NYTimes article about hospitals using particle accelerators to treat cancer. While expensive, proponents say that the proton beams generated by the accelerators are more precise than conventional X-ray radiation therapy. This results in fewer side effects and reduced irradiation of surrounding tissue. The technology's critics say that the cost is not justified by a measurable increase in the level of care given to the patients. Nevertheless, this is an excellent example of "pure scientific research" leading to a useful, unrelated technique. From the NYTimes: "Tumors in or near the eye, for instance, can be eradicated by protons without destroying vision or irradiating the brain. Protons are also valuable for treating tumors in brains, necks and spines, and tumors in children, who are especially sensitive to the side effects of radiation."
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Hospitals Look to a Nuclear Tool to Fight Cancer More

Hospitals Look to a Nuclear Tool to Fight Cancer

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  • Seems like a good stride forward for medical progress, however I am wondering if there are any potential long term side effects....

    • Re: (Score:2)

      by WaZiX ( 766733 )
      The tumor might develop cancer!
    • I don't think there are any "long term" side effects, at least not for old people that get cancer. I guess if you are young enough when you get it, you might have a shot at some.

    • Re:Side Effects? (Score:4, Informative)

      by ByOhTek ( 1181381 ) on Friday December 28, 2007 @09:37AM (#21838562) Journal
      possibly, but I'd rather be bombarded with focused protons than barely focused gamma/x rays.

      protons have very little penetration power due to their high weight and volume. Normal alpha particle emitters, for example, are blocked simply by the lining of dead skin covering your body. Goggles and standard clothing will protect you from anything short of eating the particles.

      Since they are accelerated, I'm guessing they penetrate further, but they will be stopped quicker too (charge, mass, volume, all these will make them easier to stop than high energy photon radiation). Best of all, it's the stopping/slowing of the protons that kills the cells (they hit stuff, break stuff, and stop/slow down), so less energy will be needed since the majority of the high-energy photons would just pass through. The trickiest part would be to determine how many protons and with how much energy.

      • Re:Side Effects? (Score:5, Funny)

        by vjmurphy ( 190266 ) on Friday December 28, 2007 @09:44AM (#21838608) Homepage
        Focused protons would likely give you better superpowers, too. I mean, we all know what gamma rays do, and I, for one, don't want to prance around with green skin and purple short shorts when I'm angry.

        • Re: (Score:2)

          by Lars T. ( 470328 )

          Focused protons would likely give you better superpowers, too. I mean, we all know what gamma rays do, and I, for one, don't want to prance around with green skin and purple short shorts when I'm angry.
          Well, I don't want to prance around in that outfit in any other mood, for that matter.

        • ... I, for one, don't want to prance around with green skin and purple short shorts when I'm angry.
          You're right - it's far more worthwhile and way more crowd-pleasing when you're drunk...

      • Re: (Score:1, Interesting)

        by Anonymous Coward
        Will those who think this is too expensive opt for the older, broader, X-Rays when they develop cancer?

        A lot of the cost of medical care is due to malpractice lawyers, like Edwards.

        • Hornswaggled Posting (Score:2, Informative)

          by cluckshot ( 658931 )

          This whole suggestion that Medical treatment with particle accelerators is new is not true. The use of such machines is stock medical stuff and has been so for more than 20 years. As to side effects, here is what my mother was told just after she drank some I-131 made in the local accelerator... In response to her question about cancer risk, she was told, "We don't think you will live that long."

          The use of focused beams to shoot tumors is also 20 years old or more. The use of the beams to make Gama, X

        • Re: (Score:2)

          by terrymr ( 316118 )
          As I told a doctor that I didn't sue: The real problem is the fscking malpractice in the first place not the lawyers.

          It's a lot easier to lose your law license for malpractice than to lose a medical license for malpractice.

