Increased Use Of Expensive Prostate Cancer Treatment Raises Concerns

The New York Times on Friday examined how the increased use of a prostate cancer treatment called intensity modulated radiation therapy, for which physicians receive large reimbursements from health insurers, has raised concerns that IMRT might “be emerging as yet another example of the way financial incentives can influence medical decisions in this nation’s for-profit health care economy.” Physicians receive reimbursements of $47,000 or more per patient for IMRT — a treatment introduced in the 1990s that delivers multiple beams of radiation to small areas and avoids healthy tissue — compared with $2,000 or less for other prostate cancer treatments, such as surgery to remove the prostate or implantation of radioactive seeds. Many of the 10,000 urologists in the U.S. have purchased the technology for IMRT, and some have recommended use of the treatment for an increased number of prostate cancer patients. According to the Times, urologists who have purchased the technology for IMRT maintain that they “are embracing a superior way to treat prostate cancer” but that “there is little research directly comparing IMRT with the other treatments.” In addition, critics maintain that urologists “who can profit from the new form of therapy may be less likely to recommend other proven approaches, which for some older men can involve forgoing treatment altogether,” and that IMRT might “raise the risk of secondary cancers, although no medical studies have proved such a link,” the Times reports (Saul, New York Times, 12/1).

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