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Financial incentives drive prostate cancer treatment

Buried on page A8 of the Oct. 24 News was an article worthy of front-page coverage. The topic, “Urologists’ profits tied to treatment decisions,” described a five-year study published by the New England Journal of Medicine on Oct. 23. The study found that men with newly diagnosed non-metastatic prostate cancer are much more likely to be treated with intensity-modulated radiation therapy (IMRT) when their private, self-referring physician has an ownership interest in IMRT equipment. This eye-opening study stated that IMRT usage by self-referring physicians increased by 19 percent during the duration of the study.

Researchers compared IMRT usage by non-self-referring, geographically matched cancer centers participating in the National Comprehensive Cancer Network during the same time period. These hospitals did not experience an increase in IMRT usage.

This year it is estimated that 238,590 men will be diagnosed with prostate cancer. It is a complicated disease that requires thorough evaluation of clinical findings and ultimately individualized, prudent treatment. Simply put, financial incentives drive prostate cancer treatment in an overwhelming proportion by many self-referring urologists. Physicians have an ethical obligation to provide the best advice and treatment available. All possible courses of action, along with possible side effects related to each option, must be discussed.

Patients should be encouraged to get a second opinion to “cover all the bases” without fearing disruption of their care, or worse, expulsion from their urologist’s practice. Always be wary of doctors who rush to treatment, especially if they are not transparent in their ownership of specialized equipment. It is unconscionable that high-profit medical treatment should ever be recommended at the expense of a patient’s best interest.

Joan M. Peck

President, WNY Chapter of

Women Against Prostate Cancer