US Medicare officials are taking a closer look at radiation treatments and their ability to reduce deaths and side effects in men with prostate cancer, after debates over how effective the therapy really is.
According to a recent Reuters report, the Center for Medicare and Medicaid Services (CMS) has asked a panel of experts to ensure confidence in the various radiation techniques that are meant to improve patient outcomes.
Researchers have discovered that most men with prostate cancer die from other causes, mainly because the prostate tumors are so slow-growing. The finding has many asking if the treatments, which often include surgery, are excessive.
CMS is seeking advice from experts that will at some point in the future be helpful for the group to determine its payment policies. CMS oversees 45 million elderly and disabled persons covered by Medicare, of which 40 percent are men.
Any changes in how CMS covers radiation expenses could affect the use of treatments by companies such as Accuray Inc, Siemens AG and Varian Medical Systems.
The experts will discuss several techniques used for prostate therapy including Accuray’s CyberKnife robotic radio surgery system. Another will be the use of radiation “seeds”.
There is a lot of debate surrounding how prostate cancers should be treated in the medical community, with surgeons, radiologists and urologists all taking different approaches.
“The problem is trying to find … the prostate cancers that need to be treated and which ones don’t, and that’s not perfectly clear today,” Dr. Theodore DeWeese, a radiation oncologist at Johns Hopkins Kimmel Cancer Center in Baltimore, told Reuters.
CMS said that looking at all the various treatments would be too much of a task for one day. “The scope of this (meeting) is limited to radiotherapy for the treatment of localized prostate cancer with comparisons to watchful waiting,” it said in announcing the expert panel.
Medicare currently pays for prostate cancer treatment, but the potential for a change in what services are covered is a concern for Accuray. While there is no formal Medicare rule requiring national coverage of Accuray’s CyberKnife treatment, coverage does vary by region. The Northwest and parts of the west do not cover payments.
Accuray is hoping for CMS to keep the status quo, but is very concerned that a future decision may rule against payments nationwide.
DeWeese said there is a lack of agreement over focused radiation therapy. “There is very little data to support that approach in terms of its likelihood of a cure,” he said. “It might be equally effective, but it’s certainly not proven.”
But Dr. Sean Collins, a radiation oncologist at Georgetown University Hospital in Washington who uses the CyberKnife, told Reuters that it seems CMS is “trying to hold (CyberKnife) to a higher level of standards.”
Collins plans to speak on Accuray’s behalf at a meeting on Wednesday. He says CyberKnife has the same side effect risks as other types of radiation but requires just a few visits rather than two months of daily doses. “I think CyberKnife is a reasonable treatment option,” he said.
Collins is not a paid spokesperson for Accuray.
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