Medicare Changes May Increase Surgical Castrations To Treat Prostate Cancer

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Changes inMedicare reimbursement policy might have prompted more beneficiaries to undergosurgical castration to treat prostate cancer rather than a less invasivealternative, according to a study published Monday on the Web site of thejournal Cancer, USA Today reports. Castration -- either through surgery or hormone injections -- is a common treatment for certain forms of prostate cancer.

In the 1990s and early 2000s, hormone injections became "far more popular ... with patients and doctors," in part because of high Medicare reimbursement rates for the treatment, but "doctors gave far fewer hormone injections after Medicare slashed what it paid them by half," according to USA Today. The study, led by J. Stephen Jones of the Cleveland Clinic, found that the number of hormone injections decreased by 14% from 2003 to 2005 and that the number of surgical castrations increased by 4% during the same period. Jones attributed the shifts to the changes in Medicare reimbursement policy.

However, Ethan Basch of Memorial Sloan-Kettering Cancer Center, who was not involved in the study, said that physicians have begun to administer hormone injections intermittently, rather than continuously, a shift that might account for the decrease in hormone injections. According to Otis Brawley, chief medical officer at the American Cancer Society, the shift resulted because of studies released around 2005 that found hormone injections can increase risk for osteoporosis and other health problems (Szabo, USA Today, 4/7).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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