Proton Therapy to Treat Cancers

choi

(1) Taiwan’s 1st Proton Therapy Center Opens in New Taipei. Taiwan Today, Nov 11, 2015
("The NT$5.4 billion (US$165.1 million) facility boasts four proton treatment and 10 X-ray treatment rooms, and is capable of providing linear accelerator treatment to 3,000 and proton beam treatment to 1,500 patients annually, according to CGMH" (Chang Gung Memorial Hospital in Linkou District, New Taipei City 林口長庚醫院 質子暨放射治療中心))

Note:
(a) Sumitomo supplies the equipment. Sumitomo's proton therapy system cleared America's FDA in 2013, and has sold less than ten worldwide, mostly in Japan.
(b) China also offers proton therapy.

(2)
(a) I have no idea why the Chang Gung "facility" costs it US$165.1 million. Pay attention to the "facility,"-- not just the equipment/ system for proton therapy and including the new building etc.
(b) Hitachi supplies the proton therapy equipment to Johns Hopkins Hospital. See Hitachi Sells Cancer Treatment Tech to Washington Hospital. Nikkei Asian Review, June 11, 2015
asia.nikkei.com/Business/Companies/Hitachi-sells-cancer-treatment-tech-to-Washington-hospital
("Worth slightly more than 10 billion yen ($81.4 million), the order includes 10 years of operating and maintenance fees. Hitachi will outfit three treatment rooms and one research room at Sibley Memorial Hospital, which is affiliated with Johns Hopkins University School of Medicine")

So, the "$81.4 million" is more than the equipment itself.
(c) Three proton beam facilities are within 40 miles in DC-Baltimore. They are
Johns Hopkins’ Sibley Memorial Hospital,
Georgetown University Hospital (both in DC), and
University of Maryland medical center in Baltimore.
(d) Jenny Gold, Proton Beam Therapy Sparks Hospital Arms Race. NPR, May 31, 2013
http://www.npr.org/sections/heal ... -hospital-arms-race

Quote:

"The local government in Washington, DC, is on the verge of approving two proton beam facilities at a total cost of $153 million. The centers would be owned by the two dominant hospital systems in the area: Johns Hopkins Medicine and MedStar Health [which includes Georgetown hospital].  

"The Baltimore facility is a giant cement-encased building the size of a football field, with a price tag of more than $200 million. It's being funded by for-profit developer Advanced Particle Therapy. At its heart sits a 90-ton piece of equipment called a cyclotron, which accelerates protons until they're whizzing around at two-thirds the speed of light.

* There is no need to read the rest of the NPR report. I merely want to show you what Chang Gung pays for the facility is not out of line.

choi

(3)
(a) Allison Connolly and Andrea Gerlin, Proton-Beam Cancer Sites to Get $380 Million From UK. Bloomberg BusinessWeek, July 31, 2013
www.bloomberg.com/news/articles/ ... 0-million-from-u-k-

Quote:

"The UK government set aside 250 million pounds ($380 million) to build two proton-beam cancer therapy centers [in London and Manchester] * * * The UK’s state-run health system has been sending about 100 patients a year to the US for the radiotherapy, which is used to treat hard-to-reach cancers. The National Health Service estimates it can cut treatment costs in half by building its own centers.

"Evidence for proton therapy’s benefit is limited, except in pediatric brain and spinal tumors, where research has shown it reduces damage such as cognitive decline and deafness.

* There is no need to read the rest of the BusinessWeek report.
(b) Melinda Beck, Big Bets on Proton Therapy Face Uncertain Future. Wall Street Journal, May 27, 2015.
www.wsj.com/articles/big-bets-on ... n-future-1432667393
("positively charged particles are accelerated to 60% of the speed of light, then shaped into a powerful beam that can be programmed to deposit most of its energy directly onto a tumor, minimizing radiation exposure to surrounding healthy tissues. While proton therapy isn’t necessarily better at halting cancers, proponents say it sharply cuts side effects that can add substantial costs")

choi

(4) science
(a) Mevion Medical Systems Inc
http://www.mevion.com/

In the top horizontal bar, click the tab "THE SCIENCE" and read both "Radiation Therapy" and "Proton Therapy."
(b) In "Proton Therapy," the figure is not explained. Thus please read
(i) particle therapy
https://en.wikipedia.org/wiki/Particle_therapy
(A) Neither X-ray or electron is within the definition of particle therapy. X-tau is electromagnetic wave, also photons. A proton is a hydrogen atom stripped of an electron (which is also protons are created in proton therapy).
(B) View the figure. Increasing energy of X-ray is not particularly helpful to reach a deeper target. That is not the case for proton therapy, where one can adjust the proton beam for teh depth, causing some damage to the tissue BEFORE the target but NOT after the target.
(ii) Bragg peak
https://en.wikipedia.org/wiki/Bragg_peak
(named after a British physicist)

The text explains Figure 2 this way: "The blue curve in the figure ("modified proton beam") shows how the originally monoenergetic proton beam with the sharp peak is widened by increasing the range of energies, so that a larger tumor volume can be treated."

* Both X-ray and proton therapy damage DNA--hopefully that of cancer cells, not of normal tissues.
* Proton therapy is indicated for a single solid tumor only. It should not be used in case of metastasis.