Proton Therapy Advocates Stress Importance of Fair and Timely Access to Care for Patients During National Oral, Head and Neck Cancer Awareness Week

Data show improved survival and fewer side effects for patients with specific head and neck cancers treated with proton therapy

By Alliance for Proton Therapy Access | April 11, 2018

During National Oral, Head and Neck Cancer Awareness Week, the Alliance for Proton Therapy Access underscores the need for fair, timely and transparent access to doctor-recommended cancer treatments, including proton therapy. Despite research demonstrating the clinical efficacy of proton therapy for head and neck cancer, in particular, patients routinely face payment denials from their health insurers.

“While there is an abundance of research showing proton therapy’s effectiveness in treating patients with oral, head and neck cancers, too many patients who would benefit most from proton therapy based on their physician’s recommendation are denied coverage by their insurer,” said Daniel E. Smith, Executive Director of the Alliance. “We must fix this broken review and appeals process to ensure that all cancer patients are able to receive timely, fair and transparent coverage decisions.”

For some cancer patients, proton therapy is a clinically appropriate treatment recommended by a physician, however, too many patients are forced to navigate a complex and restrictive web of insurance policies that make it difficult to obtain treatment. All too often, patients are denied access even when proton therapy is their best – or only – available treatment option.

“My granular cell tumor was located behind my ear and near my jaw, carotid artery, esophagus, brain stem, oral cavity—all necessary body elements for living a healthy life. Proton beam radiation would target the tumor and not the important surrounding tissue, and to me and my doctor, was the clear choice. Unfortunately, my insurance company didn’t agree with me or my team of medical experts and denied coverage,” said Linda Thomas, a former proton therapy patient who had to fight her insurer throughout her treatment to gain approval for her care.

As an FDA-cleared cancer treatment that is covered by Medicare, proton therapy has demonstrated effectiveness in reducing excess radiation exposure to healthy tissue while resulting in significant improvement in quality of life for patients with head and neck cancers. By precisely targeting cancer cells, proton therapy is able to minimize harmful side effects while increasing the amount of radiation delivered to cancerous tissues.

Studies have shown that proton therapy reduces rates of feeding tube dependency and severe weight loss for patients with oropharyngeal cancers and improves survival for patients with paranasal and nasal cavity malignancies. [i]It has also been shown to be an effective treatment modality for skull base chordomas. [ii]Furthermore, the National Comprehensive Cancer Network concluded that patients with specific head and neck cancers had better outcomes than those who received photon therapy.[iii]

“Cancer patients and their doctors should be fighting cancer, not insurance companies,” Smith concluded.

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[1]Patel SH, et al. Lancet Oncol. 2014;15(9):1027-38

[1]Ares C, et al. Effectiveness and safety of spot scanning proton radiation therapy for chordomas and chondrosarcomas of the skull base: first long-term report. Int J Radiat Oncol Biol Phys. 2009;75(4):1111-8.

[1]https://www.nccn.org/about/news/international_ebulletin/ebulletindetail.aspx?ebulletinid=976