      • Re:Side Effects? (Score:5, Informative)

        by johnny maxwell ( 1050822 ) on Friday December 28, 2007 @10:02AM (#21838694)

        Since they are accelerated, I'm guessing they penetrate further, but they will be stopped quicker too (charge, mass, volume, all these will make them easier to stop than high energy photon radiation). Best of all, it's the stopping/slowing of the protons that kills the cells (they hit stuff, break stuff, and stop/slow down), so less energy will be needed since the majority of the high-energy photons would just pass through. The trickiest part would be to determine how many protons and with how much energy.

        For a nice picture of energy deposition vs. depth see e.g. http://www.gsi.de/forschung/bio/energy_e.html [www.gsi.de]
        One can adjust the peak energy deposition's depth by varying the proton's energy. The surrounding tissue gets a much lower dose than in X-Ray irradiations.
        Combine the particle accelerator with a PET (http://en.wikipedia.org/wiki/Positron_emission_tomography [wikipedia.org]) and you can irradiate a cancer with cubic millimeter resolution.

        This is actually not a new, purely academic technique, it is already commercially available, see http://en.wikipedia.org/wiki/Proton_therapy [wikipedia.org]

        Attention: I'm not a doctor but a physics student :)

      • Re: (Score:3, Funny)

        by DoofusOfDeath ( 636671 )

        possibly, but I'd rather be bombarded with focused protons than barely focused gamma/x rays.

        Oh my gosh! The FDA probably didn't realize that you disagree with the findings of the medical research! I'll let them know right away! We must get this information into the hands of oncologists immediately!

        • umm, my opinion doesn't disagree actually. It's not the FDA that is complaining. The complains are on the cost, not the safety. It looks like this has been pretty much confirmed safer by all parties.

          Doofus, good name for yourself.

      • Re: (Score:2, Funny)

        by YourExperiment ( 1081089 )

        Goggles and standard clothing will protect you from anything short of eating the particles.
        Goggles? That's not what I've heard.

    • Re: (Score:2)

      by Imabug ( 2259 )
      Proton beam therapy is a logical extension of what's already being used. Electron beam therapy is already fairly common and the evolution to protons, with much higher LET (linear energy transfer) and Bragg peak, is just the next step. IANATP (I Am Not a Therapy Physicist) but I wouldn't think the side effects are much worse than conventional (x-ray or electron) therapy treatments and possibly a little less.

    • Re:Side Effects? (Score:5, Informative)

      by ZombieWomble ( 893157 ) on Friday December 28, 2007 @10:00AM (#21838680)
      Based on a couple of assumptions*, the entire reason for making use of this therapy is to mitigate the side effects of traditional radiotherapy. In traditional x-ray based therapies, the energy from the beam is deposited nearly continuously along the beam length, giving a roughly exponential falloff (I say nearly, as there is an initial buildup at the surface as secondary particle counts build up, and it is from the peak slightly below the surface that the exponential falloff begins).

      By contrast, accelerated protons deposit their energy almost evenly, at a relatively low rate, until they are slowed to a certain energy, at which point their deceleration rapidly increases, accompanied by a massive increase in linear energy deposition. This leads to the "Bragg Peak", which offers a much, much more accurately targeted beam than is possible with conventional sources. (See this illustration [www.gsi.de] as an example - compare the red line (in this case, C12 ions, but a similar principle) to the green line (an 18MeV photon beam). By carefully tuning the beam energy and orientation this point can be scanned over the tumour volume, giving a very localised dose deposition.

      What puzzles me is why this is news - I was under the impression that this concept is well-established, and has been fairly well verified already. Just some fluff to fill up the science and medicine section, maybe? Now if it was about the CERN anti-proton tests, that's certainly something with a more dubious cost/benefit analysis...

      * - I say a few assumptions, these are basically the principle ones behind all radiotherapy - that is, that all dose at the end of track structures is created equal and all dose is bad according to the LNT. While these ideas may not be strictly true, it is unlikely for them to be so wrong that it would invalidate the treatment as a whole.

