Cancer Treatment — Unaffordable, less effective than advertised!

Lancet Oncology (behind pay wall) published a symposium on the “culture of excess” in the treatment of cancer. The BBC notes:

A group of 37 leading experts from around the world say the burden of cancer is growing and becoming a major financial issue.

“The issue that concerns economists and policymakers is not just the amount of money spent on healthcare, but also the rate of increase in healthcare spending or what has become known as the cost curve.”

It says the UK’s total spend on breast cancer has increased by about 10% in each of the past four years.

“Few treatments or tests are clear clinical winners, with many falling into the category of substantial cost for limited benefit.”

The cost of drugs is not the only target for criticism. Lead author Prof Richard Sullivan told the BBC: “It’s not just pharmaceuticals. Biomarkers, imaging and surgery are all getting through with very low levels of evidence – the hurdles are set too low.”

Medicynical Note: It’s too bad this is behind a pay-wall. Patients in the US are subjected to a blizzard of misinformation regarding cancer treatment, outcomes and the “benefits” of different approaches. Costs are not an apparent consideration by providers, patients or insurers and expenditures for cancer care are rising at an unsustainable rate.

We hear about the improved survival of patients and believe that justifies the increased costs. However, most, if not all, of these improvements in survival come from earlier diagnosis of cancers and counting pre-cancerous lesions also found by screening in the cure rate. DCIS, Gleason 5 prostate cancers, and early colon cancers are automatic cures.

The decreased incidence (declining rates) of lung and a few other cancers have little to do with treatment and are a benefit of smoking cessation and in some instances other lifestyle changes.

The new mega-expensive treatments ($50,000-$120,000/year) in patients with bad disease have resulted in no cures and limited survival benefit. Uncritical use of these drugs is bankrupting our non-system of care.

Finally, we still have 20-25% of our population smoking. This fact may provide income security for the medical industrial complex but offers an opportunity for a prevention strategy with real impact.


Advertisements

One response to “Cancer Treatment — Unaffordable, less effective than advertised!

  1. Amen! I am a BC/treatment survivor. Adjuvant therapy was strongly recommended after surgery. Not only was the therapy outrageously expensive (over 100,000 dollars) but all three therapies could have heart toxic effects. The heart risk was about equal to the benefits in absolute terms. I declined. The benefit for Herceptin, over $50,000 dollars for a year’s treatment, was given to me, by the oncologist, as a 54% benefit. I don’t think she realized that was a relative statistic, the absolute benefit being closer to 8%. Many of these expensive drugs are sold to doctors and the public on the basis of relative benefit. This can be very deceiving as we tend to think in absolutes. A story for another time.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s