Source: http://cbsnews.com/stories/2008/03/19/eveningnews/main3952728.shtml

NEW YORK, March 19, 2008

(CBS) “I am the mother to a beautiful 30-year-old woman, she was diagnosed with a meningioma tumor,” said Glenda Wimberly.

When Rianta Wimberly started going blind from an inoperable brain tumor, her mother Glenda got on the Web, found a radiation treatment called proton beam therapy and sent a desperate email to doctors at Massachusetts General Hospital, CBS News’ Dr. Emily Senay reports.

“She has lost her peripheral vision and is experiencing difficulty seeing,” Glenda wrote.

Just weeks later, Rianta was getting the therapy and the tumor was shrinking.

“With four treatments left, I have 98 percent of my vision left,” Rianta said.

And with no side effects. That’s because proton beam radiation is highly targeted - delivering its dose only to the tumor and sparing the surrounding tissue, which is important for certain rare cancers.

“It’s a real delight to be able to offer patients proton therapy you see that during the treatment they have less side effects,” said Jay Loeffler, the chair of radiation oncology at Massachusetts General Hospital Cancer Center.

But proton beam therapy is at the heart of the debate over rising health-care costs. It’s the most expensive device in medicine today.

The technology is two decades old, but Mass. General is one of five proton centers, and there are eight others in the works.

The massive facility at the University of Pennsylvania - soon to be the world’s largest - will cost $140 million.

“This is three stories. This gantry that spins around the patient; this rotates completely around the patient,” said Dr. James Metz of the University of Pennsylvania Abramson Cancer Center.

It’s total weight?

“Close to a million tons of equipment,” Metz said.

A giant machine called a cyclotron produces the radioactive particles called protons.

“So this is the cyclotron itself, this is a 200-ton piece of machinery that accelerates the protons to 230 million electron volts,” Metz said.

Huge magnets direct the beam of radiation the length of a football field into treatment rooms.

“Now we’re leaving the cyclotron area and walking along the beam line,” Metz said. “The beam will travel thru these magnets and that will steer the beam into the different rooms.”

Radiation oncologist Dr. Richard Stock, of Mt. Sinai Hospital, says competitive pressure is driving the building boom.

“It’s kind of a vicious cycle because if one center opens up, other centers and other hospitals surrounding it have to try to compete for patients,” Stock said.

And while there’s little disputing the value of proton beam for certain rare cancers, increasingly it is being used for more common cancers like prostate. At double the cost of standard treatments, many experts say it’s being used without proof it’s more effective.

“There is no good evidence, medical evidence that it is better than the current state of the art intensity modular radiation therapy,” Stock said.

Is this a better treatment for adults than conventional?

“In my opinion it’s a better treatment. the bigger issue though is, is the increased costs associated with protons worth it to society? in my opinion it’s worth it if we can reduce the initial costs of building proton centers,” Loeffler said.

But while the cost is extraordinary … so are the results for this family.

“This was my only option, thru unbreakable faith I’m here,” Rianta said.

Glenda said: “She has unbreakable faith, I have unspeakable joy.”

URL: http://palmbeachdailynews.com/news/content/news/UPenn0309.html
By
Daily News Staff Writer

Sunday, March 09, 2008

Sometimes it takes a really big machine to produce thousands of small miracles.

Next year, a 220-ton particle accelerator — shipped from Belgium in January — will go online at the University of Pennsylvania’s Abramson Cancer Center. When opened, the Roberts Proton Therapy Center will be the sixth such facility in the country, the only one in the mid-Atlantic region and the largest in the world.

Most important to cancer patients, the massive device will be the driving engine for five treatment rooms — where oncologists will use proton radiation to treat 3,000 cases of cancer a year. Traditional radiation therapy goes through a tumor, damaging normal tissue behind it, according to the proton therapy center director, Dr. Stephen Hahn.

“It’s estimated there is about a 50 to 70 percent reduction in radiation doses to normal tissue with protons,” Hahn said before a Penn Medicine symposium Tuesday at The Colony. “We expect there will be a lot of reductions in normal side effects. Patients will benefit from just that alone. But you can imagine, if we can give (a reduced) dose to normal tissue, we should be able to increase the dose to tumors and potentially cure more tumors with radiation,” Hahn said.

The proton therapy center will be connected to the 360,000-square-foot Perelman Center for Advance Medicine. Ray and Ruth Perelman of Philadelphia and Palm Beach provided the $25 million lead gift for the outpatient facility, which uses a team-based approach to cancer diagnosis, treatment and prevention at a single site, according to Dr. Craig Thompson, director of the Abramson Cancer Center.

