More on Over Treatment, Colluding Physicians, PC Putting Medicare at Risk -- A Story of Greed (Docs) and Fear (Patients) -- From WSJ

 A hot topic in The Prostate Storm ... and in the Wall Street Journal this month:

Men with prostate cancer being over-treated (this time with high-dose radiation) and urologists colluding for financial gain ... oh my, could this really be true?  Are the reimbursements Medicare pays out as more Boomers move through their prostate years just too fat to pass up? Apparently...and it could bankrupt the system.

What happened to "do no harm first"?

Here's a couple excerpts from the Wall Street Journal, "A Device to Kill Cancer, Lift Revenue," on December 7, 2010.

"Roughly one in three Medicare beneficiaries diagnosed with prostate cancer today gets a sophisticated form of radiation therapy called IMRT. Eight years ago, virtually no patients received the treatment.

"The story behind the sharp rise in the use of IMRT—which stands for intensity-modulated radiation therapy—is about more than just the rapid adoption of a new medical technology. It's also about financial incentives...."

That's the lead ... later in the story:

"More than 190,000 American men are diagnosed with prostate cancer each year. How—and even whether—to treat the disease has long been controversial because prostate cancer tends to grow slowly. Many victims are more likely to die from other causes.



"Treatment options range from IMRT, which costs Medicare as much as $40,000 for a full course of radiation in places such as New York, to a cheap approach known as "watchful waiting," which means simply monitoring the cancer with regular office visits and tests. Medicare pays up to $16,000 for a prostatectomy—surgery to remove the prostate—and as much as $19,000 to implant radioactive seeds to kill cancerous cells.

"IMRT has become popular with patients because it is less invasive than surgery or seed implants. It is widely recognized as superior to the type of external radiation it replaced because it targets only the tumor, limiting damage to healthy tissue. But it has become a source of heated debate among health-care professionals, some of whom argue that it isn't being used in a cost-effective manner.

"Overtreatment with IMRT is a fact," says James Mohler, a urologist at Roswell Park Cancer Institute in Buffalo, N.Y., who chairs a physicians committee that sets national treatment guidelines for prostate cancer. Dr. Mohler cited a 2006 study in the Journal of the National Cancer Institute that found that 45% of American men with prostate cancer who received external radiation were being overtreated."