Last month, scientists at the Fermi National Accelerator Laboratory here unveiled the first proton beam accelerator built for hospital use. When the machine is ready for operation next year at Loma Linda University Medical Center near Los Angeles, many believe it will prove itself a major breakthrough in the wan on cancer.
Others, however, think the proton accelerator is a white elephant. They complain that its untested medical benefits and enormous price make it the ultimate example of medical technology run amok. Some doctors say proton therapy will prove useless in the treatment of most cancers.
It is unquestionably the most expensive piece of medical equipment ever built. The cost—$40 million, including the special building needed to house the machine—dwarfs the cost of the next most expensive medical device: the Positron Emitting Tomography scanner, which shows metabolic activity within the brain and can cost about $5 million.
Protons were first suggested as a potential cancer therapy in 1946 by Robert Rathbun Wilson, who established the Fermi National Accelerator Laboratory. But it wasn't until the 1970s that patients were first exposed to protons in physics labs at Harvard University, the University of California at Berkeley, at Fermi and at several institutions abroad.
In physics labs cluttered with cable and oscilloscopes, physicists have seen some spectacular results using physics research machines moonlighting to treat cancer patients.
At Harvard, where 174 patients with malignant tumors at the base of the brain have been treated, the therapy has had an 85% cure rate, compared with 35% cure rate for conventional therapies. (Patients in remission or cancer-free for five years are considered cured.)
The beam is virtually useless in cancers that have spread beyond the original site. Such metastacized (sic) cancers account for more [than] two thirds of all malignancies says [one] radiation oncologist.
"There's some usefulness, no doubt about it. But the candidates for proton therapy are limited. . . . It won't make a major impact on the cure rates for all cancers. It will make a little dent, but it will cost a lot to make that dent.
Compact proton accelerator for cancer therapy