Aetna Urges Doctors to Stay With Traditional Cancer Care.

Aetna U.S. Healthcare is encouraging more doctors to use standard breast-cancer treatments because there is no evidence that an alternative treatment involving high doses of chemotherapy and subsequent bone-marrow transplants is effective.

But the company said it would continue to reimburse costs of the alternative method when the standard treatment has failed patients in life-threatening situations. The only stipulation is that the alternative treatment must be done in the context of a clinical trial where there is oversight and regulations, said Dr. Joseph Carver, medical director for Aetna U.S. Healthcare's National Excellence Unit.

Aetna covered 190 bone-marrow transplants in 1998, 100 of them for the treatment of breast cancer. For the past three years, Aetna has covered bone-marrow transplants for breast cancer when two to 10 lymph nodes are cancerous (Best's Review, Life/Health edition, March 1999).

The cost of standard breast-cancer treatment is well below the $100,000 range for experimental treatment, Carver said. But he said Aetna's decision to promote the standard treatment was not based on financial concerns. The decision was made using science, safety and ethics, he said.

Aetna's new stance followed five studies presented to the American Society of Clinical Oncology.

Four of the studies were conducted in the United States and found that experimental breast-cancer treatment produced equivalent or no effect at all. The other study, originating out of South Africa, showed more positive results. But recently, it was discovered that the results were fabricated, Carver said.

"There is really no scientific evidence today saying that this is better than standard treatment," he said. "There may be actually evidence that its worse than standard because of its complexity and the risks associated with bone-marrow transplants."