Protons and Prejudice: Finding Sense and Sensibility in the Development of a Costly Medical Therapy

Proton beam therapy (PBT) is a promising but costly treatment option for cancer. This chapter provides an overview of the unique physical properties of protons and puts into context the current state of PBT in the United States and abroad. Fierce competition for market share has driven rapid proliferation of proton centers. PBT has become a therapy seeking an indication, especially in common malignancies such as prostate cancer, and is often marketed as superior despite clear comparative efficacy research to demonstrate a benefit. Restoring sense and sensibility to PBT utilization is critical to the long-term success of this technology.