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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (16781)	4/13/2010 11:56:56 AM
From: John Koligman	Read Replies (2) \| Respond to of 42652

Wait till these start coming online in force... The $150 Million Zapper David Whelan and Robert Langreth, 02.25.09, 06:00 PM EST Forbes Magazine dated March 16, 2009 Does every cancer patient really need proton-beam therapy? The University of Pennsylvania's new radiation therapy center is costing $144 million to build, is the length of a football field and contains some of the most complex and expensive medical machinery ever built. It is either a godsend to patients with intractable tumors or a stunning example of runaway health care costs. Or both. The output of the exotic machinery is a proton beam, the latest way to zap away malignancies. In one room sits a cyclotron--220 tons of metal shaped like a hockey puck. The cyclotron's magnets and electric fields can accelerate subatomic particles to 60% the speed of light. It fires the protons through 100 yards of computer-guided piping into five treatment rooms. While a patient lies on a bed, a 33-foot-high, 100-ton motorized gantry spins around to zap tumors from the most effective angle. Protons kill tumors just as X-rays do in the more conventional variety of radiation treatment, but in theory the protons are far more precise; they can release most of their radiation right onto a tumor and nowhere else. Supposedly proton machines will slash side effects and allow for higher doses that will cure more patients. "You will be able to do things with protons that you can't even conceive of now. It's the radiotherapy of the future," boasts radiation oncologist and entrepreneur James Schwade, who is raising money to build a proton treatment center at the University of Miami. Penn's proton center, when it opens this fall, will be the sixth such center in the country. Four other proton-beam machines are under construction, and at least that many more are in various stages of planning. Penn's center was built with a $15 million donation from the Roberts family of the Comcast (nasdaq: CMCSA - news - people ) cable fortune, plus money from Penn's affiliated hospitals and the government. But most of the $1.5 billion that has been sunk into or committed to building proton centers has come from investors hoping to make a profit. Even the proton center at the august M.D. Anderson Cancer Center in Houston is mostly owned by various investors. (The other existing centers are at the University of Florida, Indiana University, Massachusetts General Hospital and Loma Linda University Medical Center in California.) Protons offer advantages in certain rare spine, brain and eye tumors, as well as with kids, whose tissue is highly sensitive to stray radiation. Yet scientists have never proved in controlled clinical trials that protons work better or more safely than conventional therapies on common tumors. The cost controversy has especially erupted over their use in prostate cancer. Treating most prostate patients with protons "probably is not worth it," says Massachusetts General Hospital radiation oncologist Anthony Zietman. "There are perfectly good, much less expensive alternatives," such as surgery, X-rays and implanted radioactive seeds. Winifred Hayes, a nurse whose research and consulting firm evaluates medical technologies for insurers and hospitals, says the proton-beam construction boom is driven more by a technology arms race among hospitals than by compelling medical evidence. "At a price tag of $150 million, the public deserves to have this question answered," she says. X-ray radiation therapy machines cost $3 million each; a big clinic would have several. But patients are used to getting what they want, especially in cancer care, where any chance at living longer with fewer side effects is worth trying, especially if someone else is picking up the tab. Schoolteacher Mark Chalupsky of Carver, Minn. feared that prostate cancer surgery would render him incontinent, so he went to Florida last summer to get protons instead. "I had no side effects," he says. "I would play golf and go to the beach" after treatments. Medicare pays twice as much for a round of protons as for X-rays: $34,000 for eight weeks of therapy versus $16,000. Private insurers also cover protons, though they often require preapproval.