Facilities can get paid $350 for every treatment they do of intensity-modulated radiation therapy, an advanced technology that manipulates beams of radiation to conform to the shape of a tumor, according to the Mayo Clinic.
For proton therapy, that number can range sometimes from $800 to $900 per treatment.
But Keole said the money is not what motivates him. It's the patient outcomes.
Before coming to ProCure, Keole was at the University of Florida Proton Therapy Institute in Jacksonville, Fla.
Initially, Keole didn't believe that proton therapy would be that much better than other types of radiation.
To test that theory, he and his colleagues looked at the outcomes of about 50 patients who were being treated for prostate cancer.
“Do you know how many times a really good (intensity-modulated radiation therapy plan) was better than a proton plan? Zero,” Keole said.
Keole was sold on the anecdotes from these patients. The prostate cancer patients treated with proton therapy were playing golf and leading healthy and active lives and not experiencing side effects such as fatigue, he said.
“Proton therapy is not a fad,” said Keole, who will soon serve as lead proton physician at the Mayo Clinic's Arizona proton center. “It is steeped in science, it makes sense clinically, and let's be honest — if protons cost the same amount of money to install as a regular radiation machine, we would swap all these machines out tomorrow.”
It costs millions of dollars to install and sustain a proton therapy center. For example, ProCure Proton Therapy Center, 5901 W Memorial Road, cost $120 million to build and open.
The Oklahoma City facility was ProCure's first of three centers that are in operation. ProCure also has opened centers in Illinois and New Jersey.
Inside ProCure, there's a 220-ton cyclotron, the core piece of equipment used in proton therapy.
Oklahoma's second cancer center to offer proton therapy will have a different type of equipment that takes up significantly less space and comes at a smaller cost.
Probably by December, the Peggy and Charles Stephenson Cancer Center at the University of Oklahoma will have the Mevion S250 Proton Therapy System.
The system is more compact than ProCure's cyclotron and is estimated to cost between $20 million and $40 million.
Dr. Terence Herman is one of the doctors who will use the machine to treat patients.
Herman, the chairman of radiation oncology at the OU Health Sciences Center, describes himself as a “careful investigator.” He's interested in the biology of proton therapy, but isn't sure what the benefits of the machine will be.
Proton therapy has its advantages, but exactly what those are has not been worked out, he said.
“This place is amazing, and I was just here at the right time,” Herman said. “It is a very wonderful facility. The proton beam may very well add to that. It's going to exist — we bought it. But we're going to study it. That's the thrust of what we're doing, treatment, but research, not just doing the treatment to pay off a terribly large debt.”
Stanley Hupfeld, former CEO of Integris Health, said for hospitals, cancer and heart health are the two most profitable. Everyone wants something in at least one of these fields that will set them apart.
While at Integris, Hupfeld helped build the relationship that still exists between the Integris Cancer Institute of Oklahoma and the ProCure Proton Therapy Center. The two facilities are next to each other on Memorial Road.
“I suspect that OU views itself — and appropriately so — as a tremendous cancer resource, and as such, it wants all the latest tools,” Hupfeld, Integris Family of Foundations chairman, said. “The debate, of course, is — would we do better if we could collaborate in hospitals rather than just compete?”