      • It seems like the thrust of the article is not so much about the technology but about the sudden decision by so many institutions to make 9-figure investments in accelerators. Good news for applied physicists, though!
      • I could have sworn the new cancer centre in Leeds has a set of these:

        http://www.leedsth.nhs.uk/news/newsitem.php?newsID=278 [leedsth.nhs.uk]

        No word on if they're actually for treatment or if they're just used to create radioisotopes though. 10 seems a bit many for just producing tracers.

    • Re: (Score:3, Informative)

      by ILongForDarkness ( 1134931 )
      I'm a physicist myself by training, currently doing IT work for a radiation treatment program. Yes there is side effects with any type of treatment. Chemo can cause organ problems among other things. Surgical can "miss something", can actually poke the tumor and cause it to spread etc. Radiation can cause new tumors to grow, can damage bones (causes them to become brittle), and other organs. Example: prostate treatments you have a choice of where to put the beam. left and right are the femeral heads (tops o
      • Sorry I was incorrect. I checked with a collegue, protons can be more accurately delivered to a target, but it is pretty obtuse physics to figure it out. It has to do with the scattering cross-section of the material. Think of a pool table. Your chances of hitting something depend on the density and size of the balls on the table, the size of the ball your using, the angle etc. Similarly with particles, except because of quantum mechanics you now have a probablity density for electrons (the balls on the tab

    • "Tumors in or near the eye, for instance, can be eradicated by protons without destroying vision or irradiating the brain. "
      Doesn't radiation cause cataracts? Radiologists today wear shielded goggles to prevent that now.

  • Comment removed (Score:3, Insightful)

    by account_deleted ( 4530225 ) on Friday December 28, 2007 @09:26AM (#21838522)
    Comment removed based on user account deletion

    • Re: (Score:3, Insightful)

      by mikkelm ( 1000451 )
      That, or it's just a convenient way to group people who feel that it's better to treat a thousand people for cancer just a little worse than they could treat ten people with the same money.

      • Re:critics... let me guess (Score:5, Insightful)

        by arivanov ( 12034 ) on Friday December 28, 2007 @10:23AM (#21838820) Homepage
        Aaa... The so called ~NHS logic. Treat 10 times more people regardless of the fact that the result is nil, but do not use the treatment that may actually save one of the 10 because it is expensive.

        They do it for everything.

        They consider it OK to treat Eczema by splating children with a bucket of hydrocortisone twice a day and drowning them in Claritine despite the fact that the result is nil and the treatment drags on for decades. After all it is cheaper per-day and per-dose than Pimercrolimus or Advantan. They miss a crucial difference - the latter can actually put eczema under control and reduce it to a point where treatment is unnecessary most of the time.

        Same for allergies - there is practically no way in hell to get them to approve gammaglobulinisation therapy.

        Same for vaccines - they use "all animals are equal, but some are more equal than the others

        approach and vaccinate themselves against chickenpox and leave children who are in high risk groups like astma and eczema sufferers to fend for themselves (and die from secondary infections). After all, vaccination is expensive, isn't it.

        Same for cancer. Treat 10 people without any one of them getting improved survival rates as long as "it improves their quality of life", but do not use treatment that will actually give one of out 10 a chance to survive because it is expensive. Do not pay for herceptine because it is expensive, use cheap stuff regardless of the fact that as a result UK has cancer survival rates of a 3rd world country (worse than the whole of the EU).

        And so on.

        Sorry. NHS treatment selection logic is flawed by design. It is based on fake happy commie concepts of fairness which are misplaced here. The main goal of medicine is to try to cure the patient. If you have the choice of using a medication that has a chance of curing even one more patient and medication that will cure even one less the "cost" option is simply no longer part of the equation. It is there only if the treatments are equivalent.

        • Re: (Score:2)

          by olman ( 127310 )
          You're talking about drug therapies. Their cost of the total health care expenses is neglible (except in US) and you indeed can find many such fine examples of beancounter logic at work where the healthcare is goverment controlled. For example, if you put someone with Schizophrenia on "cheap" drug instead of the "expensive" one, you may and probably will get that person out of whatever productive life they had and hospitalize them regularly due to the neat side effects.

