We need more stories that raise questions about new technologies.
Cardiac electrophysiologist Wes Fisher tweeted this week about a Chicago Sun Times story that he said was a promo piece for ablation for atrial fibrillation but failed to discuss the risks of the procedure.
Also this week, an article in Radiology Today concludes that:
“While early results appear promising, critics in radiation oncology say longer-term data are needed before widely offering the (Cyberknife) treatment to men.”
But we see billboards on freeways luring patients with vague messages.
The Radiology Today story quotes former practicing and well-known urologist Gerald Chodak:
“The five-year data that were recently presented are positive, Chodak says, but five years is not long-term and until the long-term data are available, he wouldn’t recommend offering SBRT as an option for patients with prostate cancer, which one man in six will get in his lifetime.
Chodak also fears that “money is driving this more than anything else.” Facilities are investing millions in CyberKnife machines and may be expanding to prostate treatments largely to get more use out of them, he says.
Rohit Inamdar, a senior medical physicist and senior associate in the Applied Solutions Group at the ECRI Institute in Plymouth Meeting, Pa., a nonprofit organization that evaluates medical products and processes, agrees with Chodak that the clinical evidence on the use of the CyberKnife for prostate cancer is “a little early … and a little weak. It’s still developing and cannot stand on its feet.”
Inamdar is also concerned about the financial issues. Some physicians might be presenting CyberKnife as an option for their patients because they’ve invested $5 million in the equipment and can’t afford to have it sit idle, he says.
“One fear I have is that it’s like a hammer looking for the nails,” Inamdar says. “If you paid $5 million for it and you’re paying for staff, now you have to put it to use.”
Ablation zapping of atrial fibrillation.
You name it – we need a better public discussion about evidence for new technologies, about cost-effectiveness, and about the tradeoff of benefits AND harms.