When Cancer Treatments Do More Harm Than Good

When someone is sick, there's a deep urge to do something to help. This is a very useful urge, for the most part. It's helps drive philanthropy and medical innovation and allows people to lead longer and more comfortable lives.

But when patients are very ill, and there is no proven way to help them, the urge to help can actually cause harm, even as it drives up health costs.

An op-ed in today's NYT looks at the long history of aggressive cancer treatments that became widely popular before they were proven effective. Often, studies ultimately showed those treatments were useless, or even harmful. That history continues today.

The author, a Columbia med school doc named Barron Lerner, singles out a treatment that uses heated chemotherapy drugs along with surgery to treat certain colorectal and ovarian cancer patients. The treatment is increasingly popular, but still unproven.

"Hospitals should offer heated chemotherapy — and insurance companies should pay for it — only after controlled trials have proved its effectiveness," he writes.

We heard a lot about this sort of thing a few years back, during the health-care debate. There was a moment in the sun for the Dartmouth Health Atlas, a wonky data set that shows that spending more on health care doesn't necessarily improve outcomes.

The issue faded from the headlines since then, but it's sure to bubble up again: Rising health care costs are projected to be a huge driver of federal deficits over the next decade.

But it's very difficult to refuse a treatment, even an unproven one, to a dying patient. It runs against the deep human urge to help the sick — an urge that sometimes leads to expensive, harmful treatments.

For More:

Listen to More is Less, a This American Life episode that looked at this problem.

Read Atul Gawande's New Yorker article, "The Cost Conundrum."

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