Dr. Bruce Haffty, the president-elect of American Society for Radiation Oncology, said more research is needed to determine what patients would benefit most from proton therapy.
At this point, for a majority of breast cancer patients, proton therapy has yet to prove itself better, he said.
Haffty said if he had a patient who might experience a higher dose of radiation to the heart and lungs than what he thought was healthy, he would consider proton therapy.
“But I think one of the problems is, if we just do it because we think, ‘Well, this might be a little bit better,' without doing a fair comparison, we end up just using a technology because it's available, not because it's better,” he said.
Haffty said even though proton therapy among adults is debated, the benefit of treating children with cancer is clearer. Children have organs and bones that are still growing, and the theory that radiation could cause long-term side effects is less of an argument.
“For a breast-cancer patient who is fully grown, one where ... it's not a deep-seated tumor, but where you can get good dose distribution with current technology, demonstrating that protons — which are going to cost perhaps three times as much or more to deliver the same radiation — even if the dose distribution looks a hair better, is it really worth doing?”
Proton therapy is generally more expensive than other cancer treatments.
Haffty said 30 proton therapy treatments can range upward of $60,000 for treating any type of cancer.
Meanwhile, the average cost of intensity-modulated radiation therapy for breast cancer was $19,388, compared to $4,104 for 3-D conformal radiotherapy, or almost five times more expensive, according to the Center for Healthcare Research and Transformation.
Bye's insurance covered her treatment, and she said she wasn't left with a large financial burden.
But this is not always the case for patients.
David Raubach, the finance manager at ProCure, said the company is currently working with insurance companies to determine coverage.
He said he wasn't aware of anyone who had come in for proton therapy for breast cancer who did not have insurance.
ProCure works with patients to ensure cost isn't a barrier, and the company has financial assistance patients can apply for. Also the company has local charities to cover the cost of treatment.
“Basically, we do everything we can that, if a patient doesn't have insurance coverage, we're going to do everything we can to make sure that patient can still get treated and not have price be a burden,” he said.
For now, each patient's case must be individually approved by their insurance company. Raubach declined to release information about how much private insurers pay for proton therapy, saying it was confidential information between ProCure and the insurance company.
“Our plan for breast cancer coverage is to be competitively priced with other treatment modalities, whether that's MammoSite or IMRT,” he said. “Our goal and what we have presented to insurance companies is we will be competitively priced with those modalities.”