From Capital Region Action Against Breast Cancer
By Bonnie B. Spanier, Ph.D., Microbiology and Molecular Genetics, and CRAAB! science consultant
Last October, I was monitoring local Breast Cancer Awareness Month messages in South Jersey (visiting my family) with an eye for hype around mammogram screening. Fitting that bill was a TV ad for Cancer Treatment Centers of America (CTCA), telling every woman to go to ensure early detection and featuring its closest facility, in Philadelphia. CTCA is a for-profit firm that only takes advanced cancer patients and claims better-than-average survival rates. Now rapidly expanding in the US, its glossy foldout ads in The New Yorker this fall promised “Patient Empowered Care” and “Smart Medicine” that includes “supportive therapies like acupuncture, nutritional counseling, and chiropractic care to ease the side effects of my treatment.” Sounds good, but is that different from the up-to-date integrated approach to managing cancer treatments available in many places throughout the country? I had to find out.
WHAT I LEARNED What I learned about the founder of CTCA and its history made me look closely at how CTCA operates and who benefits. In the decade after its founding in 1988, CTCA’s ads claimed survival rates for various cancers higher than the national (SEER) averages. When in 1996 the Federal Trade Commission regulators found their statistics selective and thus inaccurate (for reasons below), CTCA was supposed to stop using misinformation in its advertising. According to CTCA and FTC spokespersons interviewed for a report I found, that settlement reached between them prevents us from knowing how well this firm is complying today. All this is in a Special Report that quotes a named FTC source, CTCA spokespeople, also named , and then experts like Donald Berry whom the reporters questioned.
I found out about CTCA’s problematic past by Googling the full name, easily finding a 2013 investigative report from Reuters that laid out how CTCA skews its survival figures. Sharon Begley and Robin Respaut’s Special Report documents CTCA’s consistent practice of cherry-picking which cases it accepts (such as no Medicaid, no uninsured, no Medicare-only, and only those able to pay for travel to CTCA for their primary treatment) and also which cases are included in its success statistics (only people treated by CTCA “for the duration of their illness,” meaning those who had the means and the health to bypass local treatment options and travel to a CTCA Center for start-to-finish treatments).
Several oncologists, including well-respected breast cancer researcher Donald Berry of MD Anderson Cancer Center in Houston, TX, explained that those selective criteria for patients and for survival statistics (ability to travel for treatment from the start and only counting full duration treatment by CTCA) select for healthier patients more likely to survive, thus skewing CTCA’s claims of better results against advanced cancer. Those experts noted that excluding from statistics those patients treated elsewhere at all— and even touting survival stats— are not standard practices for cancer centers or hospitals. The Special Report’s personal stories of patients who started with CTCA and were then turned away when their health was getting worse are horrific. To be fair, there are other patients who tell life-saving success stories. It is not easy to assess the current biomedical merit of CTCA’s care of advanced cancer patients, a sometimes difficult-to-ascertain but crucial truth, in relation to similar places in the for-profit cancer care industry.
Very recent developments for CTCA show at least one star oncologist, Dr. Maurie Markman, joining their business as they open new centers around the country. The kinds of professional organizations that give their seal of approval and the kinds of professional recognition cited on the Web site suggest to me that CTCA is trying hard to make its past disappear. In fact, a Google search now starts with a long list of public relations announcements about CTCA, resulting in the Reuters report and the stories of prior problematic behavior being pushed far down the list of search results.
Please note that Begley and Respaut’s 2013 investigative article is my only source here, so take a look yourself to decide if their cited sources seem valid, as they seem to me. (If anyone finds other sources on CTCA, would you share it with me, [email protected])
I found there another piece of CTCA history that I find very troubling. CTCA’s founder and current Board Chair, Richard J. Stephenson, used to be an investment banker who became a trustee in 1966 of Americans Building Constitutionally, in which the state of California found guilty of “grand theft or conspiring to commit grand theft” in 1969. Stephenson testified for the state while pleading no contest on false advertising, a misdemeanor. He entered the healthcare business in 1975 with a financially strapped hospital in Zion, Illinois, that was subsequently investigated for using unproven cancer treatments. Do you want to do healthcare business with this man?
Cancer survivor and blogger Kerri K. Morris retold this CTCA story based on the Reuters piece, saying “The people most likely to die aren’t included in the numbers. In fact, the bulk of the people actually treated by CTCA aren’t included in the numbers. At its best, Cancer Treatment Centers of America provides standard care on par with non-profit institutions. At its worst, [CTCA] sells hope to desperate people and profits from their desperation.”
Cancer Treatment Centers of America. www.cancercenter.com.
Sharon Begley and Robin Respaut, “Special Report: Behind a cancer-treatment firm’s rosy survival claims,” March 6, 2013, Thomson Reuters, http://www.reuters.com/article/2013/03/06/us-usa-cancerctca-idUSBRE9250L820130306.
Kerri K. Morris, “Cancer Is Not a Gift”, June 12, 2013, http://www.chicagonow.com/cancer-is-not-agift/2013/06/cancer-treatment-centers-of-america-sells-falsehope.
i. Again, according to Begley and Respaut, that organization “helped wealthy individuals set up not-for-profit corporations and personal trusts to avoid paying federal income and inheritance taxes.”