Some cancer patients who need to undergo radiation therapy need a special form of radiation called proton therapy. However, many patients struggle with proton therapy coverage in California as some insurance companies do not consider it necessary.

Proton therapy, or proton beam therapy, is a type of radiation therapy that uses proton beams to irradiate cancer cells. It is an increasingly popular noninvasive cancer treatment.

The benefit of proton beam therapy is that it affects less of the healthy tissue around the cancerous tissue.

During regular radiation therapy, multiple x-ray beams are pointed at the cancerous tissue. This often affects surrounding tissue because the beams are not very precise.

However, proton therapy is much more targeted. In fact, the proton beam can often be shaped to match the shape of the tumor. This lets doctors save healthy tissue.

Because of the benefits of proton therapy, it is important in treating cancers in sensitive parts of the body because it doesn’t affects surrounding tissues. These parts of the body include the brain, head, neck, lungs and pancreas.

In California, proton therapy is offered at different cancer centers including Loma Linda Medical Center, the Scripps Proton Therapy Center, and UCSF Ocular Tumor Proton Therapy Program.

Unfortunately, proton therapy coverage in California is hard to come by for many patients.

One such patient is a man named Ronnie. Ronnie was diagnosed with a rare form of brain cancer that gave him only a 50% chance to live over the next 10 years.

Ronnie was fortunate enough to receive proton beam therapy. However, his insurance company has denied coverage. Ronnie’s proton beam therapy cost hundreds of thousands of dollars, but his insurance company will not pay for it claiming the treatment was experimental.

Sometimes, patients like Ronnie, whose doctors recommend treatment like proton therapy, come to find out that proton therapy coverage in California has been hard to get for years.

This type of cancer therapy has been in use since the 1950s. The U.S. Food and Drug Administration approved proton beam therapy in the late 1980s for treating localized non-metastasized tumors.

Most proton beam therapy patients do not report side effects and if they do, they are usually far less significant than those from traditional radiation therapy.

Despite its growing popularity, proton therapy coverage in California is not gaining ground. It is a more expensive treatment than traditional radiation therapy, and some insurance companies who deny coverage have been criticized for doing this in bad faith.

These insurance companies claim that the therapy is experimental, it is not medically necessary, other treatments work just as well, or that proton beam therapy is outside the insurer’s network agreements.

If you or someone you love has undergone proton beam therapy for cancer but has struggled with proton therapy coverage in California, you may be entitled to legal compensation.