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Tennessee bills look to improve proton therapy cancer treatment coverage

April 4, 2014

Proton therapy might sound like a phrase from a science fiction novel, but this cancer treatment is a scientific breakthrough. Approved by the FDA in 1988, this specific form of radiation treatment is gaining ground throughout the United States. Now, thanks to the recently opened Provision Center for Proton Therapy in Knoxville, residents of Tennessee and its neighboring states have more radiation treatment options than ever before.

Much like traditional forms of radiation therapy, proton therapy is a cancer treatment that involves destroying tumors and cancerous tissues with the use of radiation. However, proton therapy can be better localized than traditional cancer treatments; this means that it destroys less healthy tissue because it can target cancerous cells more directly.

While proton therapy is a promising cancer treatment, it comes with a hefty price tag that not all insurance companies are willing to pay. In part, this is because studies on the results of proton therapy have been inconclusive. Some research suggests that proton therapy yields exceptional results; other studies don’t show much difference – if any – between proton therapy and traditional radiation treatment.

In 2012, Massachusetts General Hospital began a five-year study involving 400 patients that will hopefully provide more conclusive information about proton therapy’s effectiveness. The study will compare cancer patients receiving proton therapy with those receiving traditional treatment. By closely monitoring the side effects and outcomes of each group, researchers hope to determine whether proton therapy offers any benefits that traditional radiation does not.

In the meantime, one Tennessee man has experienced firsthand the frustrations of undergoing proton therapy when it isn’t covered by insurance. Bryan Massengale, 55, was diagnosed with prostate cancer three years ago. The middle school band director began researching treatments immediately after his diagnosis and came across proton therapy.

Unlike his other treatment options – surgery and traditional radiation therapy – proton therapy would have few side effects, short-term or long-term. However, there was a catch: The closest proton therapy treatment center was in Jacksonville, Florida.

Having determined that proton therapy was the best route for him, Massengale lived in Florida for seven weeks so he could complete his treatment there. Though the therapy was effective and he is now cancer-free, Massengale’s insurance company would not pay for his chosen treatment.

This may become an issue for other Tennessee cancer patients now that proton therapy is a readily available option for residents of the state. BlueCross BlueShield of Tennessee will cover proton therapy in some cancers, like cancers of the spinal cord. However, proton therapy treatment is not covered for some other cancer types, such as prostate cancer.

The Tennessee government is currently looking at a bill that would address insurance coverage of proton therapy: House Bill 264 and Senate Bill 435 would make coverage for cancer patients mandatory. Regardless of the state government’s decision, it is likely that more and more Tennessee cancer patients will choose proton therapy as their treatment method. Though insurance companies are not required to cover the treatment right now, for some patients the fewer side effects and shorter recovery time may be priceless.