What You Should Know About the Dangers of Prostate Cancer Treatment
In a prior post, some issues related to procuring life insurance by people with a history of prostate cancer were discussed. Eligibility for coverage was looked at from both a medical, and also a lifestyle point of view. Specific focus was placed on the approach used by physicians in prostate cancer treatment.
In this post, I will continue to focus on the role of the physician in confronting this disease. Specifically, we are going to learn a bit about the bias some doctors may have towards using radiation when treating prostate cancer.
The New England Journal of Medicine: Self-Referral Can Lead to Over-Use of Radiation
The New England Journal of Medicine recently published a study by Jean M Mitchell, PhD. Dr. Mitchell focused on the use of radiation treatment (IMRT: intensity – modulated radiation therapy) for patients with prostate cancer by both urology groups that own this technology, as well as urology groups that did not. What did she conclude?
“Urologists who acquired ownership of IMRT services increased their use of IMRT substantially more than urologists who did not own such services. Allowing urologists to self-refer for IMRT may contribute to increased use of this expensive therapy.” (1)
Dr. Mitchell elaborated on her findings in an interview with Bloomberg.com. She suggests that urology groups who can self refer over-use this expensive therapy.
Clearly, the unnecessary use of expensive technology for treating prostate cancer can have an adverse economic effect. At the same time, the health of certain patients may also be jeopardized.
“The situation may actually harm some patients. The analysis found that doctors who owned the IMRT therapy were treating men ages 80 and older just as aggressively as younger men with early stage prostate cancer. Since the cancer is generally slow-growing, and radiation can carry immediate side effects, including erection problems and urinary symptoms, the older patients may experience only the harms and no benefits.” (2)
Abuse of the System Can Lead to Health and Underwriting Problems for Patients With Prostate Cancer
From a strict life insurance underwriting point of view, the more medical ailments the potential applicant has, the higher the rate will be. Consumers, brokers, and carriers therefore all have a vested interest in minimizing the over–use of potentially harmful prostate cancer treatment. In the larger economic picture, the incentive to abuse the system should be addressed so that unnecessary waste and potential patient harm in all sectors can be identified and prevented.
This is especially true when treating elderly patients with prostate cancer. Financial commentator Mike Shedlock summarizes the problem this way:
“At a very practical level, the bureaucracy offers little incentive to weed out unnecessary treatment: Medicare hires contractors to issue payments to doctors, and those contractors are paid based not on how many claims they reject but on how many they approve.” (3)
(1) Urologists’ Use of Intensity-Modulated Radiation Therapy for Prostate Cancer
(2) Prostate Cancer Radiation Therapy Rises as Doctors Profit