“There is no doubt it’s shown to be safe and effective for many kinds of cancer,” said Jason A. Efstathiou, assistant professor of radiation oncology at Harvard Medical School and Massachusetts General Hospital, which has had proton therapy since 2001. “The question is, is it better in every indication than other options?”
The treatment’s superiority for treating prostate cancer “hasn’t been proven” because of a lack of rigorous clinical trials, Efstathiou said. Now, Massachusetts General and the University of Pennsylvania are conducting a five-year trial comparing proton treatment and conventional radiation for the disease. “If it’s better, does it justify any additional cost, and if so, by how much?” he said.
Even with the unsettled questions, the technology could be a potent marketing tool for the two hospital systems. Columbia-based MedStar Health, which is the region’s largest health system, operates 10 hospitals in Maryland and the District. Hopkins, based in Baltimore, has in recent years pushed aggressively south to Washington, acquiring Surburban Hospital in Bethesda and then Sibley in Northwest. During two public hearings on their plans, the hospitals traded jabs on everything from which hospital would better serve the poorest of the District’s residents to the type of beam technology used in their projects.
Neither design is now being used to treat patients in this country. Each hospital system is financing its own project.
A preliminary agency report by the D.C. health planning agency found that both hospitals had demonstrated a need for proton services in the District, which has some of the highest cancer rates in the country.An advisory committee to the agency is set to vote at an April 18 meeting; a final decision by Selassie is expected in May.
MedStar Georgetown officials estimate that they would treat about 300 patients a year, including about 50 children, focusing on nine tumor types, including prostate, spine and brain. The average patient would need about 28 treatments, at an average cost of about $1,700 a treatment, or about $48,000.
Health planning officials have questioned whether MedStar Georgetown’s program has the capacity to handle referrals from other hospitals. MedStar Georgetown officials said that they could and that they also could apply for permission to build a second facility, perhaps at MedStar Washington Hospital Center — but that they don’t think that would be necessary.