MedSmarts

~ Becoming CEO of the rest of your life

Got Cancer? Too Bad.

Got Cancer? Too Bad.

Overdosing on Toxic Treatments

It’d take a pretty heartless person to utter the title to this post. And yet that’s effectively what many doctors charged with treating cancer patients – oncologists – are saying to their cancer patients.

This may come as a shock to some, but America’s medical profession is increasingly motivated to preserve and enhance their inflated incomes – inflated in comparison to other developed countries with sophisticated medical systems – even if it risks shortening their patients’ lives.

Pretty harsh, huh?

Except it’s not my words that are harsh. It’s the factual evidence that proves that they’re true.

Let’s back up a bit for some context…

 The “C” Word

“Cancer” is still the most feared word in the English language – often wrongly assumed to be synonymous with death.

Many cancers can now be managed as chronic diseases like diabetes or heart failure.

But there’s no denying the greater toxicity of chemotherapy and radiation therapy cancer  treatments. Their side-effects are well-known and can even hasten patients’ demise rather than extend their lives (see our free report – “Death-by-ICU: End-of-Life Care in America“).

Most of us assume our doctors would never subject us to more of these highly toxic treatments than absolutely necessary.

And most of us are wrong.

When The Treatment’s Worse Than the Disease

Oncology’s the only branch of medicine in which physicians are allowed to make a profit on the chemotherapy drugs they administer to their cancer patients.

Because the profit margins on these were considered excessive, Medicare changed its chemotherapy payment formula for oncologists in 2003 and again in 2005. A study published in the journal Health Affairs in 2010 examined the impact of these changes on oncologists’ prescribing practices.

What they found speaks volumes to the moral decay that’s taken root in American medicine. Anyone who may think Our Healthcare Sucks is overly critical of the growth in unethical medical practices in America should pay attention to what follows. It’s pretty damning stuff.

Predatory Profiteering

Here’s the study’s bottom line: After reimbursement rates to oncologists were reduced for certain chemotherapy drugs, they shifted patients to other chemotherapy drugs with the highest profit margins and increased the volume of these toxic agents to make up for their reduced payment rates.

Remember that these are the most toxic drugs on the market – designed to kill cancer cells but also likely to kill healthy cells as one of their side-effects.

Over-prescribing cholesterol-lowering statin drugs is one thing. Most of that over-prescribing – while wrong-headed – is at least well-intentioned.

Over-prescribing highly-toxic chemotherapy drugs is another story altogether. Well-intentioned it isn’t. “Predatory” is a word that comes to mind instead.

In case you think I’m embellishing, here’s the exact quote from the study in Health Affairs:

We found that chemotherapy treatment rates increased…in response to the new payment system…Oncologists increased the volume of chemotherapy administered in their offices after the implementation of average sales price reimbursements…

“(This reimbursement adjustment) changed the likelihood that (Medicare) beneficiaries received chemotherapy treatment…

“The increase in utilization may have important implications for the well-being of Medicare beneficiaries with cancer.”

I’d say so, wouldn’t you?.

Cancer Patients are “Sitting Ducks”

This is more than merely “gaming the system”, a long-standing medical practice I note in Our Healthcare Sucks that effectively dooms the cost-cutting potential of healthcare reform.

 “Gaming the system” implies only financial gamesmanship without any real victims – except those of us paying insurance premiums and taxes inflated by such practices. Here, however, we have more serious victims – vulnerable cancer patients subjected to excess dosing of highly toxic chemotherapy drugs solely to enhance their oncologists’ incomes.

As a post at medicalconsumers.org on this subject stated, patients conditioned to believe that more treatments equals better care are “Sitting ducks for inappropriate and often dangerous medical treatment”.

 Kevorkians of Cancer

As damning as is this evidence about the unsavory practices and priorities of medical oncology, it isn’t limited to chemotherapy. Many oncologists have turned to investing in radiation therapy centers to offset their reduced chemotherapy profits.

A study of such physician-owned radiation therapy centers found the investor-doctors referred patients for radiation therapy four to four-and-a-half times more often than physicians without this financial conflict-of-interest. The fact that these centers also charged more per treatment translated into a combined cost in radiation treatments of up to 7 1/2 times the cost of other physicians.(1)

So here again we see physicians willing to subject their vulnerable patients to excessive exposure to damaging cancer treatments to enhance their incomes.

At least Dr. Kevorkian didn’t do it for the money!

Have They No Shame?

These data demonstrate the naivety of denying the financial drivers behind many physicians’ treatment practices – even in the extreme situation of patients with advanced cancer who are further compromised by toxic cancer treatments.

It’s despicable by any standard, yet it’s the norm today. The study in Health Affairs didn’t examine a subset of oncologists, after all. It examined total oncology spending for chemotherapy by ALL oncologists in America.

