An Oncologist Speaks Out: Chemo Makes Us Money, But It Doesn’t Work

Can you believe this picture?! My sister snapped it while waiting at a traffic light in Atlanta back in 2011. I couldn’t believe it when I saw it! I had just started my blog and had endured some brutal verbal attacks (about my holistic cancer healing story) on a popular cancer support forum, so I just wasn’t quite ready to talk so honestly about something like this.

I must confess that I’ve pondered some “let’s not assume…” kind of thoughts. Like “well, maybe it’s not an oncologist and it’s a foreign name, like “Kem Odoc”, or “Kemo D.” from the “OC” or something like that? 🙂

But after 5 years of hesitancy on publishing this picture, I think it’s pretty clear.

This person is a proud KEMODOC.

 

A Reasonable Look at Oncology:

Notice this doctor’s license plate does not say “HEALNGDOC,” “ONCODOC,” or “KANSRDOC.”

This picture provides much insight into the belief system of this doctor and the conventional medical model. Oncologists have been taught in their pharmaceutical-sponsored medical schools that the only thing that will cure cancer are drugs and other complicated, invasive medical treatments. In fact, if they believed and did otherwise, they would lose their medical license! It’s that serious.

The annual cost of cancer care in the United States projected to be $173 billion by 2020. The majority of cancer patients already well exceed $100,000 for the cost of their cancer treatment. Pharmaceutical cancer treatment makes oncologists A LOT of money.

Would you be surprised if I told you that in many cases 60-70% (or more) of an oncologist’s practice is coming from the sale of chemotherapy and other cancer drugs? This was really eye opening for me. In a way, oncologists are placed in a situation where the sale of chemotherapy and other cancer drugs is their livelihood. Most of the skillset they worked to achieve in their career would be rendered useless if they didn’t have chemotherapy to sell as treatment to their patients.

So could it be they are just part of a medical and financial model they find themselves stuck in?

 

The Current Model of Cancer Care Relies on the Subjective Morality of Your Oncologist:

Check out this letter from oncologist, Dr. Peter Eisenberg. It was written in 2009 as commentary around how the current healthcare model forces oncologists to rely on money they make from the sale of chemotherapy and other cancer drugs. It was originally published on Health Beat, a popular Healthcare reform and policy blog written by Maggie Mahar. Note that it is not a piece written to support holistic or alternative cancer treatment or put down chemotherapy. It is dealing with the doctor’s overall frustration of the Buy and Bill model of chemotherapy sales.

In it, Dr. Eisenberg, Medical Director at California Cancer Care, (now Marin Cancer Care) says:

      “The reason oncologists have been able to grow a practice as large as ours and provide the level of service we do is because of the revenue we obtain from selling chemotherapy drugs and services…. 

        “We are paid more for administering the drugs than we were in the past, so it makes economic sense to administer them more often. Not every doctor is willing to do that. The practices that shows some restraint and don’t treat everyone who walks through the door with chemo are the ones that are suffering….

        “When doctors are paid to “do more” there is always the potential for conflict of interest. Keep in mind that physicians are human beings  with the same kinds of responses to financial incentives as everyone else. Despite our training and promise to put our patient’s interest first, we succumb to incentives that often come in the form of more revenue.”

        “It has taken me a while to sort out how I feel about the drugs we use. I began practicing in the late 1970s, and I remember the increasing role and influence of chemotherapy. As more drugs became available, with more evidence that they were effective, our optimism increased –and use increased as well.

         It became clear to many physicians—consciously or not–that selling chemotherapy was really the business they ought to be in as we were compensated so very well for it.  The time one spent with patients was not compensated nearly as well…

       When doctors are paid to “do more” there is always the potential for conflict of interest. Keep in mind that physicians are human beings  with the same kinds of responses to financial incentives as everyone else.  Despite our training and promise to put our patient’s interest first, we succumb to incentives that often come in the form of more revenue. 

      As time went on and science grew, we became increasingly more successful in providing chemotherapy that actually worked, and it was a lot easier for doctors to sell chemotherapy than it was for them to spend the kind of time necessary to give patients choices.

       Keep in mind that in the late ‘70s and ‘80s there was not much discussion about “shared decision-making.” If a patient had cancer, and we knew that tumors responded to a certain chemotherapy regimen by shrinking, physicians assumed that patients would choose to take it, if it was offered to them.  “You have cancer, you need chemo,” seemed to be the mantra.

It was not until much more recently that the notion of quality of life, and the fact that just because we shrunk a tumor doesn’t mean that people will actually live longer, was clear to us.”

 

No Effective Chemotherapy For Most Cancers:

Then Dr. Eisenberg discusses the effectiveness of chemotherapy. I almost sense frustration in his writing about how truly ineffective the only tool he has in his toolbox is:

  (Referring to a discussion with a patient with Stage 4 small-cell lung cancer…)     

      “So rather than making it clear that the average patient lives only a couple of month longer—and that the chances of surviving for a year are less than 50/50,  it is much easier to say, “Yes, you do have a tough disease, but I think we can help you, so let’s start treatment tomorrow!  

     Of course, treating Hodgkin’s or another curable disease is something else, but most of the cancers we treat with chemo are not curable. Doctors need to be paid for the time it takes to explain the potential benefits as well as the downside of chemo—so that the patient can make a decision about how he wants to spend the time he has left…”

       “The truth is that there is no clearly effective chemotherapy for a distressing number of  malignancies.  In those cases, if I find that first line therapy  isn’t working, I won’t automatically offer a second type of chemo.  Instead, assuming the patient wants a frank appraisal of her condition, I’ll explain the realistic goals and options available.  In my experience, and in the community in which I live, patients seem to want to know as much as they can about their illness, even if the news is bad.  Delivering terrible news is difficult, time-consuming and extraordinarily painful for all involved.  But good decisions depend upon an honest and forthright discussion and providing the patient with the information and tools to make decisions. 