          But hey, we saved a bit of money on th
          • For example, if you put someone with Schizophrenia on "cheap" drug instead of the "expensive" one, you may and probably will get that person out of whatever productive life they had and hospitalize them regularly due to the neat side effects.

            Even in the USA, with HMOs and such, there is indeed pressure for cheaper drugs over expensive ones. Still, I feel the need to point out that a expensive drug is not necessarily better than the cheap one. Everybody's different, after all. Still, from what I've heard

        • Re: (Score:2)

          by Fweeky ( 41046 )
          While insurance based private healthcare never cuts corners by telling patients to fuck off and die because of any of a long list of excuses, and indeed always at least tries for the tens of millions without insurance. And of course those with insurance can always afford their treatment despite deductables and co-pay schemes.

          Wait, doh. Well, at least they do pretty well with catastrophic care when insurance does pay up, but if you don't think it's similarly flawed I have a bridge you might be interested i

          • Re: (Score:2)

            by Rich0 ( 548339 )
            In my observations, it all comes down to what you're willing to pay for. If your insurance costs $500/yr you won't get the same level of care as somebody who pays $10k/yr for their insurance. Sure, the same company might write both policies, but they don't treat both customers in the same way.

            It isn't like health care is a charity - in any country. Lots of people need to get paid to make it work. In some countries the sick are expected to pay, or at least the healthy are expected to pay in case they get

        • Re: (Score:2, Interesting)

          by Anonymous Coward
          If you have the choice of using a medication that has a chance of curing even one more patient and medication that will cure even one less the "cost" option is simply no longer part of the equation.

          That, too, is based on a "fake happy commie concept of fairness". At some point you have to draw the line. To wit: treatment X is able to help 1% of patients (and we don't know which 1%). If the treatment is only $10/patient, it's certainly worth it, but what if it's $500,000 per treatment? You're now spending 50

        • Patient perspective on marginal treatment (Score:2, Insightful)

          by Anonymous Coward
          Much more research needs to be done in the area of cure vs. 'band-aid'. I have cancer that recurred three years ago, and have done everything from chemotherapy to radiation to surgery to radiosurgery. All of these things had a reasonable expectation of reducing the tumor load, and some of them had a chance, a rather small chance but still real, to cure me completely.

          Now, for me, personally, every single procedure that has a reasonable chance of giving me a normal lifespan (I'm under 30, so figure anoth

    • Re: (Score:1)

      by Arccot ( 1115809 )
      critics is just a shorthand for "Insurance Companies" right?

      It is relevant to anyone in a shared risk situation that it does not increase quality of care. Why should I or anyone else pay (through increased insurance premiums) for something that is extremely expensive, and not proven to do squat more than the more traditional methods of treatment? It's hopeful that improved care may come out of this, but using this technology right now for more than research is premature.

      There's other things I would l

    • private health care will strangle this? (Score:3, Interesting)

      by Anonymous Coward
      Correct me if I am wrong (I am not in the US and haven't had any serious illnesses), but isn't medical insurance cover up to a certain limit of dollar value (usually extremely high), which makes the cost of a treatment irrelevant so long as it is scientifically proven to have a noticeable beneficial effect?

      If insurance companies refusing a treatment over cost disgusts and shocks you, you might be interested to know that active government policy in every country with free health care (including those highlig

      • Of course, you could always travel to a third-world country and have the drug illegally injected, at the risk of losing your house if it's discovered.
        Is this for real? Why would someone be at risk for losing their house if it was discovered that they left the country to receive alternative medical care?
      • "but isn't medical insurance cover up to a certain limit of dollar value".

        No, at least that's not how my insurance works with my company in the US. Your country or your plan may vary by location.

