Changing Outcome Targets in Health Care
May 31st, 2009Posted by: admin
In what might be a microcosm of the pending struggle over the nation’s health care system, a radiologist has proposed in Nature magazine that stablizing tumors at a manageable size, rather than eliminating them entirely (H/T 60 Second Science Blog). This is a significant shift in traditional strategy, which is usually to knock out the cancer – sometimes repeatedly, should it recur. Put another way, treat the disease as chronic and manage it with smaller doses of chemotherapy, rather than seeking the death strike and risk the potential of resistant cells returning with a vengeance. Robert Gatenby, the radiologist behind this idea, compares this different strategy to the integrated pest management approach to invasive species, which was accepted by the Agriculture Department as far back as the Nixon Administration (as it happens, the beginning of the War on Cancer can be traced to the Nixon Administration as well).
A parallel with the upcoming debates over the U.S. health care system would be the current emphasis in the United States on treatment and prolonging the last years of life over prevention and other longevity measures. While it may be an open question in either situation whether or not changing tactics would be more effective, there will be significant resistance to entertaining the idea in either case.