That Buzz You Hear Is


Leonard Zwelling

         Lots of MD Anderson’s faculty live in Bellaire as I do. We
all get the local magazine called the Bellaire Buzz. In August, the Buzz had a
paid advertisement from MD Anderson’s proton center with these statements:

“When facing cancer, a
fraction of a millimeter can make a world of Difference”  and

“Lung cancer patients see
quality-of-life benefits with proton therapy”

         All I could think was here we go again.

         There are several critical truths about proton therapy as I
understand them (and I am happy to be proven incorrect).

1. It costs a lot to build one of those proton centers.

2. It costs a lot to run one, too.

3. Thus, the charges for proton treatments are much
higher than those for conventional radiotherapy.

4. For certain CNS and ocular tumors, especially those in
children, proton therapy is a superior form of cancer treatment.

5. For most other cancers like primary prostate cancer or
localized lung cancer, the jury is still out on any survival advantage proton
therapy has over conventional forms of ionizing radiation.

6. If proton therapy for prostate and lung cancer was a
drug, I am not sure the FDA would have approved it yet.

therapy for lung and prostate cancer is still experimental in that while
probably safe, it is not clearly better clinically and is certainly more costly
to administer. Whether it provides any advantages to patients with longer
survival or fewer side effects remains to be seen. What is more, the text of
the MD Anderson ad says as much:

MAY include better local control of the disease, higher survival rates, and
improved quality of life”. (caps are mine and better than what?)

also reduce some of the side effects of traditional radiation” (again caps are

2005, MD Anderson has published more than 175 studies focused on proton therapy
for lung cancer, providing answers to critical knowledge gaps” (but clearly no
answer to whether or not it is better than conventional forms of radiotherapy or
that would have been in the text).

really isn’t helpful to anyone to mislead the public into believing a form of
cancer treatment is truly better than a conventional, more accessible and less
expensive treatment modality. It is unconscionable to do so as an advertising
ploy. Even if the scientists and doctors at Anderson BELIEVE proton therapy to
be superior to conventional radiotherapy, the onus is on the academic
institution claiming superiority to prove it. Thus far, that has not occurred.

is my understanding that studies are currently underway to find out whether
proton therapy is better than conventional radiation for the treatment of
primary prostate cancer. I assume the same may be true for studies with
patients having lung cancer. But to advertise to the public the superiority of
a treatment without proof despite having published 175 papers on the subject is
simply a bad idea.

is not the MD Anderson I came to in 1984. MD Anderson can do better than this.

Leonard Zwelling