        We have 3 plans each have different cost,deductibles, MooP (maximum out of pocket) and coverage % (and lots of other numbers but for simplicity)

        For the sake of argument lets use whole numbers:
        Cost: $7/month (Subsidized by my employer)
        Deductable: $1000
        MooP: $10,000
        Coverage %: 90%

        So for the first $1000, I'm on my own.
      • that is not entirely correct. there are laws about compassionate use of unapproved drugs in most EU countries. same thing with off label use.

    • Bad guess (Score:4, Insightful)

      by hrvatska ( 790627 ) on Friday December 28, 2007 @10:14AM (#21838764)
      No, it's shorthand for prominent and respected radiation oncologists who don't see any difference in cure rates and side effects for advanced x-ray therapy and proton beam therapy for many cancers. They are concerned that medical centers and their financial backers, which are investing over 100,000,000 USD per facility, are pushing patients to the new therapy just to recoup their expenses, with no real benefit for the patient. The article offers this example.

      Dr. Zietman said that while protons were vital in treating certain rare tumors, they were little better than the latest X-ray technology in dealing with prostate cancer, the common disease that many proton centers are counting on for business. "You can scarcely tell the difference between them except in price," he said. Medicare pays about $50,000 to treat prostate cancer with protons, almost twice as much as with X-rays.

      Insurance companies frequently follow Medicare's lead, so we may find in a few years that we're paying gobs of money for proton beam treatments that do not offer better outcomes than alternatives. Once it gains acceptance as a standard treatment for cancers on which it offers no better outcome, we'll be paying a huge collective sum in taxes and insurance rates with no discernable benefit.

    • critics is just a shorthand for "Insurance Companies" right?

      In principle, we could probably keep you alive longer and in better shape if we had a full medical team follow you around for the rest of your life. The could monitor your blood pressure, sample your urine and stool, perform a full-body MRI every week to check for changes, have thoracic and neurosurgeons standing by....

      In practice, we recognize that such an approach is ridiculously costly and provides a very small marginal benefit over telling

  • Proton packs (Score:5, Funny)

    by Rob T Firefly ( 844560 ) on Friday December 28, 2007 @09:43AM (#21838594) Homepage Journal
    As another unrelated side benefit, you can strap it to your back and use it to catch ghosts.
    • Who the hell modded this as funny?

      They'll have a much different attitude when Gozer reappears next. He may even take the form of a giant Sloar again. During the last reconciliation many Shubs and Zuuls knew what it was to be roasted in the depths of the Sloar that day, I can tell you!

  • Oldest operator of a proton therapy center in USA (Score:3, Informative)

    by martyb ( 196687 ) on Friday December 28, 2007 @09:52AM (#21838658)

    For more information on proton beam therapy, albeit from a provider's point of view, here is a link to Loma Linda's Proton therapy [protons.com] page. (They were the first to set up a proton therapy center.) In addition to static informational and historical pages, there are also some videos [protons.com] explaining what they have to offer and how it works.

  • yesterdays news? (Score:3, Interesting)

    by spectrokid ( 660550 ) on Friday December 28, 2007 @10:02AM (#21838698) Homepage
    I visited a proton accelarator for cancer treatment near Ghent in Belgium 15 years ago. In which way is this new?

    • Re: (Score:3, Informative)

      by WaZiX ( 766733 )
      Well the University of Ghent is one of the most advanced oncology research centers... I guess what's new is not the method itself, but the fact that hospitals are starting to buy these (for operating leverage?)...
    • Ernest Lawrence, inventor of the cyclotron, used accelerators in the treatment of a relative's cancer way back in the day. it would have been protons then, also. they had found out that bombarding aluminum or beryllium produced tons 'o' neutrons, but also knew that particle was to be seriously respected, as it wasn't pulled into anything to crash because of its neutrality.
    • I did some manual work on the construction of a synchrotron for this around 1980. I was a student and filed copper pieces to specification by hand for some moolah - I guess most Slashdotters weren't even born yet...

