Yesterday’s New York Times article about health care reform and the overly inflated cost of the American health care system should ring large and loud alarm bells in the prostate cancer community. This article, along with the recent increasing pressure to halt prostate cancer screening, should put a major scare into the community. Unfortunately, the Times article specifically focused only on prostate cancer and has managed to throw additional fuel on the debate over whether men with early-stage prostate cancer benefit more from active and expensive treatment or from “watchful waiting.
In all honesty, the article did raise a number of legitimate concerns. Should treatments, which are used to combat prostate cancer, considering that there is no demonstrated survival advantage of one treatment over the other, be limited solely on the economic costs? This is a good question, especially when you consider the cost of proton beam radiation is often four times more expensive than surgery. However, when temporally linked with the PSA debate this can only signal devastating results for the prostate cancer community.
What about men with advanced prostate cancer, where does this debate leave them? I can assure you that they too are going to suffer. Those of us with advanced disease no longer can talk about cures and most of us are no longer as focused on side effects, but are instead intensely battling for our lives, trying to extend our survival time. However, we too will get lost in this debate. Fortunately, I have yet to hear the argument that men with advanced prostate cancer should not be treated, but only time will tell if this also changes. My concern remains that men with advanced disease do not get the research dollars or the insurance consideration but instead will lose their identity with the masses with the possible result hastening their demise.
Don’t believe me, yesterday. the stock market raised this very same question. Should men with advanced prostate cancer not be treated? The market spoke and raised this same question. Dendreon, the potential manufacture of Provenge (search this blog for a complete description and discussion about Provenge) had a significant drop in stock price purely as a response to this New York Times article and the recent general attack on treatments and screening for prostate cancer. The investment world is clearly thinking that along with the increasing resistance to prostate cancer screenings there will also be a growing resistance to spending money for the treatment for men with advanced prostate cancer.
Joel T Nowak MA, MSW
Damn. (Pardon my French.)
Thanks for raising this issue, Joel. My plan has always been to survive from year to year on clinical trials or the next best treatment, until there is a breakthrough.
Reading your post caused a sinking feeling in my stomach. I’ve been trying to sort through Medicare and the best private gap coverage, since I go on Medicare in October. Now, health insurance has been covered by a gray cloud.
I’ve got to shake this off and get back to living in the present, but we need to let Washington know that this is unacceptable. I look forward to any additional thoughts you might have.
One thing I think was overlooked in the article, and applies to health care in general, is that we have multiple modalities of treatment if for no other reason we are not all genetically identical, so to speak. Simply put, we understand that one medication works for one cluster of patients better than another; and, therefore, we offer two or more medicines for things like high blood pressure. This is the same reason why, while there may be no statisitcal difference over the whole population of PCa patients for one treatment over another; for individuals or sub-populations some treatments will present the better option for survival and quality of life. The author of the Times article clearly had no understanding of this. What is of concern is that it’s likely neither will Congress.
What we need now is not individual action, but strong collective activity from all advocacy groups. I would hate for us to look back at this time as the “golden age” of cancer treatment because of health care reform. Especially when we think of our children as being more highly predisposed to these cancers. It’s imperative that these options remain viable.
I find it sad that when articles like this appear there isn’t a more robust response from all cancer advocacy groups. The author could just have easily picked breast, pacreatic, lung or any other cancer to make his argument.