"I wouldn't give chemotherapy to a dog," pronounced a Minneapolis nurse practitioner who had left a hospital practice to pursue "alternative" healthcare.
That was almost two decades ago; a time when chemotherapy came under broad attack as being "primitive" and "barbaric." Its gradual demise was widely expected. We were wrong.
An increasing number of my friends and colleagues are undergoing chemotherapy for the treatment of a cancer that was asymptomatic. They become sick, and sometimes die, not from the cancer, but from the chemotherapy.
"She feels fine and if she hadn't been told she has this presumably fatal condition, we wouldn't be particularly concerned," a colleague's husband informed me. "Tomorrow she enters a new and aggressive round of chemo. We're doing what the doctors say. After all they know more about this cancer stuff than we do."
He is right. But in the "Do-I or-Don't-I-Take Chemo" decision, patients should be aware of the "cancer chemotherapy concession," a congressionally- approved exception to the long-standing rule forbidding physicians from selling and profiting from the drugs they prescribe.
The concession gives medical oncologists the unique and extremely profitable ability to buy chemotherapy drugs at discounted prices, often for less than the patient's co-pay. The oncologist has complete logistical, administrative, marketing and financial control over the process.
A Michigan-Harvard study authored by Dr. Joseph Newhouse concluded that medical oncologists over-whelmingly select chemotherapy based on its profitability.
A similar study by Dr. Neil Love showed that academic-based oncologists (who do not profit from infusion chemotherapy) overwhelmingly prescribed oral chemotherapy, in contrast to community-based oncologists, who overwhelmingly prescribed expensive, highly-remunerative drugs.
"It's not that all oncologists are bad people," observes an Oncology News commentator. "It's just that it is still an impossible conflict of interest. The system is rotten."
(Pro bono legal information, advice and assistance is available to persons 55 and older, through the USD Senior Legal Helpline, 1-800-747-1895;mmyers@usd .edu).