California Proton Treatment Center (CPTC) has filed for Chapter 11 bankruptcy protection.

[Chartreuse Wombat]

California Proton Treatment Center (CPTC) has filed for Chapter 11 bankruptcy protection.

---

Members don't see this ad.

 

[Gfunk6]

I wonder how long they will be able to continue operating?

 

[medgator]

The first of many more proton dominoes to fall....

Press release mentions "corporate restructuring" but not Chapt 11

http://www.prweb.com/releases/2017/03/prweb14114315.htm

 

[medgator]

http://www.sandiegouniontribune.com/news/health/sd-me-proton-bankruptcy-20170302-story.html

The out-of-town investment group that owns the $220 million state-of-the-art facility on Summers Ridge Road filed Wednesday under Chapter 11 of the U.S. Bankruptcy Code, stating in court papers that the center “has not operated on a profitable or even a break-even basis.”

The facility is known throughout the region as the Scripps Proton Therapy Center and is operated under contract by the Scripps Clinic Medical Group.

At a hearing in Delaware bankruptcy court scheduled for Friday, owner California Proton Treatment Center will ask a judge to approve a $16 million short-term loan to keep the center operating while the restructuring process proceeds.

In a statement, the company indicates that patients should not notice a difference.

“Our doors will remain open to administer highly-specialized cancer therapies, and a Patient Ombudsman will ensure that our transition to a new organizational framework won’t affect patients or staff,” said Jette Campbell, the restructuring officer brought on by the company to oversee the bankruptcy reorganization process.

 

[Reaganite]

The scripps guys are awesome dudes and GREAT doctors....But this was an ill-conceived plan from the get-go. To build a 200+ million dollar center near San Diego in a market full of urorads, medonc rads, etc. never made any sense.

 

[medgator]

The scripps guys are awesome dudes and GREAT doctors....But this was an ill-conceived plan from the get-go. To build a 200+ million dollar center near San Diego in a market full of urorads, medonc rads, etc. never made any sense.

There are so many ill conceived proton centers that have sprouted up in recent years, sometimes more than 1 in the same city (Jacksonville, FL is a great example). At best, there should be 10-15 max with the current data and proven indications vs IMRT/3D. FL alone is looking at 4 centers operational this year (2 in Jax, 1 in Orlando, 1 in Miami).

 

[Palex80]

There are so many ill conceived proton centers that have sprouted up in recent years, sometimes more than 1 in the same city (Jacksonville, FL is a great example). At best, there should be 10-15 max with the current data and proven indications vs IMRT/3D. FL alone is looking at 4 centers operational this year (2 in Jax, 1 in Orlando, 1 in Miami).

Well, Florida does probably have the highest cancerous prostate rate in all of the US, right?

 

[medgator]

Well, Florida does probably have the highest cancerous prostate rate in all of the US, right?

Unclear whether

1) all of that needs to be treated
2) protons is superior to brachy or imrt.

In addition, I know some private insurers will not cover prostate ca outside of high risk, if at all, while Medicare leaves it up to the regional heads. I've gotten referrals from the VA where they specifically exclude proton therapy for payment without prior authorization.

Prostate ca should not have been the business reason for all of these centers to have been built

 

[Gfunk6]

Well you need to consider that proton centers need prostate cancer patients more than prostate cancer patients needs proton centers.

The cause specific survival for low risk prostate cancer patients treated with protons is probably 100% at ten years.

However the cause specific survival of proton centers who don't treat low risk prostate cancer patients is 0% at ten years.


Sent from my iPhone using SDN mobile

 

[Phantom1]

Thats a pretty high Hazard Ratio..

 

[Palex80]

Unclear whether

1) all of that needs to be treated
2) protons is superior to brachy or imrt.

In addition, I know some private insurers will not cover prostate ca outside of high risk, if at all, while Medicare leaves it up to the regional heads. I've gotten referrals from the VA where they specifically exclude proton therapy for payment without prior authorization.

Prostate ca should not have been the business reason for all of these centers to have been built

Of course prostate cancer doesn't need protons. But prostate cancer is the main driver behind all those proton centers popping up.
Loma Linda led the way.

It's something we have seen in Europe too. Half a dozen heavy particles / proton projects in Germany have been cancelled or are fighting for survival.
They had projections of 4000 patients per center per year being treated...

 

[RadOncDoc21]

Well you need to consider that proton centers need prostate cancer patients more than prostate cancer patients needs proton centers.

The cause specific survival for low risk prostate cancer patients treated with protons is probably 100% at ten years.

However the cause specific survival of proton centers who don't treat low risk prostate cancer patients is 0% at ten years.


Sent from my iPhone using SDN mobile

Did you read the 2 yr data on laser treatment vs AS? Of course it was 98% survival so justifies treatment (per Urologists).

http://www.nhs.uk/news/2016/12Decem...r-low-risk-prostate-cancer-shows-promise.aspx

 

[medgator]

https://m.dotmed.com/news/story/35917

“Unfortunately California Proton Treatment Center’s(CPTC) projections, which they used to build and finance the center, never lived up to their expectations,” Chris Van Gorder, chief executive of Scripps Health, told the San Diego Tribune last week.

One of the biggest reasons for financial difficulties, he observed, was the move away from using the approach for prostate cancer.

 

[thesauce]

Unclear whether

1) all of that needs to be treated
2) protons is superior to brachy or imrt.

In addition, I know some private insurers will not cover prostate ca outside of high risk, if at all, while Medicare leaves it up to the regional heads. I've gotten referrals from the VA where they specifically exclude proton therapy for payment without prior authorization.

Prostate ca should not have been the business reason for all of these centers to have been built

I would say that it has become clear that...

1. They don't
2. They aren't

However, the one thing that bothers me is that some insurers will cover it for high risk and not for low risk. What is the logic there? If you believe they both need to be treated, low risk are the ones most likely to derive the (theoretical) benefit of protons.

 

[medgator]

However, the one thing that bothers me is that some insurers will cover it for high risk and not for low risk. What is the logic there? If you believe they both need to be treated, low risk are the ones most likely to derive the (theoretical) benefit of protons.

I don't work at a proton center so I'm not really that knowledgeable but remembering back to residency days, isn't there a slight RBE advantage? Also maybe they can dose escalate protons better, and extrapolating the brachy data suggests dose may be the real important aspect of controlling these more aggressive cancers....

 

[Chartreuse Wombat]

I don't work at a proton center so I'm not really that knowledgeable but remembering back to residency days, isn't there a slight RBE advantage? Also maybe they can dose escalate protons better, and extrapolating the brachy data suggests dose may be the real important aspect of controlling these more aggressive cancers....

Nope. There may be increased RBE at the end of the Bragg peak but you don't hear about any of the protonists excalating dose beyond what is achievable with photon IMRT. The only theoretical advantages of protons are 1) decreased second cancers because of reduced total absorbed dose or 2) decreased bowel, bladder and sexual toxicity. The first advantage will never be demonstrable given the low rate of second cancers (and basically argues for active surveillance or brachytherapy (the most conformal radiotherapy technique evah) and the second may be proven with the ongoing head to head comparison but I would not bet on it.