CANCER FACTS National Cancer Institute National Institutes of Health In an April 1996 report prepared by the U.S. General Accounting Office (GAO) for Senator Ron Wyden, Health Insurance Coverage of Autologous Bone Marrow Transplantation for Breast Cancer, GAO researchers summarize the current policies and practices of insurance companies as they relate to the use of high-dose chemotherapy with stem cell transplant for the treatment of breast cancer. The following are answers to questions regarding the release of this report on what is still widely considered an experimental treatment.
What is breast cancer?
Breast cancer is a group of related diseases in which cells within the breast become abnormal and divide without control or order, invading and damaging other tissues and organs. When cancer cells break away from the original tumor and enter the bloodstream or lymphatic system, breast cancer may spread and form secondary tumors (metastases) in other parts of the body, including vital organs. The most common types of breast cancer arise in the lining of the milk ducts or in the milk-producing glands.
What are the main findings of the GAO report, which was released by Senator Ron Wyden's office?
The GAO report, Health Insurance Coverage of Autologous Bone Marrow Transplantation for Breast Cancer, overall finds that although most experts believe the clinical research has not yet established that high-dose chemotherapy with stem cell transplant for breast cancer is superior to conventional therapy or which patients this treatment benefits, insurance coverage of the treatment has become relatively common and use of the treatment is increasing rapidly. The report emphasizes the need for definitive answers about the effectiveness of high-dose chemotherapy with stem cell transplant for breast cancer, and points to the National Cancer Institute's (NCI) three randomized clinical trials as the means for gathering this information.
What are the implications of the report?
The GAO report underscores concerns that the widespread availability of high-dose chemotherapy with autologous stem cell transplant for breast cancer outside of NCI-sponsored trials will hinder enrollment and delay completion of the critical NCI studies.
What are bone marrow and peripheral blood stem cell transplantation?
Bone marrow and/or stem cell transplants are used in breast cancer patients as supportive therapy to "rescue" patients from the otherwise potentially fatal effects of treatment with high-dose chemotherapy (anticancer drugs). Bone marrow transplantation is a procedure in which bone marrow, the spongy material found inside bones that produces white and red blood cells and platelets, is removed from the bone with a needle. This marrow contains the stem cells which can then reproduce all the types of blood cells.
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