( Very informational, good tips, Molers pictures, art work and much
----- Original Message -----
Sent: Monday, December 18, 2000 7:36 AM
Subject: pet_mail Washington Post, Saturday, December 16, 2000
> (submitted: Mon, 18 Dec 2000 09:37:05 -0500)
> Medicare to Pay for Cancer Scan
> By David
> Washington Post Staff Writer
> Saturday, December 16, 2000 ;
> The Medicare program said yesterday it will begin
paying for an
> test called positron emission tomography
> use in the diagnosis of nearly half the cases of cancer each
> America's elderly.
> The decision could add
hundreds of millions of dollars to the cost of
program. Each PET scan, which detects
> increased metabolic activity in
cancerous tissue, costs about $2,000.
> The Health Care Financing
Administration (HCFA), which oversees
> had been heavily
lobbied to add broad use of
> PET scanning to its menu of benefits. Early
this month, 19 members of
> Senate signed a letter to Donna E.
> of health and human services, urging expanded
coverage of the
> Yesterday's decision was a
compromise between two extreme positions:
> doctors a blank
check to use PET, or approving
> it only for the handful of uses in which
its benefit has been proved
> any doubt.
The decision, whose details purposefully weren't released until after
> stock market closed for the week, will take effect no
than next July.
> The University of California at Los Angeles
last summer asked the HCFA
> approve PET scanning in 20
different cancers, as
> well as in Alzheimer's disease and ischemic heart
disease. Given the
> prevalence of those conditions in people over age 65,
> broad coverage might quickly make PET scanning commonplace in
> The HCFA approved PET
for use in only six of the 20 cancers. However,
approved cancer, a physician will basically
> be free to order it as he or
she sees fit. The agency said it would pay
> PET scanning as a
backup diagnostic test in heart
> disease, and referred the Alzheimer's
indication to an advisory
> for further study.
> "I'm ecstatic. This is really fantastic," said Michael Phelps, a
> UCLA, who invented PET in the 1970s and
> prepare the university's application.
chairman of the Medicare Coverage Advisory Committee, a group
> mostly of academic physicians that provided
advice to the agency, also praised the ruling.
> "I think the
folks at HCFA tried very hard to do this in the most
sound way, under very pressing time circumstances
> . . . I think they did
well," said Harold C. Sox, chairman of medicine
Dartmouth-Hitchcock Medical Center.
> PET scans do something that
CAT and MRI scans don't. PET reveals
> function as
> well as
anatomic shape and location of tissue.
> Specifically, it identifies
tissue that absorbs radioactively labeled
> glucose molecules--glucose
being the main fuel of living cells.
> No matter what organ they
arise in, cancer cells consume glucose at
> 20 times the
rate of normal tissue. Because of that,
> malignant tumors "light up" on
PET, often when they're still invisible
> other scans.
> Medicare had previously agreed to pay for PET for very specific use in
> cancers where its benefit to patients had been
proved by well-designed studies. Proponents said it was time to assume
> would be useful in virtually all cancers. They said
should not wait for studies proving benefit in literally
> of different clinical scenarios.
> The HCFA
concluded that if a well-designed study proved PET useful for a
purpose in a specific cancer, then the
> agency would cover PET for other
uses in that same cancer. For example,
> study showed that PET
helped doctors decide
> whether lung cancer patients were candidates for
surgery. That was
> enough to
> persuade the HCFA to pay for PET
> other reasons in lung cancer patients--for example, to look
> cancer after surgery.
> The agency
approved broad use of the technology in these cancers: lung,
colon and rectum, lymphoma, melanoma,
> and mouth and throat.
> Sean Tunis, a physician at the HCFA, said the agency had
> when PET was of actual benefit to
> because research on that question was rarely done, or rarely
> "As we increase our investment in producing new
> really needs to be matched by a
parallel increase in
> investment in good studies evaluating the clinical
utility of those
> innovations," he said.
2000 The Washington Post
> Barbara Y. Croft, Ph.D.
Biomedical Imaging Program
> National Cancer Institute
Executive Blvd., EPN 6064
> Rockville, MD 20892-7440
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