Too Many Doctors Use Too Much Radiation to Treat Prostate Cancer Pain

Although radiation can be a vital diagnostic tool and a life-saving cancer treatment, its dangers are well-documented (see our backgrounder on radiation overdose injuries).

A recent study published in the Journal of the American Medical Association (JAMA) suggests that doctors might be using radiation therapy too often for patients with advanced-stage prostate cancer. That puts them at risk of normal cell damage, skin irritation, diarrhea, bleeding and other problems. It also adds to the cost of their treatment.

Radiation therapy is prescribed to treat pain in patients whose prostate cancer has spread to their bones. This intervention is not for improving chances of survival in these advanced-stage cases, only to address severe pain. Radiation treatment of 10 sessions or more is recommended only in fewer than 10% of cases, and only if the patient’s cancer also might have spread to nearby soft tissue.

As discussed on AboutLawsuits.com, the researchers found that very few prostate cancer patients receive only one radiation treatment to reduce pain; more than half of the patients they studied got more than 10 treatments.

Radiation also is prescribed to treat pain caused by other kinds of cancer that have spread to the bones in advanced stages. But researchers aren’t certain if a single session is used appropriately in those situations.

The study analyzed Medicare claims from more than 3,000 males who underwent radiation therapy from 2006 to 2009. Only 3 in 100 of the prostate cancer patients got a single session of palliative radiotherapy. (“Palliative” means easing the effects of a condition, not treating or resolving it.) But more than half of the study’s prostate cancer patients got more than 10 radiation treatments.

The cost for a single treatment averaged $1,900; it was $5,000 for 10 or more treatments.

According to AboutLawsuits, previous studies found that the benefits of radiotherapy for pain relief were no greater for multiple sessions than they were for only one if the patient’s bone metastasis was uncomplicated. Those studies concluded that one treatment typically is sufficient to provide the maximum pain relief possible.

So why aren’t those results reflected in common practice?

In some cases, the researchers speculate, doctors might be worried about pain recurring after only a single treatment. Some doctors might not be aware of the previous research on radiotherapy. Some might be financially motivated, because they’re paid per treatment.

Researchers say that single treatments often are better for the patient’s quality of life, and should be standard care. If your doctor recommends radiation therapy for prostate cancer pain, discuss the benefits and risks of single versus multiple treatments. Get a second opinion if you’re not convinced that the best practice for your situation is more than one treatment.

Learn more about radiation therapy from the National Cancer Institute’s fact sheet.

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