Fairfax, Va., June 27, 2013 A new study, "Use of Advanced Treatment Technologies Among Men at Low Risk of Dying from Prostate Cancer," published Tuesday, June 25, 2013, in the Journal of the American Medical Association (JAMA), by Bruce L. Jacobs, MD, MPH, et. al., analyzes treatment data for 55,947 prostate cancer patients (aged 66 years or older) in the Surveillance, Epidemiology and End Results (SEER)-Medicare database from 2004 to 2009. The study found that the use of advanced treatment technologies increased from 32 percent to 44 percent among men with low-risk prostate cancer, from 36 percent to 57 percent among men with high risk of non-cancer mortality, and from 13 percent to 24 percent among men unlikely to die from prostate cancer. In discussion, Dr. Jacobs, et. al., raise several concerns about increased treatment: "aggressive direct-to-consumer marketing and incentives associated with fee-for-service payment may promote the use of advanced treatment technologies;" "more diligence is needed to reduce the potentially unnecessary treatment of men with a low risk of dying from prostate cancer;" and "more immediately, policy change may help curtail the excessive use of advanced treatment technologies among patients least likely to benefit."
Michael L. Steinberg, MD, FASTRO, chairman of the American Society for Radiation Oncology's (ASTRO) Board of Directors, states that Dr. Jacobs, et.al.'s study reaffirms the Society's commitment to closing the self-referral loophole for radiation therapy within the Ethics in Patient Referrals Act, also known as the self-referral law.
ASTRO supports the use of intensity modulated radiation therapy (IMRT) as an appropriate, effective treatment for prostate cancer patients, however, IMRT should be carefully considered along with other effective treatments and management options, including active surveillance, by patients and their doctors. Treatment decisions should not be based on the phy
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American Society for Radiation Oncology