Protect yourself against unnecessary chemo

Astonishing. Shameful. Negligent. These words just begin to describe the reactions that members had in response to an e-Alert I sent you last month (“Breaking Even” 3/17/03) about cancer patients who are administered chemotherapy for types of cancer that are known to be unresponsive to chemo.

A member named Libit wrote: “You mentioned that there are some cancers that do not respond to chemo. You said to ask your doctor whether your cancer is one of them. Are we to believe that we’ll be told the truth? If it’s known that there are certain cancers that don’t respond, can’t we have a list of them now?”

Whether your oncologist will tell you the truth is, unfortunately, impossible to answer. I would guess that in most cases you would be told the truth. But according to a Massachusetts study that examined the medical records of almost 8,000 cancer patients, of those who were prescribed chemo in the last months of life, patients with cancers unresponsive to chemo were treated just as often as those with responsive cancers.

One of the lead doctors of this research stated that “providing chemotherapy to patients with unresponsive cancers is hard to justify.”

That’s putting it mildly, to say the least.

As if these cold facts aren’t disturbing enough, there’s an additional wrinkle that makes the situation even more upsetting. Cancer patients often receive chemotherapy drugs in the offices of their oncologists. Oncologists purchase the drugs themselves and bill their patients. Typically patients pay far higher amounts than their doctors pay for the drugs. This practice even has a name: it’s known as “chemotherapy concession.”

Oncologists defend the steep markup as necessary to maintain on-site staff and facilities to administer the chemo. And yet according the Medical Group Management Association, over the last ten years oncology has become one of the most lucrative fields of medical practice, largely due to the chemotherapy concession. By some estimates, two-thirds of many oncologists’ total revenue comes from the concession.

According to our research, the specific types of cancer listed as not being responsive to chemotherapy are: pancreatic, melanoma, hepatocellular, renal cell, and gallbladder. If you are diagnosed with one of these cancers and are prescribed chemotherapy, you know it’s time for a second opinion.

To Your Good Health,

Jenny Thompson
Health Sciences Institute