St. Louis medical organizations plan more proton therapy

ST. LOUIS -- Despite problems at several proton centers across the country, St. Louis medical organizations are planning to increase their use of the cancer-treating procedure.

Siteman Cancer Center at Barnes-Jewish Hospital plans to open a second proton therapy center in 2020, and Mercy Hospital St. Louis expects to open its own proton center two years later, The St. Louis Post-Dispatch reported.

Proton therapy zap cancerous cells with precise beams of radiation while sparing surrounding tissue. Unlike traditional X-rays, the proton beams stop at the tumor instead of traveling through the body.

The new $32 million proton system planned at Barnes-Jewish Hospital will provide "pencil-beam" precision to target tumors, said Dr. Jeffrey Bradley, director of Siteman's S. Lee Kling Proton Therapy Center.

It will be built next to a $20 million machine, which opened in late 2013, that uses magnets to scatter proton beams across a tumor. Siteman has treated about 800 patients with the proton therapy, close to its projections of 200 patients a year.

The first proton centers built in the 1990s were known for their football-field size and up to $200 million price tag.

To offset the costs, the centers marketed heavily to men with prostate cancer, despite a lack of evidence patients have better outcomes or fewer side effects compared to cheaper treatment alternatives.

In 2013, Washington University was the first to open a smaller, less-expensive proton system with one treatment room.

"That's very different from other centers that went all in, borrowed money, and put in four-room centers," Bradley said. "The one room at a time idea is a very viable idea."

Bradley and other radiation oncologists say a major hurdle is insurance companies' reluctance to cover proton therapy. That can cost 50 percent to 75 percent more than traditional radiation, according to industry groups.

"Where the insurers like to say that proton therapy is not beneficial is often because they do not perform an adequate review of the evidence," said Scott Warwick, executive director of the National Association for Proton Therapy. "We have notified the payers that they have often either misinterpreted data, reviewed older evidence or omitted key evidence in development of their coverage policies."

Information from: St. Louis Post-Dispatch, http://www.stltoday.com