Alliance for Proton Therapy Access Underscores Need for Timely Access to Treatment During National Brain Tumor Awareness Month

Proton therapy advocates call for solutions to insurance denial processes that delay patient care

By Alliance for Proton Therapy Access | May 2, 2018

WASHINGTON – In recognition of National Brain Tumor Awareness Month in May, the Alliance for Proton Therapy Access is calling for policies that hold insurers accountable for providing fair, timely, and transparent access to cancer treatment. For many cancer patients diagnosed with brain tumors, insurers are routinely denying payment for doctor-recommended proton therapy, delaying access to treatment and potentially putting patients’ health at risk.

“May is a month to recognize all who have been diagnosed with brain cancers including those who have experienced barriers to treatment when facing a life-threatening diagnosis,” said Daniel E. Smith, Executive Director of the Alliance. “Today, too many patients face agonizing delays and denials by private insurers when their physicians recommend proton radiation therapy to treat cancers of the brain and nervous system. All cancer patients deserve timely, appropriate access to doctor recommended treatments, and it’s past time to fix the broken insurance review and appeal process.”

“When I was diagnosed with a brain tumor, I immediately started exploring my treatment options, and at the recommendation of my medical team, chose proton therapy because of its ability to protect my healthy brain tissue. As a young man planning to start a family, my long-term health and quality of life were important considerations when selecting my treatment,” said Paul Penke, who recently completed proton therapy to treat his Grade 3 Oligodendroglioma. “Despite the scientific literature showing how effective proton therapy is at treating cancers of the brain, my insurer denied payment. Only after I fought the denial and went to the press did my insurer finally approve payment.”

Oncologists recommend proton therapy to treat some brain cancer patients because it is more precise than traditional radiation, drastically lowering the risks of radiation to healthy tissue. With proton therapy, unnecessary radiation doses can be avoided in patients with brain cancer, resulting in significant improvement in quality of life during and after treatment. As a result, there is a lower risk of side effects and permanent brain damage. Research suggests that any radiation on a healthy brain is dangerous and increases mortality, underscoring the clinical value of proton therapy for brain cancers.

According to The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, more than 23,000 Americans will be diagnosed with brain canceror other types of nervous system cancers in 2018, while 16,000 will lose their lives this year as a result of their illnesses.

“Cancer patients and their doctors should be fighting cancer, not insurance companies,” added Smith. “During National Brain Tumor Awareness Month, we recognize the important role proton therapy has in treating patients diagnosed with brain tumors and encourage fair, timely, and transparent insurance payment decisions for patients in need of this care.”