Congressman Battles For Medicare To Cover "CyberKnife" Cancer Treatment, For One Reason Or Another

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Some Texas cancer patients and their physicians are up in arms over a regional Medicare contractor's denial of coverage for a non-invasive radiation therapy conducted via a device with the William Gibson-esque moniker "CyberKnife."

Trailblazer Health, the Medicare contractor for Texas, Oklahoma, Colorado and New Mexico, says there simply hasn't been enough testing to determine CyberKnife's efficacy. But, at the behest of some CyberKnife supporters, U.S. Representative Charles Gonzalez this morning toured a cancer treatment center in San Antonio where the CyberKnife is used.

A spokeswoman for Gonzalez told Hair Balls that Gonzalez wanted to make sure that cancer patients had access to various treatments. She also gave us information provided by CyberKnife's manufacturer, the California-based Accuray, about CyberKnife's high success rates. And a spokeswoman for Accuray told us that Medicare contractors in more than 30 states cover CyberKnife procedures.

Well, clearly, Trailblazer Health has to be evil, right? Why else would a Congressman appear alongside cancer patients and furnish a statement to Accuray's PR firm that "Denial of coverage for one of the most advanced treatments for prostate cancer is hard to understand, especially when one considers it has been used to successfully treat 70,000 patients nationwide"? We can only assume that, in order to issue such a statement, Gonzalez pored over peer-reviewed publications and interviewed oncologists across the country.

Or could it have anything to do with the fact that San Antonio physicians with South Texas Oncology & Hematology, a group that offers CyberKnife treatment, contributed over $12,000 to Gonzalez's 2008 campaign?

We're not experts, but we're not sure about everyone's motivation here. Trailblazer Health (a subsidiary of Blue Cross/Blue Shield of South Carolina -- confusing, no?) tells us that its non-coverage of "stereotactic body radiation therapy" (i.e., CyberKnife) for prostate cancer is based in part on "extensive input" from the American Society of Therapeutic Radiation Oncology.   

Per Trailblazer, "The literature in peer-reviewed medical and scientific journals regarding medium- and long-term effects of [stereotactic body radiation therapy] in prostate cancer, and regarding comparisons with the other existing forms of prostate cancer therapy, is sparse. Long-term effects are not well understood. The total number of patients treated in a planned, statistical comparitive manner is not high. Early investigational studies are still going on, and the conclusions from some of he studies are not known." 

We don't know if CyberKnife is effective or not. But we hope Texas's Medicare contractor isn't unnecessarily blocking patients' access to the best care possible. And we also hope that legislators won't automatically lobby for medical treatment they know absolutely nothing about, relying only on information from campaign contributors and other financially interested parties. Who wins then?  


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