I see the price of proton therapy varies wildly between thousand and tens of thousands of dollars per treatment. Still too high. Perhaps if the cost were lower and some streamlined review process existed, it would be less of a lift to say “hop on the table while the accelerator spins up, won’t be expensive if this doesn’t work.” (in this example) Rationing human supply (labor) makes sense, making humans takes time and supply is constrained. Other costs can be ruthlessly driven down (with some combination of manufacturing learning, research, etc). Consider the costs of Western disease (obesity) and bariatric surgery with recent developments in semaglutide, for example.
On what basis are you claiming that the cost of proton beam therapy is not too high?
You state that non-US healthcare "wouldn't have paid for this either", but later you mention "need to travel to the US because there are no [PB] centers" (which is true). But then you continue "the doctor wouldn't have even considered it as a treatment option".
Now, I'm not an expert at PB treatment, but the fact that patients have to travel would suggest that at least some do that; I'm not sure if the treatment is partially or fully covered. But a quick Google seems to suggest that this option is known, and that there is lobbying to create such a center in Canada; and they acknowledge that the treatment, lasting 6-8 weeks in a distant city can be challenging.
But if it isn't an option considered or offered, why bother to build something with no demand?
I said "in the case of the patient in the article".
Proton beam therapy is in the clinical guidelines, just not first line for throat cancer (or at least not right now, maybe future evidence will prove otherwise).
What concerns me is "This rapid growth in the number of proton beam therapy centres, [...] is viewed with concern by advocates of evidence-based medicine. " [1]
It seems like Proton beam therapy is still -as yet- somewhat controversial.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474264/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130814/#:~:tex...
However, the patient never would known about it because it wouldn't have been on the list of "approved therapies", so the doctor never would have suggested it.
The article dances around it, but for this particular cancer, proton beam therapy has little evidence supporting it. The current treatment guidelines like NCCN list a number of evidence-based therapies for first line, second line and subsequent line treatments.
So in places like Canada (whose patients, it's important to note, need to travel to the US because there are no proton beam centers) the doctor wouldn't have even considered it as a treatment option in this case.