BONE MARROW TRANSPLANTS: CONTROVERSY SURROUNDS EFFICACY
NBC "Nightly News" featured an "In Depth" look at the debateThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
over the effectiveness of bone marrow transplants for the
treatment of breast cancer. NBC's Brokaw noted that it's a
"controversy that raises some of the most agonizing questions in
medicine: For some desperately ill breast cancer patients a
controversial bone marrow transplant might be their last best
hope for survival, but it is enormously expensive, it is risky
and many experts say it is ineffective." University of
California-San Francisco's Dr. Craig Henderson said that "there's
no evidence" that the procedure prolongs breast cancer patients'
lives or "that it cures any patient who wouldn't be cured
otherwise or that there's a net improvement in the quality of
EXPENSIVE AND WIDESPREAD: NBC's Bazell reported that the
treatment, known as autologous bone marrow transplant (ABMT), is
expensive, costing $100,000 or more per patient. It is also
widely used according to a recent General Accounting Office (GAO)
report that found approximately 5,000 of the procedures performed
in the U.S. every year. However, Bazell reported, the GAO found
that "about 75% of the patients whose cancer has spread before
the transplant died soon afterwards, most from the cancer,
although the procedure itself kills five percent. Still 20% do
survive. But is that more than what would survive with standard
INSURERS: Health insurers "have tried resisting paying" for
the transplants, Bazell reported, but "most insurers now pay"
after a California jury awarded a breast cancer victim's husband
$89 million in damages after she died following her insurer's
refusal to pay for ABMT. Patient advocates also question whether
the procedure should be covered, according to Bazell. National
Breast Cancer Coalition's Fran Visco said, "Funds that go toward
bone-marrow transplants are funds that could be used to fund
trials and studies to find out what really does work."
NIH STUDY: Bazell reported that NIH researchers are "trying
to conduct clinical trials to compare bone marrow transplants
with regular chemotherapy." However, NIH is having difficulty in
attracting enough breast cancer patients to participate in the
study, and results from the analysis "won't be available for at
least two years." In the meantime, many experts say the
controversy will continue "until researchers find truly effective
treatments for advanced breast cancer" ("Nightly News," 6/3).