Cervical cancer is one of the easiest cancers to detect early. It’s also one of the easiest to treat, if caught early. WUSM researchers even developed a method for gauging the effectiveness of treatment to determine the best therapy for each patient, but many insurance companies and Medicaid won’t pay for the process – a routine PET scan.
Researchers at the School of Medicine learned that a PET scan three months after treatment can give a good idea of the long-term prognosis, and they are lobbying the goverment for better Medicare coverage for women with cervical cancer.
In the following St. Louis Post-Dispatch article, health reporter Kay Quinn provides more details about the process and limitations of health care coverage.
Test checks effectiveness of cervical cancer treatment
(Republished with permission from the St. Louis Post-Dispatch. This article originally ran in the Health & Fitness section on Monday, July 5, 2004)
By Kay Quinn
Cervical cancer, one of the easiest cancers to detect early, is also one of the most treatable if caught early. Even better, doctors have found a way to gauge the effectiveness of treatment in women diagnosed with this type of cancer. But in spite of this medical discovery, Medicaid and most insurance companies won’t routinely pay for it.
The American Cancer Society says 10,520 new cases of cervical cancer will be diagnosed in the United States this year. The cervix is the lower part of the uterus. If doctors regularly look at cells from the cervix under a microscope in a screening test called a Pap smear, abnormalities that may turn into cancer can be caught and treated early.
Between 1987 and 2000, the number of women who had a Pap smear in the previous three years increased to 81 percent from 74 percent. Rates are still lowest among women living below the poverty level and women 65 and older. Ten to 15 percent of American women are rarely screened, or have avoided it altogether. That group accounts for 60 percent of newly diagnosed cases of cervical cancer.
Once diagnosed, women are typically treated with surgery, radiation or chemotherapy, or some combination of the three.
Until 2001, doctors had no timely way to gauge the effectiveness of treatment. But in studies done at Washington University School of Medicine, researchers learned that three months after treatment, women with cervical cancer can undergo a scan using positron emission tomography and get a much better idea of their long-term prognosis.
These women typically fall into one of three categories:
- The PET scan shows treatment has been effective and the cancer is gone.
- Patients may show no new areas of tumor growth, but the initial cancer may still linger.
- The PET scan shows a new area of tumor, a finding that carries a poor prognosis.
Washington University researchers are already working to determine if early repeated treatment of women who fall into the second group can increase survival.
But those same researchers are also lobbying the government on behalf of the women who they believe should have PET screenings included as a standard part of treatment. Medicare covers PET scans as part of the treatment involved in many causes of cancer, but cervical cancer is not one of them.
Almost a year ago, the U.S. Department of Health and Human Services was asked to lift its noncoverage status on PET for seven cancers: cervical, pancreatic, brain, small-cell lung, ovarian, testicular and multiple myeloma. So far, no ruling has been handed down.
Local doctors believe that the evidence is already clear and that a PET scan as part of cervical cancer therapy is the best way to determine the right treatment and whether more is necessary.
Kay Quinn is an anchor and health beat reporter for KSDK (Channel 5).
Copyright 2004 St. Louis Post-Dispatch, Inc.