“That really allows us to make a patient-centric form of care that really doesn’t exist,” Thompson said. “Most of the time when people are diagnosed with cancer, they run from physician’s office to physician’s office. Here we have all the services in one place.” The Perelman Center is set to open later this year.

According to Penn Medicine, the proton therapy center will be the first in the world located at a top academic medical center.

Vaccines for cancer

Dr. Carl June said Penn researchers are investigating vaccines for leukemia, myeloma and other cancers. Penn Medicine is supplying white blood cells to the Moffitt Cancer Center in Tampa for a human trial of a potential vaccine for lung cancer. That trial started this month, June said.

The first successful cancer vaccine is Merck’s Gardasil, which can protect women from acquiring the two types of the sexually transmitted human papilloma virus (HPV) responsible for most cases of cervical cancer.

“Right now, the major reason people die from cancers is not because you can’t control the initial tumor. It’s that cancer spreads or metastasizes and becomes resistant to chemotherapy,” June said. “So where vaccines like this will have a real impact is to prevent that metastatic spreading from occurring, that chemotherapy and surgery can’t deal with. So I think it will be used in conjunction with surgery and radiation therapy and prevent reoccurrences.”

Private dollars important

June and Thompson emphasized the importance of private philanthropy in supporting emerging research. Thompson thanked the Perelmans for their support.

“That lead gift allowed us not only to start the project, but more importantly it gave confidence to a lot of other people in the Philadelphia area that this project would be seen through to the end and join in philanthropy. They are really the philanthropic leaders of our community and so we are very indebted to them.”

The cost of constructing and equipping the Perelman Center and the Roberts Proton Therapy Center is about $450 million, Thompson said.

Central DuPage says there’s enough demand for 2 proton-therapy sites, but school objects

URL: http://chicagotribune.com/news/local/…
By Greg Canfield
March 6, 2008

A week after getting state approval to build a proton-therapy cancer-treatment center in West Chicago, Northern Illinois University officials on Wednesday blasted Central DuPage Hospital’s plan to build another, arguing it is motivated by greed and the facility is not needed.

In a hearing before the Illinois Health Facilities Planning Board, hospital officials and their corporate partner, ProCure Treatment Centers Inc., said NIU came out against the $140 million proton-therapy facility to prevent competition. NIU officials, whose project is a non-profit venture, said ProCure’s goal is to make money.

In early April, the board will rule on Central DuPage’s application to build the center in Warrenville.

NIU Vice President of External Affairs Kathy Buettner pointed out that only five proton-therapy centers exist in the U.S., 20 years after the technology was discovered. She noted the proton-therapy center in Loma Linda, Calif., advertises for patients in the Midwest, and she views this as proof that two centers only 6 miles apart cannot possibly operate successfully.

“We stand ready and able to treat the very patients CDH/ProCure would treat at its proposed site,” said Buettner, who described Central DuPage’s proposed project as duplicative and premature.

NIU Executive Vice President Eddie Williams said ProCure is exaggerating the demand for proton therapy by including prostate cancer patients when it has yet to be proven that the technology is a panacea for the disease.

Physicians say proton therapy is generally superior to X-rays because its energy can be more finely directed at a cancerous tumor. The treatment also releases less energy into the body and causes less damage to surrounding healthy tissue, which doctors say is especially beneficial to children.

Rob Rederer, a Schaumburg resident, urged the board to approve another proton-therapy center because there are not enough of them to meet the need, he said. He said his daughter has battled brain cancer for years, but only recently was able to start proton therapy at a facility in Bloomington, Ind.

“We’ll never know what would have happened if she had received proton therapy right away. We need to do everything we can to ensure there are enough treatment centers close to home,” Rederer said.

Dr. Jay Loeffler of Harvard Medical School explained that many patients are turned away from proton-therapy centers due to lack of capacity. He believes the Chicago area could support five or six centers, especially when proton therapy becomes cheaper.

“I’m a firm believer that proton therapy can be made less expensive,” he said after his testimony. “The issue here is not whether the Chicago area can support two centers. If one of these centers were downtown, we wouldn’t even be having this discussion.

The issue is that these centers are just 6 miles apart, but I’m sure you will see patients from the city using them.”

Dr. James Cameron, president and CEO of ProCure, acknowledged that proton therapy is not the most effective treatment for all types of cancers but said thousands of patients could still be helped.

