Proton therapy technology is the least of your worries.
Proton therapy lived in large research institutes for almost half a century. The method used to convert a current of protons into a beam that could be used to treat tumors was limited by the technology that was available from the 1950’s onwards. In 1986 pencil beam scanning (PBS) was introduced at the Paul Scherrer Institut. PBS allows for the maximal reduction in integral dose. With the PBS delivery technique of Intensity Modulated Proton Therapy (IMPT) it also provides greatest flexibility in shaping the dose distribution.
It took two more decades — and further advancements in especially imaging — before PBS was fully recognised as the way forward. Today all vendors provide PBS as their main or even only method of treatment delivery. As all protons are created equal there are only marginal differences in the quality of the dose distributions delivered by the various vendor solutions.
Of course there is still enough to choose between, and identifying the right vendor for an initiative is still important. But it is important to realise why proton therapy initiatives have stalled, and why too many proton therapy centers have struggled to the point of bankruptcy1. The reasons include the following:
- Not having made transparent how offering proton therapy aligns with the mission of the organisation
- Overestimating how many of their own radiotherapy patients would benefit from proton therapy
- Assuming the mere offering of proton therapy treatments would result in substantial patient referral
- Underestimating the time the organisation needed to climb the learning curve
- Failing to engage with stakeholders in a structural and timely fashion
There are still other reasons too, but “because of failing equipment” is not among them.
If you found this to be of interest perhaps you may want to read the following original contributions: Solutions in proton therapy — for initiatives (a report), Procuring proton therapy equipment (a case) and A Business Case for a proton therapy initiative (a case).Back to all explanations Message me about this explanation
Don’t buy equipment, identify the right vendor.
Because of the vendor lock-in for the lifetime of the proton therapy center, the services and capacity for innovation a vendor offers are of much greater importance than current functionality of the equipment. Shift the focus.Read more
Patient selection and patient referral are pivotal.
Many proton therapy centers struggle because of unrealistic projections of patients being treated. But even when making a realistic projection, the challenges of patient selection and referral remain.Read more
Independent consultancy made the difference for us.
Proton therapy vendors have a lot of expertise and a need to sell equipment. They may not protest when unrealistic assumptions are made. Some consultants combine great expertise with ties to a vendor. Independent consultancy can make a difference.Read more
You can start to minimise risk in proton therapy today.
A decision is a conclusion reached after careful consideration. If you have to think it means something is not transparent. Each decision increases risk. Risk is minimised by unambiguous aims and access to expertise. You find it here.Read more