  • Comment removed (Score:5, Insightful)

    by account_deleted ( 4530225 ) on Friday December 28, 2007 @10:08AM (#21838734)
    Comment removed based on user account deletion
    • Agreed. We should be dumping money left and right into medical/genetic research that shows results. Anything that provides us with a better arsenal against diseases and cancer would be a plus.

      • Re: (Score:3, Insightful)

        by h2oliu ( 38090 )
        Disclaimer: I work for a radiation treatment manufacturer.

        No arguments here. Unfortunately, economics will always have some role. When you can buy one accelerator that gives un-paralleled treatment options, or a TomoTherapy, Accuray, or Cyberknife device for between 1/40 and 1/20 the cost. There will be one patient who can't get treated due to the lack of proton treatment, but 20 people get a treatment that they wouldn't have on conventional radiotherapy devices because there are more of the advanced radiot

    • Re:As the husband of a survivor... (Score:5, Insightful)

      by Rich0 ( 548339 ) on Friday December 28, 2007 @12:11PM (#21839908) Homepage
      Personally, who cares how expensive it is.

      The person paying for it. In the US that would probably be an insurance carrier (those who pay a higher premium might get access to it). In most of the rest of the world it would be your government (if you are lucky you might get access to it).

      I have only sympathy with what you went though - I've had someone close to me go through life-threatening medical problems as well. I'm all for improving the level of technology available. However, economics always comes into play - it just isn't politically-correct to admit it.

      No nation on earth fully meets their medical needs financially - everybody rations care at some level. Every nation also faces questions like "is it better to spend $500M on one machine in one hospital that will cure 10 extra people per year, or $500M on something else that might save more lives?". The cost of one of those machines would also pay for a lot of doctors and nurses as well - you might save more lives just by giving patients more time with caregivers.

      The problem in medicine is that nobody is allowed to discuss the hard questions like this without being branded as insensitive or inhuman. The problem is that the hard decisions get made one way or another, and without genuine debate the decisions are probably made in a less-than-ideal way. Money spent on particle accelerators saves lives - but so does money for food/education/sanitation/law-enforcement/doctors/clean-air/etc. There is only so much money to go around - and economics are all about spending it where it will do the most good...
      • Comment removed based on user account deletion

        • Re: (Score:2)

          by curunir ( 98273 ) *
          I don't think its even about profits really, only economics. Obviously, once someone has cancer they're all for these expensive but effective treatments. And that's just another form of "after my profit is had, I'll help the village."

          But what about before they get cancer? If everyone was given the opportunity to pay $500/month more in health insurance premiums, starting on their 18th birthday, knowing that in the 10-20 percent chance that they get cancer, all treatment options will be available to them, no

        • Re: (Score:2)

          by Rich0 ( 548339 )
          Profit motive is just human nature - in megacorps like insurance carriers it just happens at a bigger scale.

          When you buy stock - do you invest in companies that do the most good, or companies that have the highest return on your investment? Most people opt for the latter, and companies act accordingly.

          When you got out of school and got two job offers, did you pick the place that looked like it would be enjoyable to work at, or the one where you might have had the biggest impact on helping out the poor? Mo
      • Or do you spend $250M a year. "Improve the quality of life" for a few hundred people. Then turn the other $250M as profit for your share holders.

        Not that the government is any better, but a "For Profit" company trying to please both shareholders AND help people just is beyond my realm of belief.

        • Not that the government is any better, but a "For Profit" company trying to please both shareholders AND help people just is beyond my realm of belief.
          You mean help out the people who gave the capital to make something happen in the first place? The problem isn't profit, it's the profit + massive regulation + massive litigation risk. The reason the govt should handle health care is because the latter two items can't be dealt with adequately in the private sector
          • You mean help out the people who gave the capital to make something happen in the first place? The problem isn't profit, it's the profit + massive regulation + massive litigation risk. The reason the govt should handle health care is because the latter two items can't be dealt with adequately in the private sector

            Government caused the problems, so it should take over private industry to solve those problems? You're being sarcastic, right?

