RENEE MONTAGNE, HOST:
If there's one thing all sides in the national healthcare debate might agree on, it is the need to keep down the rising cost of medical care. Despite all the talk of getting healthcare spending under control, the competition rages on between hospitals trying to get their hands on the most expensive and newest technology. And this can be true even when the new devices aren't proven to work better than the older and cheaper alternatives.
A case in point is a new high-tech radiation treatment for cancer called proton beam therapy, which is the hot item these days for hospitals in and around Washington, D.C. Jenny Gold has this report.
JENNY GOLD, BYLINE: There are already 11 proton therapy centers in the U.S., with another 17 being developed. One of them is going up in the heart of downtown Baltimore. It's the size of a football field, a $200 million project from for-profit developer Advanced Particle Therapy. Vice president James DeFilippi took me on a hard-hat tour.
JAMES DEFILIPPI: We're walking right now through the cyclotron maze, so we'll have a 90-ton piece of equipment. It'll sit right in this hole here, and the hole is about two-and-a-half stories tall.
GOLD: This big machine is needed to deliver a tiny stream of radiation in the form of protons directly to a tumor. The idea is that it's so focused, that only the tumor gets irradiated, which Dr. Minesh Mehta believes means fewer side effects. He's a doctor at the University of Maryland and director of the center.
MINESH MEHTA: At the end of the day, when I face a patient and I tell a patient I can treat you with a technology that will treat less of your normal tissue with radiation that you don't need, versus more radiation to the tissue that should not be radiated, which would you like to choose? The vast majority of patients will choose the technology that gives less radiation to their tissues.
GOLD: It sounds impressive. Some researchers call the treatment very promising for children who have brain tumors. But there's not much evidence that it's better than standard radiation for most cancers. And as for the even more targeted proton therapy coming to the Maryland facility...
MEHTA: This particular technology has not been subjected to randomized clinical trials at all.
GOLD: Nonetheless, they're planning to treat about 200 patients a day, at a cost twice that of standard radiation - patients with prostate cancer, lung cancer, abdominal cancers and more. A high patient volume is the only way that centers like Maryland can afford to stay in business, and that's what has people like Dr. Ezekiel Emanuel up in arms.
Emanuel was a healthcare advisor to the Obama administration.
EZEKIEL EMANUEL: It's hard to bend the cost curve when you're spending a lot of money. These are tens, if not hundreds of thousands of dollars in treatment for interventions that do not improve survival, improve quality of life, decrease side effects or save money.
GOLD: And that's not all. Just 40 miles away in Washington, D.C., the city is on the verge of approving not one, but two more of these facilities at a total cost of $153 million. They'd be owned by the two dominant hospital systems in the region: Johns Hopkins and another called MedStar. Here's Emanuel again.
EMANUEL: Neither should be building. We don't have evidence that there's a need for them in terms of medical care. They're simply done to generate profits.
GOLD: In Washington, D.C., hospitals can't just add buildings or services willy-nilly. The Health Department gets to decide whether the services are actually needed, or whether they'll just add more expensive and unnecessary care.
CHIP DAVIS: Clearly, we wouldn't be at this point if we believed that.
GOLD: That's Chip Davis. He's the president of Sibley Hospital in D.C., where the Johns Hopkins proton center would be built.
DAVIS: And we believe that this therapy is absolutely necessary, but we also think that it's appropriate to be applied to certain types of cancer with certain treatments, and not everything.
GOLD: Back in Baltimore, doctors at the University of Maryland say their proton center is more than enough for all of the patients in the area. They even invited radiologists at both Hopkins and MedStar to practice there, but that's unlikely to happen. Both D.C. projects have already passed the first round of approval with the Health Department. A final decision is expected soon. For NPR News, I'm Jenny Gold.
MONTAGNE: Jenny Gold is a reporter with Kaiser Health News, a nonprofit news service.
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