Was saving these notes in my files but the story was entertaining enough that it reminded me I have a public notebook I should use for more of my notes. (And then I put some effort into making my notes comprehensible to others and it reminded that I shouldn’t waste time making my notes public.)
Anthony Zietman (British clinician sci @ Harvard) v fun on proton beam therapy.
Anthony Zietman now at #ncri2017 on #ProtonTheray – starting with why it's so brilliant… on paper. Tissue sparing and very targeted. pic.twitter.com/WMGM80VcZX
— Science and Innovation at Cancer Research UK (@CRUKresearch) November 7, 2017
A brief overview of why it’s exciting — much more targeted and tissue sparing than traditional RT cos it dumps most energy at a specific depth instead of dumping energy wherever it hits tissue. Why it’s especially good for brain, eye, childhood cancers (cue slide of child survivor with deformed spine caused by RT collateral damage).
But while the physics is better, the biology isn’t entirely settled.
But the fun bit was comparing different countries’ approaches to implementing proton beam. Especially so given that in the UK it’s mainly known for the Ashya King case, where the UK was portrayed as being behind in implementing the technology that was portrayed as revolutionary.
While still none are complete in the UK, the US rushed into building 26 (very very expensive) facilities.
But most of the capacity isn’t being used for kids cancers, or hard to treat cancers, or cancers that need the innovation — it’s being used for prostate cancer!
Zeitman #ncri2017: Rapid growth in very expensive #ProtonTherapy centres in the US, most of them treating prostate cancer... pic.twitter.com/hheLUV3B59
— Science and Innovation at Cancer Research UK (@CRUKresearch) November 7, 2017
And as we know, PC is/was frequently overtreated anyway.
Zeitman #ncri2017: given the ProtecT trial, we often don't need to treat these at all, beyond monitoring, let alone with #ProtonTherapy pic.twitter.com/tXPPeibhF3
— Science and Innovation at Cancer Research UK (@CRUKresearch) November 7, 2017
It was just a fun illustration of how their private healthcare market can rush into crazy things — building very expensive treatment facilities for a patient population who don’t need treatment at all — because that population of patients includes those who are most likely to be in a position to demand/buy expensive treatments when expensive treatments are marketed to them.
And then the bubble started bursting and facilities are now going bankrupt.
The NHS is building 2 PBT facilities for the nation — plenty enough for all the patients we can expect to be able to benefit from it. It remains to be seen what purpose the 3 private facilities being constructed in the UK will serve.
Disclaimer: these are my hastily scribbled notes, don’t count on them, pls don’t blame Zietman for anything I might have (mis)attributed to him, don’t take them as representative of my own views let alone my employer’s or anybody or anything else oh god now I remember why I stopped using a public notebook.