            The trouble with socialized healthcare, is that Freedom is forfeit in

            • The trouble with socialized healthcare, is that Freedom is forfeit in the name of cost savings. Those ends don't justify those means.
              Those freedoms are already forfeit. The huge government bureaucracy and regulation involved with the medical field eliminates most choice. In the hybrid industry the government is artificailly limiting competition, without in turn limiting price increases caused by such artificial restrictions, the worst of both worlds.
              • I agree with your conclusion, but feel we should work towards a better system, not surrender.

                I understand in New York fee-for-service may already be illegal, at least that's what I read (not confirmed). Government-mandated 3-rd party payer is an awful way to go.

      • Re: (Score:2)

        by kmac06 ( 608921 )

        and economics are all about spending it where it will do the most good...
        No, socialism is all about spending it where it will do the most good. Economics is about me spending it where it will do the most good for me (or giving some away if I choose to).

        • Re: (Score:2)

          by Rich0 ( 548339 )
          Well, generically economics is just the study of how resources get allocated and trade occurs in general.

          There are many different economic systems out there, and most have the goal of spending money where it will do the most good. The only difference is the algorithms and the outcome.

          Socialism is basically a government-centric system with the goal of a somewhat-egalitarian allocation of resources for basic necessities.

          Capitalism is more of an anything-goes system that posits that the most good will come ou
      • The person paying for it. In the US that would probably be an insurance carrier (those who pay a higher premium might get access to it). In most of the rest of the world it would be your government (if you are lucky you might get access to it).

        Well, there's your problem. I admit it's true - in the US the news has been abuzz with a girl who died because an insurance company refused to pay for a liver transplant until it was too late to do any good (and only through some news media pressure). What I can't u

    • Re: (Score:2)

      by bgat ( 123664 )
      Furthermore, I don't understand the "expense" argument against a machine that's already built and operational. There are several running proton accelerators in the USA today (I've been to one); to say that proton therapy is "too expensive to use" forces you to throw away all the money invested in building and maintaining these machines.

      Why not try to recapture some of that expense by actually _using_ them for what they were designed for? To do anything else seems fiscally irresponsible, patient care argum
    • Personally, who cares how expensive it is.

      I care, because I can't afford health insurance. If I get cancer, I'm screwed. Hell, if I break an arm, I'm screwed. Anything that increases the potential cost of treating my future health problems makes health insurance more expensive. The worst part is that like many fad drugs, other cheaper treatments are equally effective for many people.

      There are those people that can be helped by proton gun treatment over traditional radiation, and in that case, I don't care h

    • Re: (Score:2)

      by daigu ( 111684 )
      The other side of this is that traditional radiation is sometimes a better option. If you are irradiating the area where you have resected a glioma in the brain, the whole point is to get the tumor cells around that area. With photon radiation, you run the risk of defining the area too well and leaving some of them without any exposure to radiation.

      This is just another treatment tool, and it is perfect for certain types of treatments. However, like any tool, it has its limitations.

      Also, for the asshat respo

  • Medicare pays about $50,000 to treat prostate cancer with protons, almost twice as much as with X-rays.


    And yet Medicare is already paying for such treatments? I'm guessing it was all over the major radiation oncology journals?
    • You've never heard of this until now, so you seem surprised other people know about it? An interesting outlook. The idea of using protons for radiotherapy is relatively old (4 decades or more of papers from a quick google scholar search), and this particular type of facility is also well-established: it's been in commercial production for a decade or more, so it's not surprising its available on standard programs now. Unfortunately both you and the NYT are just a little behind the times.

      • Re: (Score:3, Informative)

        by ColdWetDog ( 752185 )
        You missed the point. It's not that proton beam therapy is new. It's not that proton beam therapy works or doesn't work.

        TFA is all about:

        The relatively recent decision of some hospitals (and some entities that are set up to minimize economic risk rather than just do healthcare) to build a surprisingly large number of these very expensive, rather limited machines and

        The lack of good science to suggest that, for most cancers, this technology is not any better than the older (still advanced, still expens

  • We're having a particularly slow news day today?

