• 8/2/2007
  • Seattle, WA
  • Leslie Helm
  • www.washingtonceo.com

Expensive new equipment adds fuel to hospital rivalries

The Swedish Cancer Institute (SCI) announced Wednesday it is has signed a contract to buy a $22 million system that uses the latest technology to help treat cancer. But the purchase may trigger a costly “arms race” between competing hospitals and medical centers to see who can provide the most technologically advanced care.

To avoid such a costly race in the field of medical equipment, Swedish says it is speaking with other medical providers in the area to partner in employing the revolutionary technology. But there are other plans already in the works.

The new system is the latest generation of proton beam radiotherapy equipment, known as the Clinatron 250, built by Still River Systems of Littleton, Mass. Swedish argues it will be the first center in the Pacific Northwest to offer proton beam radiation therapy (PBRT) when it receives the equipment sometime in 2010. But the Seattle Cancer Care Alliance, made up of several medical institutions affiliated with the University of Washington, announced plans last year that it would build its own center using similar technology for $100 million.

Rod Hochman, who became CEO of Swedish Medical Center in April, says Swedish wants to create a consortium with other hospitals and universities to share both the cost and use of the new machine. “It will be great for the community,” says Hochman. Compared to the way hospitals have approached the acquisition of such cutting-edge equipment in the past, says Hochman, “some of my colleagues have said it is ‘a breath of fresh air’.”

Hochman says sharing the new technology is just one of many ways in which he hopes to move away from an environment in the medical community of competition toward one that emphasizes cooperation. It is unclear how ownership and management of the system would be handled.

“We want this to be a true community resource,” says Swedish’s executive vice president and chief operating officer, Cal Knight. “There is no need for multiple institutions to invest in duplicate medical technology if we can share it effectively for the benefit of all patients in the Pacific Northwest.”

Swedish currently operates the Seattle CyberKnife Center, which uses another cutting edge technology for treating cancer. The CyberKnife competes with the Gamma Knife treatment offered at the Harborview Medical Center. Those systems cost millions of dollars and compete with each other. The Proton Beam system is considered to be an improvement on those existing technologies because it produces a beam that stops once it hits and destroys tissue in the tumor, avoiding the destruction of other tissue that otherwise would be in the path of the radiation beam.

Proton beam radiation therapy is ideally suited for tumors in close proximity to critical structures. Protons are currently used in treating cancers of the prostate, eye, brain, head and neck, spine, breast, and esophagus. Because proton treatments are able to minimize long-lasting tissue damage, the therapy has also proven particularly effective in the treatment of pediatric patients.
“The idea of making this leading-edge technology available to patients from throughout the region via a partnership is a win-win,” says Dave Brooks, chief operating officer of Providence Everett Medical Center. “As a leader in oncology care via the Providence Regional Cancer Partnership, we agree that this could be an exciting collaborative project and is one we’re considering because of our commitment to continuously provide Snohomish County patients access to the most advanced care available.”

“With protons it’s possible to precisely concentrate the radiation damage inside the tumor so radiation oncologists can use higher, more effective doses,” says Dr. Albert B. Einstein Jr., executive director of the Swedish Cancer Institute. “Proton beam radiation therapy will be an ideal complement to the array of other cancer-fighting tools already available to area residents.”

“The availability of proton therapy here in the Puget Sound will eliminate the need for patients to travel outside of our region to access this innovative therapy,” says Dr. Todd Barnett, medical director of radiation oncology at the Swedish Cancer Institute.

But does Swedish’s announcement signal an end to the arms race? Hardly. Dean Forbes, spokesperson for the Seattle Cancer Care Alliance, which is made up of Fred Hutchinson Cancer Research Center, University of Washington Medical School and Children’s Hospital, notes that the alliance announced nearly a year ago, in September 2006, that it planned to build a new proton-beam therapy center at a cost of $100 million. Forbes argues that Swedish is making an unnecessary investment. “It doesn’t make sense to have more than one of these here,” says Forbes.

Ed Boyle, spokesman for Swedish, says that Swedish reached out to the Seattle Cancer Care Alliance last year in hopes of working with the Alliance on the proton technology and moved on its own after it was unable to make headway. Boyle argued that the system Swedish ordered, though far cheaper than the Hitachi-made system ordered by the Alliance, was as good or better. Still River Systems was able to dramatically reduce the cost of the technology by applying new concepts with super-cooled magnets developed in collaboration with scientists at the Massachusetts Institute of Technology’s Plasma Science Fusion Center, Boyle says. Still River Systems is working toward obtaining marketing clearance for the Clinatron 250 by the U.S. Food and Drug Administration and is hoping to receive approval and open the first unit in fall 2008.

But Swedish’s Boyle says the door is not closed to collaboration. “We’re still hoping the SCCA may initiate talks with us,” Boyle says.

The Proton Beam technology is only available at about 20 proton therapy centers around the world according to the National Cancer Institute.

Leslie Helm is the executive editor of Washington CEO Magazine.