Benefit of the doubt in short supply
I really don’t want to think the worst, but some oncologists make it very difficult to give the benefit of the doubt.
Putting myself in their shoes, I can’t imagine what it would be like to look into the eyes of elderly cancer patients, day after day, and tell them there’s nothing that can be done.
So I want to think that many oncologists are simply offering treatments they know are ineffective in order to give some hope and to make their work just a little bit less heartbreaking.
It might be wrong but at least I could understand it.
But sadly, that’s probably not the primary reason why desperate patients are being subjected to needless — and worthless — chemo treatments.
No, it’s much more likely that it’s all about the billing in most cases…and it’s a national disgrace.
University of Chicago researchers recently examined medical records for more than 1,000 patients with metastatic colon cancer.
They found that about one in every eight patients (approximately 130 patients total) received chemotherapy that was either shown to be ineffective, or its use was not supported by evidence, or there was no compelling rationale for the use of the drug.
One of those drugs — Avastin — can cost as much as $90,000 per year.
A few months ago I told you about potential side effects linked to Avastin. Here’s just a partial list…
* Gastrointestinal perforation — sometimes fatal
* Incomplete wound healing — sometimes fatal
* Serious bleeding in the stomach or brain — sometimes fatal
* Kidney problems — sometimes fatal
* Vision disturbances — including blindness
So I have to ask: What kind of a monster do you have to be to administer a drug like that to a patient who you know will receive scant or possibly no benefit at all?
I guess you have to be a financially desperate monster. But that’s obviously no excuse. It’s robbery, pure and simple. The UC team reports that the patients in the study who were put at significant and unnecessary risk paid out more than $2 million for the cancer drugs.
It’s beyond despicable!
What’s worse, this study confirms a long, ongoing problem…
In 2003, an oncologist examined the medical records of almost 8,000 cancer patients. He found that in cases where chemo was given in the final six months of life, ONE-THIRD of the patients had cancers that are known to be unresponsive to chemotherapy.
In a 2008 review of about 600 cases in which cancer patients died within 30 days of receiving chemo, 40 percent experienced “significant poisoning” from their treatment, and about one-in-four deaths were accelerated or actually caused by the treatment.
And in 2005, Medicare reduced payments to oncologists who administer outpatient chemo. In response, some doctors simply began treating more patients with chemo and began using more expensive drugs to offset their lost revenue.
A late-stage cancer is a desperate time for a patient. He and his family are vulnerable and scared, and they’re likely to cling to any bit of hope. But hard as it is, that’s when they have to be most diligent in challenging doctors with tough questions through every step of therapy.
And while saying “no,” can feel like giving up, it may end up saving you a lot of money and, more importantly, a lot of pain and frustration.
“Chemo for Late-Stage Cancer Patients May Be Unjustified” Robert Preidt, HealthDay News, 6/9/11, nlm.nih.gov
“Chemotherapy Contributes to a Quarter of Cancer Deaths: Study” Sara Everingham, ABC News (Australia), 11/13/08, abc.net.au
“How Medicare’s Payment Cuts For Cancer Chemotherapy Drugs Changed Patterns Of Treatment” Health Affairs, Published online ahead of print 6/17/10, content.healthaffairs.org