    These things have been used all over the world for a very long time now. Over ten years ago I programmed a Proton Therapy Planning System with my brother - and while our system was very fast ( 10 seconds), there were several others around already (usually Suns, 2-4 hours). And the therapy itself was used a lot already - particularly for eye treatment and brain cancers.

    Treatment centers were found in Germany, France, England, Japan, South Africa (!) and - yes -

  • This idea may sound a bit wacky, but I believe that at some point in the future we will have mathematical models of disease, and we will be capable of modelling and "treating" diseases with mathematics. For example, perhaps we could model cancer as some form of deviance from a Pareto optimal frontier of the body or something like that. And when I say "model" I mean to model every cell at very low level (of course we would need good algorithms and supercomputers, but at some point I believe this will be po

    • No, it's not wacky at all; there are many people working on exactly the sort of thing you describe; do a Google search on, say, "mathematical models of cancer" to see some of the current work in the field. However, speaking as a bioinformaticist, I can tell you that we're a long way from being able to model everything with the precision and comprehensive coverage needed to do what you describe. We need faster computers and better algorithms, yes; we also need the biological data to put into the model to a
    • And at the same time we can solve the 3-body problem! Yeah, that'll work!

      More seriously, it's full of random factors and phenomena that are fractal in their complexity: the more you spend energy and time measuring the factors, the more you'd wind up taking away the person's life and freedom, and even risking their health from the testing.
  • We spend 15x more on breast cancer treatment and research than on prostate cancer. It pays to be Oprah, where's my ribbon magnet.
    • Where'd you get the 15x figure from? According to the National Prostate Cancer Coalition [70.84.59.4], "Breast cancer research will receive about $870 million next year. Compare that to $485 million for prostate cancer research."

      It's arguably due to the relatively lower social and economic impact of prostate cancer versus breast cancer. Prostate cancer is uncommon in men less than 45, but becomes more common as men age. The average age at the time of diagnosis is 70. However, many men never know they have prostate

      • Re: (Score:2)

        by gelfling ( 6534 )
        Not just research - which at this point is almost wasted since morbidity and mortality from Breast CA leveled out more than decade ago - no the total outlay for screening, treatment, surgery, support etc etc etc etc etg. Even the DoD spends between 1 and 2 billion dollars a year in support of breast cancer.
        • Where do you get you statistic that morbidity and mortality from breast cancer leveled out more than a decade ago? The American Cancer Society [cancer.org] claims that death rate from breast cancer has been declining since 1990.
          • Between 1975 and 1990, the death rate for all races combined increased by 0.4% annually;
          • Between 1990 and 2002, the death rate decreased by 2.3% annually.

          Unless there was a huge drop in mortality from '90 to '97, and then nothing between '97 and '07, it seems unlikely that mortality rates wou

  • "Nuclear" (Score:3, Insightful)

    by Schraegstrichpunkt ( 931443 ) on Friday December 28, 2007 @12:31PM (#21840170) Homepage
    There's nothing new about using a "nuclear tool" [wikipedia.org] in medicine.
  • Not. Maybe they should just bring back the http://courses.cs.vt.edu/~cs3604/lib/Therac_25/Therac_1.html [vt.edu]Therac-25?

    Bugs and all? Does anyone else recall that this (happened in 1985, so some of you may not be up on this stuff) was all caused by the operator using unexpected key sequences to input data. Oh, and no hardware interlocks to prevent massive overdoses.

    I bet this new-fangled stuff isn't even multi-mode. Nothing is truly new. May we learn from the past...

    Of course, the new stuff is so much better,
  • When I was at Loma Linda (Calif.) medical center about 5 1/2 years ago when my son was there for a heart transplant, I saw that they had a proton therapy facility for cancer and I don't think it was brand new even then. I didn't have time to learn about it then, so I don't know how many others existed at that time, but there was at least that one.

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