New York, NY
In a recent investigation, the Wall Street Journal found that roughly one in three Medicare patients diagnosed with prostate cancer receives a form of radiation therapy called intensity-modulated radiation therapy, or IMRT. The article claimed that the rapidly rising use of IMRT is not just about adopting the latest in medical technology – it’s fueled by financial motives. Dr. David Samadi, a robotic prostatectomy expert, as well as the Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City, is a longtime critic of radiation therapy treatment for prostate cancer, “And this latest news only concerns me more as to which audience we are truly serving in the fight against prostate cancer,” he said.
Critics claim they are losing business to IMRT. “Independent radiation oncologists say many urology groups convince patients to go for IMRT for financial incentives, though many practices deny this claim, saying the trend is driven by patients themselves,” said Dr. Samadi. IMRT Medicare payments can go as high as $40,000 per patient, depending on the state, with the bulk of the payments going to the urologists, which own the equipment.
Physician “self-referrals” for testing, imaging and treatment centers have long been criticized for their implied financial interest. The article claims the groups are capitalizing on a federal law exemption that dictates patient referrals, which have spurred them to unite fronts with radiation oncologists and reap the benefits of lucrative Medicare reimbursements. Urologist groups buy the equipment, hire radiation oncologists to administer the therapy and refer patients for in-house treatment, even though many claim they are just coordinating care and offer other treatment options to patients.
IMRT proponents claim that radiation therapy is more effective and results in fewer side effects than other treatments. IMRT is supposed to be superior to the older type of external radiation because it only targets the prostate tumor and reduces damage to healthy tissue. Patients claim to prefer it because it is less invasive than surgery or seed implants. Dr. Samadibelieves the best treatment is a radical prostatectomy, specifically a robotic surgery, as it is the only method that removes the prostate gland entirely for better staging, grading and cure. “Radiation therapy may be less invasive externally but it’s can do much more residual damage internally than surgery,” he said, “A robotic prostatectomy is just as minimally invasive and provides far superior results.”
Dr. Samadi noted that eight years ago, practically no prostate cancer patients received IMRT treatment, interestingly enough, he says, “It’s hard to believe that the patients are coming in and demanding IMRT, with all of the risks involved with the treatment. I don’t believe that the patients drive the trend, because we, as medical experts, should be partnering with our patients and recommending the best treatment for them on an individualized basis,” he said.Press Release