…I have told patients, “I know that I can make you sick, but I am not certain that I can make you better! …  In the foreshortened time that you have left, you need to think about what you want to do. Do you want to spend that time in this office, with me and my staff, or is there someplace else you would like to be, something else that you would like to do?”

——————————–

Chemotherapy may work in the short run in killing cancer cells and shrinking tumors, but I think what most people with cancer and their families are interested in is LONG TERM wellness, not short term tumor shrinkage and drug and doctor dependency.

I HIGHLY recommend reading the entire letter. Dr. Eisenberg seems like a reasonable guy. His honesty is refreshing and it provides some much-needed perspective to those in the natural health world that the conflict between conventional and natural medicine isn’t so black-and-white/ good-guys vs. bad-guys. In the end, greed can get the best of anybody.

I’d love to hear your thoughts! 🙂 Feel free to comment below or on the Green Drink Diaries Facebook page.


Sources and Additional Reading:

A Very Open Letter From an Oncologist with Dr. Peter Eisenberg

Private Oncologists Being Forced Out, Leaving Patients With Higher Bills (with Dr. Eisenberg)

The High Cost of Cancer Care and What We Can Do about It (Mayo Clinic)

Study in Journal of Clinical Oncology: Are Oncologists’ Financial Incentives Aligned With Quality Care?

A List of 20 Questions For Your Oncologist Before Choosing Treatment

Study in Journal of Clinical Oncology: Medical Oncologists’ Perceptions of Financial Incentives in Cancer Care

The Reimbursement Process for Buy and Bill

 

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7 thoughts on “An Oncologist Speaks Out: Chemo Makes Us Money, But It Doesn’t Work

  1. I’ve posted this before and I’m going to keep posting it. There is a true cure out there and it is a cheap Unpatentable chemical- 3-bromopyruvate. Drs Young Ko and Peter Pedersen discovered it a decade and a half ago and politics have held it back. But now it is winning approval in other countries. Keep a watch out for it- it will come to this backwArd country. Isn’t it amazing?- discovered here and can’t be used here!!!!

  2. There are multiple issues with the medical profession, standard of living, and how the treatment of cancer is approached. However, having watched my father step through 10 year of therapy and have a successful bone marrow transplant and multiple variety of chemo therapy I would caution you on generalizations that most chemo therapy does not help and won’t provide improvement. It does help and can bring someones life back, yet my father saw many friends he made in the moffet hospital die from these treatments as well. My point is please don’t scare a person into thinking that a Dr. must be lying to them because they are recommending chemo, because it really can be the best possible choice to save a persons life and improve their quality of life. My father would not have made it to my wedding with out chemo, and for that I am thankful.

    • Hey Andrew, I am very grateful that your father was able to be at your wedding and I hope is still doing well. This is wonderful to hear. For most people this isn’t the case for long-term survival (which I assume is the goal for most everyone when dealing with cancer.) I didn’t say that chemo isn’t effective in most cases of cancer, this ONCOLOGIST says it. And the data supports it as well.

      As the title of this blog shows, I am in the camp of changing your lifestyle and approaching cancer through holistic, whole body overhaul: detoxification, heavy nutrition through plant-based sources, supplements, and various alternative treatments (and surgery if helpful.) A middle-ground would be surgery if helpful, minimal chemotherapy or conventional treatment to shrink tumor burden, and then detox and continued support with plant-based nutrition, supplements and detox. Also: emotional healing in both cases as well! I did not intend to scare anyone off, just to inform.

  3. My wife died this past July from breast cancer. We dealt with a hospital that was considered the best in the Chicago area, Northwestern. I feel that one of the biggest problems we had was poor communication on the part of the doctor and medical staff. My wife and I had to rely on searching for information through the internet or talking with other lay people who had cancer experience in their own families. That often can be misleading information because every case is so different, and people always don’t remember all the important details of their own situations. I could go on for hours writing about the problems we had and how I wished we would have dealt differently with her illness. We were given no choices or alternatives. Our system of dealing with cancer needs a lot of improvement and changes. The more I read now about holistic medicine and proper diet the more I feel cheated. I also feel that, as a husband, I was not a good protector for my wife. I feel guilty and a failure. I now need to do more to protect the future for my adult children and grandchildren. I look forward to reading and studying more about the treatment of cancer.

    • Oh William, your comment broke my heart. I encourage you to allow yourself to mourn during this season, but be encouraged that there are many others in your same situation, feeling the same as you. Ty Bollinger’s work is based primarily on this and look at how many he has impacted! (thetruthaboutcancer.com) Prayers for you and your family during this time.

  4. So just last week my dad was diagnosed with Stage IV Lung Cancer. The oncologist recommended chemotherapy once every 3 weeks and radiation 5 days a week. I’ve been doing a lot of research on a healthy diet (raw vegan, vegan, etc.) and also alternative treatments. At this point my dad has started his first round of chemo/radiation. My family only knows about the conventional treatments and I don’t think would understand the alternative. I don’t think I will be able to stop the conventional but my plan is to do a combination of both and having my dad be as healthy as possible through this treatment. I’m looking for advice how I can help my dad with alternative treatments while he is going through chemo and radiation. Is there a specialist that can help in? We live in Seattle, WA. Thank you!

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