Already too late to stop costly radiotherapy and surgery technologies?
How to measure the value of novel cancer treatments? That question, an increasing area of focus, was explored at a workshop convened by the National Cancer Policy Forum (NCPF) of the National Academy of Medicine. Speakers expressed concern about the rapid proliferation and diffusion of expensive new technologies in oncology without adequate assessment. A summary report is expected by the end of the year. They noted that new technologies such as proton beam radiation and robotic surgery cost more than existing treatments and may or may not lead to better health outcomes; and inappropriate use of expensive technologies has been identified as a key factor threatening the affordability of U.S. cancer care.
Among them was Jim Hu, M.D., director of the LeFrak Center for Robotic Surgery and holder of the Ronald P. Lynch Chair in Urologic Oncology at Weill Cornell Medical College.
“In some specialties, like urology, you are expected to have a robot; this is a very patient-driven phenomenon,” he said.
No one doubts that robotic surgery has certain advantages: 3D visualization, wristed instrumentation for better range of motion, lower blood loss, smaller incisions, a shorter hospital stay, and usually an easier recovery time. But, he continued, does robotic surgery improve functional outcomes (urinary, sexual) or survival outcomes among prostate cancer patients?
“Most of what we know is from observational data, and there is a need for solid data to show whether there are really improved outcomes from robotic surgery.”