(NewsNation) — Intraoperative radiation therapy is a faster, less invasive and often cheaper treatment for breast cancer that is common in Europe and Asia; however, access remains limited in the U.S.
IORT was approved by the Food and Drug Administration in 1999 and involves just a single dose of radiation to a patient’s breast tissue following surgery, which contrasts with other radiation treatments that often require multiple sessions and cost more.
“IORT offers the same benefits as other types of radiation therapy in just one treatment session,” according to the Cleveland Clinic.
IORT access limited in US
Despite its widespread use in other countries, IORT remains out of reach for many in the U.S., as some insurers consider it experimental and will not cover its costs.
Advocates for IORT argue that hospitals and insurers favor costlier, more drawn-out treatments over the shorter and cheaper alternative.
According to NBC News, Medicare estimates from 2022 indicate that radiation oncologists who perform IORT receive about $525 per treatment. In contrast, when they perform whole breast radiation over five sessions, the payment increases to approximately $1,300, and it reaches around $1,730 for 15 sessions. Hospitals also profit from repeat patient visits, creating an incentive to favor extended treatment plans.
IORT treatment can cost $8,000 to $10,000, in comparison to the upwards of $30,000 cost for whole breast irradiation. Research published in 2018 suggests that IORT for breast cancer treatment could save $1.2 billion in the U.S. health care system over five years.
Not everyone agrees with efficacy of IORT
While some advocates call for its widespread use, others oppose it. The American Society for Radiation Oncology, or ASTRO, argues that IORT is ineffective from a scientific standpoint due to higher recurrence rates than other forms of treatment, and does not recommend its use outside of clinical trials.
Chair of health policy for ASTRO, Dr. Amar Rewari, told NewsNation that, contrary to what some believe, “there’s more access in the United States” to IORT than internationally.
The best candidates for IORT are postmenopausal women with small, early-stage tumors and no evidence of lymph node involvement, as reported by NBC News.
NIH warns IORT could face more hurdles without support
The National Institute of Health warns that without ASTRO’s support, it’s challenging to expand access to the treatment.
“A better approach would be to support it in selected low-risk patients… if ASTRO does not support IORT, insurance companies will no longer pay for IORT, and we will regress,” NIH said in a statement.
NewsNation spoke to breast cancer patients who find the process of evaluating the variety of complex treatment options, even for covered procedures, exhausting.
“Even with premier benefits, you had to have a PhD to navigate some of the drugs and protocols… and everything was a negotiation,” Breast cancer survivor Marva Bailer told NewsNation.