Cancer fight goes nuclear

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... With Heavy Price Tag

NYT: Hospitals Chase a Nuclear Tool to Fight Cancer

Medical centers are rushing to turn nuclear particle accelerators, formerly used only for exotic physics research, into the latest weapons against cancer.

Some experts say the push reflects the best and worst of the nation's market-based health care system, which tends to pursue the latest, most expensive treatments — without much evidence of improved health...

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Pummeling Cancer With Protons

Proton radiation therapy is potentially a better way to treat cancer because it has fewer side effects, but the technology is still very expensive. The University of Florida Proton Therapy Institute took eight years and $125 million to build, and it can serve up to 150 patients a day.

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The For-Profit Side of Cancer Treatment

The promise of profit from proton therapy equipment presents financial and ethical quandaries for the nonprofit and academic medical communities...

Investing in Treatment, With Eye on Returns

LOS ANGELES — To doctors visiting his company's booth at a recent medical meeting, Scott Phillips extolled the medical virtues of the company's equipment for treating cancer with protons. But he also appealed to their financial interests.

With enough patients "it becomes a very lucrative system," Mr. Phillips, a sales manager with Optivus Proton Therapy, said at the meeting of the American Society for Therapeutic Radiology and Oncology held here in late October. Referring to one proton center that treats up to 175 patients a day, he added, "You can imagine what the return on investment is on that."

It is not a bad return, either, for the companies that make and sell the equipment, which can cost as much as $60 million. The market leader appears to be Ion Beam Applications of Belgium. Others include Hitachi of Japan and Siemens of Germany. Varian Medical Systems, a leader in X-ray equipment, acquired a proton equipment company, Accel, earlier this year.

Other companies help finance, build and operate the facilities. The most well known, ProCure Treatment Centers, is signing up community hospitals and even private medical practices. The hospitals or doctors get a small ownership stake, and therefore a small part of the profits, while directing the medical treatments.

ProCure's first project is an estimated $100 million setup being built in Oklahoma City by two medical practices with a total of six radiation oncologists. Some wealthy local residents, led by Aubrey McClendon, who runs a big natural gas company in the area, invested $35 million in ProCure. The company then arranged the rest of the financing through two Belgian banks that do business with Ion Beam Applications, the equipment supplier. Financing the proton centers has been a challenge even for big academic medical centers, which have taken different approaches. While M. D. Anderson Cancer Center is part of the University of Texas, its proton center is not. To avoid endangering the university's credit rating, the proton center is a separate, for-profit entity. M. D. Anderson staffs the facility, but owns only 15 percent. The rest is owned by various investors recruited by a Houston investment bank. In a more traditional approach, the University of Pennsylvania 's $140 million proton facility, now under construction, will be part of a nonprofit medical center. It is being built with the medical center's own money and donations, including $15 million from Ralph J. Roberts, the founder of Comcast Cable, and his son, Brian, who now runs the company. Children's Hospital of Philadelphia will also chip in for a 15 percent stake.

Timothy R. Williams, former co-chairman of the radiation oncology society's health policy committee, said in a talk at the October conference that the profession was threatening to debase itself if doctors were building centers for the money or competitive advantage.

"Plenty of programs," Dr. Williams said, "are doing it for the wrong reasons."

By ANDREW POLLACK
December 26, 2007
Posted in NYT Business for registered members.