Conventional radiation delivered from outside the body is a big part of cancer care in the United States. With the help of computers and specialized imaging, it can be a very safe and effective treatment. But proponents of proton therapy say the up-and-coming form of radiation attacks tumors with greater precision and intensity.
So why shouldn't every cancer patient demand it? There is concern that excitement around this technology may be getting ahead of the research.
Zoe Meier could be any typical 10-year-old. She likes video games, stuffed animals and singer Taylor Swift. But her life is far from ordinary right now. Monday through Friday she climbs on a table and gets what is considered to be the cutting edge in cancer treatment: proton therapy. She is among one of the first patients now being treated with this form of radiation in suburban Warrenville.
The $160 million center built by Central DuPage Hospital and ProCure Treatment is one of only nine in the United States. Just about a month ago it began treating patients.
"She shows no side effects at all. She gets dropped off at school after the treatment," said Carl Meier, Zoe's father.
Meier has a brain tumor called a ganglioglioma. She's had surgeries and chemotherapy. Now, doctors are hoping proton therapy will not only keep the tumor from coming back but will spare healthy tissue and save her from side effects later in life.
"The ultimate tool in the battle against cancer. We are able to deliver treatment with sniper-like precision as opposed to a shot-gun approach," said Dr. John Han-Chih Chang, radiation oncologist, Central DuPage Hospital Proton Center, a ProCure center.
Radiation destroys cancer cells by messing up their DNA. Proton beams differ in the way they deposit energy. Standard radiation gives off energy all the way through its path. Advocates say proton beams can unleash their power mostly within the tumor.
"As it stops at the tumor, it transfers all of its energy at the tumor like a controlled explosion, and there is no energy given off beyond the tumor," said Dr. Chang.
Proton therapy has been around since the 1950s, but it's still not a commonly used treatment. It's used on children with many cancer types. It's also used on adults to treat tumors in areas around vital organs, such as the brain the spine and prostate. But there's still disagreement about whether it is better than other forms of radiation.
"If it was a panacea that could treat and cure everything, you would see it all over the place," said Dr. Das Gupta, director of radiation oncology for Edward Cancer Center.
Dr. Neil Das Gupta says standard radiation has a proven track record. It's what Rodney Blauser chose to fight his lung cancer.
"They have been using it for many years, so I figured, go with the experience," said Blauser.
Some oncologists agree proton therapy may be the right choice for some patients. But skeptics say there won't be any proof its better until it's compared head to head with traditional radiation.
Another big catch: it's expensive -- anywhere from two and a half to three times the cost of standard radiation.
"I think it becomes difficult to recommend. Some go for a much more expensive treatment to get the same result," said Dr. Das Gupta.
The Meier family was thrilled to even have the proton option so close by.
"For us, it was the perfect fit at the perfect time," said Zoe's mother.
As more proton centers emerge, the treatment may be offered to a wider range of patients with more common tumors.
Skeptics worry this will be more about generating business as opposed to good medicine.
Dr. Chang at the CHD ProCure center says they don't treat just anyone, and they have already been redirecting patients to conventional radiation when it is more appropriate. And even though the center is for profit Dr. Chang says the Warrenville center will be participating in research studies.
CDH Proton Center/ a ProCure Center
4455 Weaver Parkway
Warrenville, Il. 60555
Edward Hospital & Health Services
801 S. Washington, Naperville, IL 60540
Neil A. Das Gupta, M.D.
Director of radiation oncology for Edward Cancer Center
National Cancer Institute