I got a letter from Allegra Poggio, an advocate with the Men’s Health Network (MHN), who asked me to pass on the following very important information to you and ask you to sign a petition on behalf of men with prostate cancer who are receiving hormone therapy. This treatment is difficult enough without having the government decide which medications a patient should take, based on cost — but that’s what Medicare is doing right now, interfering with the doctor-patient relationship. Hormone therapy for prostate cancer is no place to cut corners. Waste can be eliminated elsewhere.
Please everybody, educate yourself about this issue and sign this petition:
Click on http;//www.menshealthpolicy.com/advocacy/lcaPetition.php
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I also want to mention that Malecare, my sponsoring organization, has a petition circulating requesting that the government give parity in funding for breast cancer and prostate cancer. So while you’re at it, sign that one as well. Ask the government to make prostate cancer a national priority.
Click on
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Message from the Men’s Health Network:
One of the important policy issues highlighted on the MHPC website is the issue of access to vital drugs for prostate cancer patients on Medicare. . .
Right now, Medicare applies a practice called “least costly alternative” (LCA) to one and only one class of drugs – hormonal drugs – which are used by prostate cancer patients to fight this disease. This policy allows the Centers for Medicare and Medicaid Services to deny payment for the additional cost of a more expensive prostate cancer drug therapy if a comparable therapy costs less.
MPHC recently began a petition to US Congress to demand that Medicare repeal the LCA policy for prostate cancer drug therapies. Withdrawing Medicare’s LCA policy is needed to ensure patients have equitable access to “Vital Prostate Cancer Drug Therapies” and also because:
* A full range of approved drug therapies are currently available to treat prostate cancer
* Medicare’s LCA policy allows the government to interfere with prostate cancer patients’ access to those approved therapies solely due to cost
* LCA policy unfairly singles out prostate cancer patients, disproportionately affects low-income patients, and does not apply to other conditions
* The government should not interfere with treatment decisions made between prostate cancer patients and their physicians
I am including part of a conversation with Theresa Morrow, Director, Marketing and External Affairs Men’s Health Network:
“LCA is very problematic because it targets prostate cancer therapy alone, and it assumes that all prostate cancer patients and hormonal drugs are the same. In fact, these patients’ needs vary greatly, and the drugs have never been determined to be equivalent by the Food and Drug Administration. Essentially, you have the government dictating which drug a doctor can use with a very sick patient—it’s a one-size, fits-all mandate based on cost.
“Q: What are some of the detrimental effects of LCA on prostate cancer patients?
“A:. Unfortunately, there are several serious downsides to LCA. For one, these hormonal drugs are available in different size needles, they are administered differently, and they have different dosing regimens (monthly, yearly etc). Prostate cancer patients can be very frail, be in pain, or may bleed easily due to blood thinning agents. A patient may have trouble getting to his physician’s office. A patient and his physician may feel strongly about needle size, length of therapy, or whether an injection or an implant is preferable. Medicare’s use of LCA can steer a physician toward a choice that is not clinically appropriate for a particular patient.”
“To obtain a non-LCA drug, the patient will have to pay the difference in cost plus his usual copayment. This means that many low-income patients will be disadvantaged, creating a “haves and have nots” scenario.
If you have not already signed the petition, go to:
http;//www.menshealthpolicy.com/advocacy/lcaPetition.php
I’ve been on total androgen block for a year now following biochemical failure following radiation treatment for a localized Gleason 9 cancer.
As long as the therapy is effective- as it has been to date, I obviously plan to continue.
It is VERY IMPORTANT to remember that the human testicle synthesizes a certain amount of Estrogen, and the presence of this natural Estrogen in the system slows the progression of Prostate Cancer.
Castrated mice with Prostate cancer die MUCH FASTER than those treated with ADT. While mice and people are two different species, we are both mammals, and there is plenty of anecdotal evidence with men which implies that what is experimentally observed in mice is also true in humans.
It is very callous and fallacious for Medicare or any other health insurance provider to assume that surgical castration and ADT provide equal results- they don’t.
Also, many men on prolonged ADT have a very prolonged remission or even cure when removed from therapy…so why surgically castrate them? Surgical castration is irreversible.
Maybe the gentlemen making these health care decisions should be required to have their testicles removed! Actually I think that the people making these decisions for health care providers ARE NOT informed, experienced physicians who handle this type of illness regularly…they have a “scatter-shot” approach- and the paid responsibility to “cut corners” without really evaluating the problems and risks of surgical castration.
I can say from experience that the side effects of any kind of castration are serious. Since there is always the possibility that a persons life can be indefinately extended and eventually returned to a more normal hormonal situation, it is, as I said, “callous” to “write men off” and assume that the expense of chemical ADT is not worth it.
So much of this syntheitic ADT material is made by the pharmasutical companies, the cost certainly can and should be reduced. I can buy Casodex from Cipla in India for 15% or less of the retail brand cost of that drug in the United States.
Best Wishes to everybody…and thanks in advance to the government for its refusal to act rashly!
Sam Cox