Urology-owned radiation oncology self-referral can increase patients' travel distance for treatment

August 15, 2012

Men with prostate cancer in Texas may be driving more than three times farther than needed to obtain radiation oncology treatments for their cancer when treated at a urology-owned radiation oncology practice versus other facilities, according to a study to be published online August 15, 2012, and in the September 1, 2012, print issue of the International Journal of Radiation Oncology*Biology*Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

This study reviewed 229 urology practices in Texas and found that 5 percent (12 centers) offered radiation oncology services, and 53 percent of the state's population lives within 10 miles of these centers. The 12 urology-owned practices were found to have multiple urologic clinics, but each practice has only one radiation oncology center focused on . This often resulted in extended because radiation therapy is not available at the same physical location as the urologic clinic where the patient was initially diagnosed. The mean patient travel distance was found to be 19.7 miles (26.11 minutes) to the urology-owned center versus 5.88 miles (9.15 minutes) to the nearest radiation oncology center.

The patient benefits of this practice model, known as physician self-referral, have been questioned particularly with regard to its impact on increasing . Self-referral is being investigated by the U.S. and others due to concern that could steer patients to more costly, unnecessary and/or less effective procedures. This article reinforces concern about the increase in urology-owned radiation oncology practices across the country, and further notes that 28 percent of Texas urologists now work in practices that self-refer for radiation oncology services. According to a national Urology Times survey, published on December 1, 2011, 19 percent of urology groups report owning linear accelerators to provide radiation oncology treatments, and these medical groups refer patients for treatment within their own radiation oncology center.

"Integrated urology-radiation oncology practices are increasingly common in Texas and have the potential to impact patient care. For example, our study illustrates that patients diagnosed by a urologist whose practice owns a radiation treatment facility will, on average, drive three times farther to reach the radiation treatment facility owned by their urologist than they would have to drive to reach the nearest independent radiation treatment facility," said Benjamin D. Smith, MD, a radiation oncologist at the University of Texas MD Anderson Cancer Center in Houston and one of the study's authors.

Study authors affirm that their findings are limited to their research area of the state of Texas and recommend additional analysis of how urology-owned self-referral practices affect patient care, quality of treatment and patient satisfaction and outcomes, not just patient travel time.

"Travel time to cancer care centers is crucial, especially for older men with advanced disease, because external radiation therapy often requires daily treatment for six to eight weeks. These patients often need to lean on friends and relatives to help them get to and from these multiple appointments. We must be judicious when proposing treatment options to our patients and appreciate the time and travel investment, including significant transportation and fuel costs, they make when choosing ," said Colleen Lawton, MD, FASTRO, and president-elect of ASTRO. Dr. Lawton is a specialist and professor and vice-chairman of the department of at the Froedtert and Medical College Clinical Cancer Center in Milwaukee.

Explore further: IMRT cuts GI side effects from prostate cancer in half vs. 3D-CRT

Related Stories

IMRT cuts GI side effects from prostate cancer in half vs. 3D-CRT

June 1, 2011
Intensity modulated radiation therapy, a newer, more precise form of radiation therapy, causes fewer gastrointestinal side effects when combined with hormone therapy than using three-dimensional radiation therapy, according ...

Antioxidant beta-carotene use safe during radiation treatment for prostate cancer

May 31, 2012
Despite past safety concerns, the antioxidant supplement beta-carotene, is safe to use during radiation therapy treatments for prostate cancer and does not increase the risk of prostate cancer death or metastases, according ...

Recommended for you

Gene circuit switches on inside cancer cells, triggers immune attack

October 19, 2017
Researchers at MIT have developed a synthetic gene circuit that triggers the body's immune system to attack cancers when it detects signs of the disease.

One to 10 mutations are needed to drive cancer, scientists find

October 19, 2017
For the first time, scientists have provided unbiased estimates of the number of mutations needed for cancers to develop, in a study of more than 7,500 tumours across 29 cancer types. Researchers from the Wellcome Trust Sanger ...

Researchers target undruggable cancers

October 19, 2017
A new approach to targeting key cancer-linked proteins, thought to be 'undruggable," has been discovered through an alliance between industry and academia.

Study shows how nerves drive prostate cancer

October 19, 2017
In a study in today's issue of Science, researchers at Albert Einstein College of Medicine, part of Montefiore Medicine, report that certain nerves sustain prostate cancer growth by triggering a switch that causes tumor vessels ...

Suicide molecules kill any cancer cell

October 19, 2017
Small RNA molecules originally developed as a tool to study gene function trigger a mechanism hidden in every cell that forces the cell to commit suicide, reports a new Northwestern Medicine study, the first to identify molecules ...

Fundamental research enhances understanding of major cancer gene

October 19, 2017
New research represents a promising step towards better understanding of a key cancer gene. A long-running collaboration between researchers at the Babraham Institute, Cambridge and the AstraZeneca IMED Biotech Unit reveals ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.