Proton therapy is an ultra-precise form of radiation that spares patients excess radiation to the heathy tissues and organs surrounding their tumor.
It has been shown to be effective in reducing short- and long-term side effects and improving health outcomes for adults and children with a wide range of cancer types. It is particularly effective in treating tumors near sensitive organs, which is why it’s recommended for certain prostate cancer patients.
Despite prospective evidence with over a decade of follow-up demonstrating its safety and efficacy, proton therapy up until recently has been designated “experimental,” which makes it less likely for some payers to cover the treatment for patients, restricting access to the very important treatment option.
A new consensus statement from the Particle Therapy Co-Operative Group (PTCOG) may broaden the use of proton therapy to treat prostate cancer, which might improve patient outcomes and quality of life.
In the article Consensus Statement on Proton Therapy for Prostate Cancer, which analyzes the decades of data we have on proton therapy, the researchers demonstrate why proton therapy should no longer be considered an “experimental” treatment for prostate cancer.
It is not correct to refer to proton therapy as “experimental” for a condition we know it treats highly successfully..
This report is significant because it is the first time a group of genitourinary oncology experts have come together and gone on record officially stating that the body of academic research supporting the efficacy of proton therapy for prostate cancer has reached a point of critical mass. It is not correct to refer to proton therapy as “experimental” for a condition we know it treats highly successfully.
This statement is a line in the sand for the industry; hopefully it can help us move the conversation forward with patients, providers, and payers in a productive way that makes proton therapy more widely available for appropriate patients.
The PTCOG report is a good start, but governing bodies must join the PTCOG Genitourinary Subcommittee in changing their designation for the use of proton therapy for prostate cancer. In addition to the three-plus decades of existing research, even stronger data are on the way.
We know proton therapy is an effective treatment for prostate cancer, but the real question is can it deliver better results than conventional radiotherapy?
Randomized evidence in other disease sites report reduced side-effects with protons compared with traditional radiation therapy, leading to improved quality of life with proton therapy, but those metrics are complicated to measure and require more dedicated and detailed studies to make definitive claims about superior efficacy.
Thankfully, there is an ongoing, randomized study conducted in partnership by 55 cancer centers across the country that should give us a better understanding of the efficacy of proton therapy when directly compared with traditional photon radiotherapy.
We hope that studies like this will provide the evidence to satisfy the stringent requirements of certain payers and even some providers who, despite the existing evidence of high efficacy and low rates of toxicities, are unsure of the benefit of proton therapy for patients with prostate cancer.
These types of studies analyze important factors with granular data, and not just the subjective physician-reported toxicities, but also patient-reported quality of life metrics.
Prior studies using such metrics have suggested a benefit to bowel function and reduction in toxicities with proton therapy compared with traditional radiation therapy, and future studies will help further determine which patient population could benefit the most from protons.
The good news is proton therapy is getting less expensive. With few side effects, proton therapy can often be delivered in fewer treatments than has historically been delivered with traditional radiation therapy. Furthermore, the costs of building proton therapy centers has continued to decline over time.
As the cost of proton therapy gets closer to traditional photon radiation, as the equipment, technique and processes improve proton therapy outcomes, and as additional long-term data are published showing the benefits of proton therapy over traditional photon therapy, there is a lot of excitement and many indicators that proton therapy access will continue to broaden.
Our team at the New York Proton Center is working with cancer centers across the country to help patients and deliver clinical results that will help determine the important role proton therapy plays in the prostate cancer landscape.
But in the meantime, it is really important to shine a light on the new PTCOG consensus statement to keep the momentum going in the direction of furthering the role of proton therapy for patients.
