The National Cancer Institute says 200,000 American women will get breast cancer this year and 20% will die from the disease.
A lumpectomy is a common treatment but up to 40 percent of women see the cancer return, a number that is reduced to about 10 percent with radiation of the (whole) breast.
But between 2001 and 2006 partial-breast treatments, brachytherapy, went up 1000% - despite real evidence it works.
How did it increase then? Because the FDA approved a device to deliver the radiation in 2002 and Medicare began reimbursement in 2004. "It brings to the front the issue of when we should enact a new technology," says radiation treatment expert Dr. David J. Sher. "What the paper shows it that it really is done in the absence of evidence."
We can't continue to complain that the cost of health care is too high for working people while expensive and unproven treatments are used simply because well-insured Medicare patients can get them and drive the taxpayer costs up even more. Medicine needs to be more evidence-based and not 'if we can save even one life no matter the cost' logical fallacy.
Citation: Grace L. Smith, Ying Xu, Thomas A. Buchholz, Benjamin D. Smith, Sharon H. Giordano, Bruce G. Haffty, Frank A. Vicini, Julia R. White, Douglas W. Arthur, Jay R. Harris, and Ya-Chen T. Shih, 'Brachytherapy for Accelerated Partial-Breast Irradiation: A Rapidly Emerging Technology in Breast Cancer Care', Journal of Clinical Oncology DOI:10.1200/JCO.2009.27.0942
A lumpectomy is a common treatment but up to 40 percent of women see the cancer return, a number that is reduced to about 10 percent with radiation of the (whole) breast.
But between 2001 and 2006 partial-breast treatments, brachytherapy, went up 1000% - despite real evidence it works.
How did it increase then? Because the FDA approved a device to deliver the radiation in 2002 and Medicare began reimbursement in 2004. "It brings to the front the issue of when we should enact a new technology," says radiation treatment expert Dr. David J. Sher. "What the paper shows it that it really is done in the absence of evidence."
We can't continue to complain that the cost of health care is too high for working people while expensive and unproven treatments are used simply because well-insured Medicare patients can get them and drive the taxpayer costs up even more. Medicine needs to be more evidence-based and not 'if we can save even one life no matter the cost' logical fallacy.
Citation: Grace L. Smith, Ying Xu, Thomas A. Buchholz, Benjamin D. Smith, Sharon H. Giordano, Bruce G. Haffty, Frank A. Vicini, Julia R. White, Douglas W. Arthur, Jay R. Harris, and Ya-Chen T. Shih, 'Brachytherapy for Accelerated Partial-Breast Irradiation: A Rapidly Emerging Technology in Breast Cancer Care', Journal of Clinical Oncology DOI:10.1200/JCO.2009.27.0942
