Proton - Mayo

An interesting Proton Beam - Mayo article in today's paper, so much for proton going away.

The part of interest to us would be "For our prostate patients, it used to be 40 treatments," she said. "It's now five treatments — one eighth of the length of time." Sound like SBRT with a different machine.

Hope this link works for a while

https://www.startribune.com/mayo-announces-200-million-expansion-of-proton-cancer-therapy-center/600088339/

Just did a check and found there are currently 38 operating Proton Therapy Centers in the US and 3 currently under construction. Worldwide there are 89 in operation and 42 under construction

I found it interesting in the article Mumbo cited that Mayo treats about 900 people a year. Assuming 30 fractions each that is some 27,000 fractions in a year or about 108 per weekday. However there are numerous reports over the last 5 years showing significant overcapacity with generally low utilization. For example, the Proton Center here in Atlanta opened in December 2018 and reports it is on schedule to treat 300 patients this year. It has five treatment rooms that can operate simultaneously so that is only about 7 per room per day. Very underutilized at this point as the capacity is several times that.

Essentially third party payors limit reimbursements to mainly pediatric cancers and where the radiation is needed in close proximity to vital organs that would be easily damaged. Brain, nasal-pharyngeal, eye, are good examples of the utilization. So limited reimbursement is not just PCa, but many other cancers, as well. Particularly the more common like breast cancer. It remains that most centers must charge a much higher price than photon due to the very significant cost of the Proton centers versus Photon. A Proton center costs at least $300 million and for that you could build 10-20 photon centers depending on how many Linac machines are utilized.