Proton beam therapy for Cancer

The UK Government is to spend £250 million on a cutting edge cancer treatment called proton beam therapy despite there being “no reliable, objective evidence” that it improves patients’ lives.

It has not been assessed for clinical or cost effectiveness by the National Institute for Health and Clinical Excellence (Nice), according to an article in the British Medical Journal.

Last week Andrew Lansley, the Health Secretary, revealed that University College Hospitals in London and The Christie in Manchester would each house a facility, to be fully open by 2017. They would treat about 1,500 people a year, mainly children. Up to £250 million will be spent on the facilities.

Proton beam therapy is a form of radiotherapy that is particularly suited to tumours buried deep in the brain and spine, and eye tumours, because it causes less damage to less healthy tissue.

But Nigel Hawkes, director of a campaign group called Straight Statistics, argued in the BMJ that due to the lack of a Nice appraisal, “it is not yet clear that its cost could not have achieved greater benefits if applied elsewhere in the NHS, either in cancer treatment or in other areas”.

He continued: “In 2008 Fergus Macbeth, the then director of the Centre for Clinical Practice at Nice, commented in the Journal of Clinical Oncology that there was no reliable, objective evidence that proton beam treatment improved clinical outcomes, either survival or quality of life, and the only tumours for which there was any evidence of benefit were base of skull cordomas and ocular tumours.”

Cancer cells
Cancer cells

The Government has a soft spot for eye-catching cancer initiatives, most notably the £200 million-a-year Cancer Drugs Fund, which gives patients access to drugs turned down by Nice as too expensive or not medically effective enough.

Some radiologists were critical of that decision, saying many more lives would have been saved by improving access to general radiology.

However, the Royal College of Radiology has welcomed the proton beam announcement.

Adrian Crellin, its dean of clinical oncology, said: “Proton treatment will be of benefit to patients with certain rare cancers. It will offer significantly better outcomes in curing cancer in children and some adult cancers of the skull and spine.”

A spokesman for Nice said proton beam therapy had not been referred to the organisation for appraisal by the Department of Health.

A departmental spokesman said that Nice did not have to approve every treatment, and that providing the evidence the organisation required to make a decision was difficult because proton beam therapy was used for rarer cancers.

Department of Health analysts had carried out their own assessment “which suggests that the health gain from using proton beam therapy comes within the conventional Nice criteria”.

She added: “We are currently unable to provide Proton Beam Therapy in this country and are having to send children and their families overseas for long periods of time, which can be highly disruptive.”

“Bringing proton beam therapy to England will mean we can help improve the lives of those most in need, including those who cannot travel overseas.

“It would be wrong to withhold life saving cancer treatment from those who desperately need it.”

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