The Promise of Proton-Beam Therapy

A radiation therapist at M.D. Anderson moves Glaros into position. The rotating device above him, which is connected to a particle accelerator, will fire protons at his tumor.

The lingering questions about prostate cancer are helping to fuel a debate over the location of new proton beam centers and the pace of expansion. Experts who believe prostate cancer should be widely treated estimate there could be a need for scores of new centers. Others contend that five to 10 evenly distributed academic research centers could better serve the rare patients who most need protons—and help determine whether the therapy should be extensively used to treat prostate and other common tumors.

"Prostate mill." In suburban Chicago, the two expansion strategies are at odds. Two centers have been proposed within just a few miles of each other. One would be run by Northern Illinois University as an academic facility; the other by Central DuPage Hospital, which has partnered with ProCure. "To roll out multiple facilities competing against each other is illogical and a waste of resources," says Thornton. An Illinois planning board validated that viewpoint in early April when it denied the latter proposal. Thornton adds that bottom-line considerations could turn a for-profit facility into what he calls a "prostate mill."

Central DuPage plans to appeal. The Chicago area has enough demand, including from some prostate cancer patients, to support as many as six proton centers, says ProCure CEO Hadley Ford. With so many cancer patients lacking access to the technology, he says, the country needs a nationwide network of proton facilities, which is exactly what his company plans to build. And while academic proton centers have been slow to get off the ground, he adds, his company is ready to start building today.

Meanwhile, proton beam technology itself is rapidly advancing. The existing American centers are on the verge of upgrading to what's called intensity modulated proton beam therapy, a beam upgrade that will make it more accurate. Also in the works: drastically cheaper and more compact systems, which are crucial for solving the availability problem. One company, Still River Systems, is working on a system that would fit in one room and cost about $20 million. The device is neither finished nor Food and Drug Administration approved, but eager hospitals are already placing orders.