The March issue features coverage of the 2012 Genitourinary (GU) Cancers Symposium, which was held in San Francisco.
On the cover are two news articles, one of which reports on two two studies comparing prostate cancer treatment (PCa) modalities. Among the chief findings: Brachytherapy is less toxic and less costly than either external beam radiotherapy or radical prostatectomy, and proton beam therapy—the most expensive PCa treatment of all—is no better than intensity-modulated radiotherapy. In the end, decisions about which treatment is best for a patient depends in large part on factors other than those explored in the two studies.
Although clinicians may be averse to letting cost to be an overriding issue in the treatment they recommend, they might have no choice in the future. These data could be considered by public and private health insurers as they develop reimbursement policies aimed at cutting health care spending. They could formulate payment guidelines that encourage the use of one treatment (the cheaper one) over another.
Symposium news coverage continues on pages 16 and 17, where you will find a report on a large study showing that clinicians are not following the U.S. Preventive Services Task Force recommendation against PSA screening for men aged 75 years and older. The study did not look at why, but the lead investigator suspects that one reason may be that clinicians do not believe that the controversy surrounding the value of PSA screening in this subpopulation has been resolved.
And be sure to read about the study showing that 11% of men with metastatic PCa receive no anticancer treatment. The study found that Medicaid, Medicare, and uninsured patients were more likely than the privately insured to go without treatment. What I thought was particularly interesting was that Medicare patients were more likely than Medicaid patients to be untreated. I would have thought the reverse given that the Medicaid population tends to be more disadvantaged socioeconomically.
Lastly, we have a report on a study suggesting that everolimus may be the first effective pharmacologic treatment for angiomyolipoma (AML). Nearly 42% of patients with this benign tumor had an AML response compared with none of the placebo recipients.
For additional news reports from the symposium, I invite you to visit our website, where you can view video podcasts of colleagues providing details of their studies.