If you or a loved one is diagnosed with cancer, make sure you and they are wise to what’s really going on here.

Demand an integrative approach to cancer treatment that minimizes the dose of chemotherapy and/or radiation therapy by using herbal and/or nutritional supplements like melatonin and astragalus. These, among others, may help you reduce the amount of chemotherapy and/or radiation exposure needed for a given result and reduce treatment side-effects.

Do not simply comply with what may be a self-serving treatment overdose to fatten your doctors’ wallets without doing your homework and everything possible to avoid treatment injury that could shorten rather than extend your life.

[1] Consensus of physician ownership of health care facilities – Joint Ventures in radiation therapy. N Eng J Med, 1992;327:1457-501.

This article is provided for informational and educational purposes only.
It does not constitute medical advice and should not be relied upon as such.

Rate This Post

 

Like this post? Sign up for Free to get more.

Subscribe to our e-mail newsletter to receive updates.

3 Awesome Comments So Far

Don't be a stranger, join the discussion by leaving your own comment
  1. Michael Wosnick
    June 21, 2012 at 12:21 am #

    John,

    I’m not sure, but I don’t think this happens in other jurisdictions, such as Canada, where our cancer drugs are paid for by universal health insurance. That said, ours is not really “universal” in that each province can decide what goes on its formulary and so equity of access is not always apparent. And that also means that sometimes governments are “shamed” into covering (paying for) a drug that has questionable scientific validity if there is enough public outcry to make politicos cave in.

    Interestingly, however, there has been a recent furor here in Ontario where the provincial government, in trying to reign in health care costs, has suggested a cap on self-referrals from physicians like cardiologists who often own diagnostic suites as part of their practice. It is apparently fairly well documented that those (cardiologists, for example) who also own diagnostic machines and suites are far more likely to be referring patients for tests, suggesting that some of these tests are unnecessary from a medical standpoint and that the ability to “self-refer” is a flagrant conflict of interest and one that leads to higher costs for medically unnecessary tests.

    While this may be true, I have not yet seen an analysis of the clinical outcomes compared to the rates of self referral. It may well be that those patients do far better in the long run. While I am skeptical that this is the case, to simply suggest that self-referral in these cases is wrong is an incomplete analysis until we know how patients fared.

    And that brings me to the final point – I have long believed that there is more of a “damn the torpedoes” mentality in the USA, compared to Canada. I don’t think it is simply because of who pays, but I sense that there may be a far greater tendency in the US to treat as aggressively as possible and never declare defeat until someone actually dies. In Canada we are far less likely to treat at all costs, literally or figuratively. Sometimes we just say, sorry there is nothing else we can do except make you comfortable. Some may criticize, and others applaud, but I think we are more apt in Canada to not go futilely into more and more treatment just because we can…

    It just makes me wonder, therefore, if at least SOME (?) of what you describe is motivated by that spirit of “never say never” as opposed to the motivation of pure greed that you are inferring.

    • John Lynch
      June 21, 2012 at 9:53 am #

      Michael,

      That “never say never” spirit might help explain often overly aggressive treatment regimens in general, but I don’t think it explains why these regimens were intensified after payment changes were instituted. The data show pretty clearly that prescribing behaviors changed in direct response to payment changes, so I’m afraid my inference is well-founded.

      I’d like to think otherwise, but there’s just too much evidence – not just in oncology, but across the medical spectrum – that unethical practices have increased dramatically in American medicine.

      Physician self-referrals, of course, are more prevalent in the US than in Canada, but they’re just the tip of the iceberg. Outcomes data for this practice are hard to find, but the cost impact is not (see above example of radiation therapy centers). Unneeded surgeries and hospitalizations for defensive medicine purposes are even more prevalent.

      These expose patients to avoidable treatment risks – hospitals, as you know, are dangerous places – and explicitly violate the AMA’s own Code of Ethics. It’d take a huge leap of faith to think the victims of these unethical practices might somehow fare better in the long run. And why would anyone want to give the benefit of the doubt to such unethical behaviors in the first place?

      Thanks for your thoughtful – and thought-provoking – comment.

    • Tiao
      July 23, 2012 at 3:42 pm #

      Then read about Dr. Burzynski and his righteous fight and cunerrt victory w/ the FDA in Phase !I Clinical trials. His anineoplaston treatment is hugely successful over 60% sucess rate; I know 3 folks who’ve been cured at his Houston clinic after which they continued to heal fully at home. Major threat to the big biz called cancer industrial complex.  And what’s your problemo with someone describing the physiochemistry of cancers and the failed standard treatments?

Leave a Comment

Remember to play nicely folks, nobody likes a troll.