He cited National Cancer Institute data that show about 180,000 people living within 250 miles of Warrenville will be diagnosed with cancer annually.

NIU officials say their research shows those numbers are inflated.

More information:

• Taking sharper aim at cancer
• Northern Illinois Proton Treatment and Research Center
• Proton Therapy Center of Central Du Page Hospital
• Council Passes Resolution in Support of Proton Therapy Center
• ProCure Treatment Centers, Inc.

NIU will build state’s first proton-therapy center in West Chicago, but another treatment site is proposed nearby
http://chicagotribune.com/news/local/northwest/…

By James Kimberly | Tribune reporter
February 27, 2008

Northern Illinois University won state permission Tuesday to build a $160 million proton-therapy cancer-treatment center in West Chicago, the first such facility in Illinois, but another is proposed only 6 miles away.

The Illinois Health Facilities Planning Board approved the DeKalb university’s ambitious plan to build the 130,000-square-foot cancer-treatment and research center in the DuPage National Technology Park.

Proponents of proton therapy believe it holds tremendous potential to treat cancer with radiation. Besides bringing the treatment to the Chicago area, the project will spur research and development and be an economic boon, NIU officials said.

“We are talking about something that is absolutely unprecedented,” said Cherilyn Murer, chairwoman of the NIU Board of Trustees.

Central DuPage Hospital and partners want to build a similar $140 million facility in Warrenville. There are five proton therapy facilities in the United States and 24 worldwide.

Although NIU does not have a medical school, officials said it has a strong tradition in accelerator particle physics research, so it makes sense for the school to open a cancer-treatment center. NIU said it is negotiating an agreement with physicians from Northwestern University’s Feinberg School of Medicine to provide clinical services at the center.

The center, which NIU agreed to build in two years, faster than one has ever been built, will treat as many as 1,500 patients a year when it is operating at capacity. It will have a strong emphasis on research by the school’s accelerator particle physics and engineering departments, officials said.

Although NIU intends to pay for the project primarily with tax-exempt bonds, federal and state grants also will be used.

Physicians say the therapy is superior to X-rays because its energy can be more finely directed at a cancerous tumor. The therapy also releases less energy into the body and causes less damage to surrounding healthy tissue, they say.

“The big promise of protons is we can treat where we want to and miss basically everything else,” said Dr. Bill Hartsell, president of Radiation Oncology Consultants, a physicians group that is an equity partner in the Central DuPage Hospital project. “Where this has been used most is in children and patients with brain tumors.”

Christal and Chris Bemont of St. Charles credit proton therapy with saving their daughter Brooke, 10, from a cancerous brain tumor. The Bemonts went to Boston for proton therapy at Massachusetts General Hospital last fall.

Christal Bemont said they sought the treatment after Brooke’s oncologist warned her about potential side effects from X-rays, saying, “All I can say is don’t expect Brooke to go to Harvard.”

But after five weeks of proton therapy, Brooke’s tumor is gone and she has suffered few noticeable side effects, her mother said.

“She came back on Oct. 9 from Boston. She went to school on Oct. 11 and she’s been in school ever since,” Bemont said. “It’s remarkable to see how much of a 10-year-old kid she is after everything she’s been through.”

Central DuPage’s corporate partner says the potential for proton therapy as a cancer treatment is so great that two facilities can serve the roughly 60,000 new cancer patients diagnosed annually in Illinois.

NIU is not so sure. The university has asked the health board, which regulates health facility expansions and major medical equipment purchases in the state, to reject Central DuPage’s application. The board is scheduled to consider the application April 8 and 9.

“I think there is a market for one facility. I just would be very, very skeptical of two coming into the market at the same time,” said John Lewis, an NIU associate vice president overseeing the university’s project.

After announcing it would build a proton-therapy facility, Alexian Brothers Hospital in Arlington Heights decided against it, saying there were not enough cancer patients in Illinois to support several centers. The hospital withdrew its application from the state board.

Central DuPage has partnered with ProCure Treatment Centers for its proposed proton-therapy facility, which also could treat about 1,500 patients a year when operating at capacity. ProCure has secured private funding.

John Henderson, chief operating officer of ProCure, said there are more than enough potential patients in Chicago for two facilities. Central DuPage has provided letters with its application from 12 radiation oncologists who said they would refer more than 1,100 patients to the facility a year.

“We believe there should be more than two of us talking about it,” Henderson said. “There could be as many as seven or eight of these facilities just here in the Chicago area to service people as you look over time.”

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