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Targeted Beams: New Machine Speeds Radiation Treatment

Rating

2 Star

Targeted Beams: New Machine Speeds Radiation Treatment

Our Review Summary

This was a totally uncritical story about a newly approved radiation treatment which can be used against prostate cancer. It describes a modification of an existing treatment (IMRT) that merely decreases treatment time, though not the number of treatments.  The quality of life benefit of reducing treatment time by 3 to 7 minutes seems marginal, and there is no evidence that this would lead to better treatment outcomes.  Although the manufacturers have distributed news releases on this technology, one wonders why the WSJ chose to publish this story now. The story failed to:

  • quantify the harms and benefits of the approach;
  • disclose the actual costs of the treatment;
  • include any independent expert perspective;
  • explain what options were available to patients. 

The story even referred to the manufacturer as "the industry leader in radiation technology."  That line, and the entire story, reads more like a paid advertisement than independent journalism.

The Wall Street Journal does some of the finest health care reporting in this country on most days.  This story was a major disappointment.  

In an era in which healthcare costs are skyrocketing, it is not responsible reporting to herald a new device without critically evaluating its contribution. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story states that "The cost of RapidArc is similar to other radiation therapies.  It is covered by Medicare and most insurers". But that doesn’t tell us the cost, and it seems to suggest that since it is covered by insurers, the consumer need not worry about the costs.  In fact, the acquisition of this sort of equipment is quite expensive and the doctors investing in the technology will need to recover their costs, which may lead to unnecessary treatments.  That’s why actual cost is a big deal and should have been in the story.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story provided no information about how effective the radiation from this device is in the treatment of prostate cancer.  How do the lifespans of men treated with the RapidArc compare to men receiving radiation treatment from other devices?  How about those having surgery?

The major cited benefit is that treatment time is reduced from 5 to 10 minutes to less than 2.  It does not reduce the number of treatments. 

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The only harm of treatment mentioned was that the patient interviewed for the story feels a little sleepy in the afternoon after treatment.  However the experience of a single individual cannot be considered sufficient information on the possible harms associated with a treatment.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story both laid out the thinking behind the use of more targeted radiation (i.e. to minimize radiation exposure of surrounding tissue) and indicated that data comparing treatments is difficult to come by.  It then went on to state categorically that the use of this technology reduces risks.  However it never provided insight about how the reader could ascertain that this was the case.  The story actually gave no information documenting the effectiveness of this treatment or anything about the incidence of side effects.

Does the story commit disease-mongering?

Satisfactory

The story did not engage in overt disease mongering.

 

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story included comments from a number of individuals, all of whom have a vested interest in the RapidArc (a company spokesperson, a spokesperson for a cancer center that has acquired the technology, a professional society spokesperson, and a patient who has selected this treatment).  The story should have included comment(s) from someone who could have provided an unbiased evaluation of what, if any, added benefit this approach contributes to the arsenal of available treatment options.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story stated that the radiation provided by the RapicArc is much greater than that of 40 years ago.  That said, the story provided the reader with no information about the treatment options available to those diagnosed with prostate cancer beyond radiation. 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story indicated that the highlighted device, the RapidArc, was currently in use in only 30 locations in the US.  

 

Does the story establish the true novelty of the approach?

Not Satisfactory

While the RapidArc may be new to the market, the story provided no insight as to how the radiation treatment from this device compares to others on the market.  Is it delivering something that is truly unique or are there other systems out there that can similarly focus the radiation beam used in treatment? (In fact – going to the company website, it appears that RapidArc is just a modification of existing intensity-modulated radiation therapy technology. The story says RapidArc is used in conjunction with IMRT and image-guided radiation therapy.  But what does that mean?)

Does the story appear to rely solely or largely on a news release?

Not Applicable

We are tempted to give this an unsatisfactory score, but because we see no text that is identical in the story and in the company’s news releases, we will post a N/A score because of our uncertainty.  What fuels our suspicion is:

  • The company sent out a news release this same day about this technology being discussed at a Swedish scientific meeting.  The story never mentioned the Swedish conference and never actually stated why this is newsworthy now. Unless, of course, it’s because the WSJ got a convincing company news release.
  • The story refers to Varian, the maker of the RapicArc as "the industry leader in radiation therapy." That sounds more like a corporate promotion rather than an objective observation. 

Total Score: 2 of 9 Satisfactory

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