The Massachusetts Public Health Council has delayed a vote on a proposal from the Dana-Farber Cancer Institute to build a new proton beam therapy center in Boston, citing concerns about equity and access.
Proton beam therapy is a highly precise form of radiation treatment for cancerous tumors that spares more of the healthy tissue around the tumor from radiation, according to Johns Hopkins Medicine.
Massachusetts General Hospital is currently the only hospital offering proton beam therapy in the state. UMass Memorial Health in Worcester received approval in December to bring a $54 million proton beam center to Marlborough Hospital.
Dana-Farber wants to construct an approximately 4,500-square-foot proton beam therapy center at 35 Binney St. in Boston. The project is valued at approximately $50.5 million, with a $2.5 million contribution from the Community Health Initiative, according to the proposal presented by Torey McNamara, senior policy adviser at the Massachusetts Department of Public Health.
Mass General owns two proton beam therapy systems, one of which is operational. Dana-Farber maintains that even with the approved center at the UMass Memorial Marlborough Hospital campus, additional capacity is needed in the state.
The Dana-Farber presentation suggested it had seen “widespread difficulty among its patients seeking access to proton beam therapy,” based on clinical and patient reports. According to approximate data, 24% of Dana-Farber patients in “group one” — those who medically require proton beam therapy — reside near the proposed center, which is anticipated to be operational by December 2027.
Public Health Council says equity, access are issues
But Dr. Ramnath Subbaraman, a Public Health Council member, said there are “a few problems across both payer mix, race and ethnicity, and geographic location in terms of equity.”
According to information packets presented to the council, “the proportion of patients in group one, those most likely to benefit from PBT, is only 4.4% MassHealth overall, 2% for children,” Subbaraman said.
Other council members raised similar concerns about the center’s geographic location and the patient population it’s expected to treat.
The health council, chaired by Department of Public Health Commissioner Robbie Goldstein, advises the DPH on major policy decisions at the discretion of the commissioner, and grants the commissioner authority to take necessary actions to protect public health upon a declaration of a public health emergency by the governor.
The Dana Farber proposal said the center would treat approximately 216 patients per year, based on historical data, but does not account for expected increases in need for PBT treatment.
Dana-Farber cites access to Boston Children’s Hospital
Dana-Farber plans to use the proton beam clinic to collect more data on their patient profiles to inform broader research on proton beam therapy centers.
“This is an opportunity to bring this therapy to patients that may have had barriers to accessing them,” said Magnolia Contreras, vice president of community health at Dana-Farber.
Susan Chi, a Dana Farber pediatric neuro-oncologist, addressed concerns about the center’s location — inside a building connected to Boston Children’s Hospital, where her patients most often receive treatment. Currently, children must travel to other proton beam therapy facilities to receive treatment.
“This is stressful for children and families who are already undergoing treatment at Dana-Farber, Boston Children’s, which often leads to treatment delays and puts patients at risk for communication errors, and transferring care for very sick children is just not feasible,” Chi said.
The council is expected to revisit the proposal next month, according to a Dana Farber spokesperson.