Monthly Archives: November 2015

Think Twice about Medicare Advantage

It is that time of year again. The time of the year when many people are choosing their health insurance plan for the next year. People really need to pay attention to more than just the medicare-dis-advantage-780x490premium rates.

“I’m seeing more and more patients in my clinic with Medicare Advantage insurance plans. They’re stunned when they find out it’s not the same as traditional Medicare. Not all procedures and medicines are covered,” says Dr. Edward Hughes, Medical Director of First Dayton Cancer Care. Dr. Hughes’ experience is not the exception. Medicare Advantage plans have doubled in the past 9 years and now cover over 15 million seniors.

Medicare Advantage is run by private companies, unlike traditional Medicare, which is run by the federal government.

A recent study by the Wharton School of the University of Pennsylvania asked the question and was titled, “Who benefits When the Government Pays More? Pass-through in the Medicare Advantage Program.” Mark Duggan, a Wharton professor and co-author of the study, said “We’re talking about billions of dollars in additional government spending … I was somewhat surprised to see so little benefit passing through to consumers in the form of better benefits. We see more people enroll and we see more advertising expenditures. But we actually don’t see much better quality when you pay plans more.”

Rather than respond with a Congressional hearing, Congress instead gave Medicare Advantage a 0.4% increase in lieu of a planned 1.9% cut.

What’s the senior to do? Dr. Hughes recommends that “before you sign up for Medicare Advantage, look carefully and read your policy’s coverage for major illnesses that are likely to happen to seniors, like diabetes, heart disease, cancer, and COPD. Your quality of life and financial health depend on it.”

Early Stage Lung Cancer-More Than 1 of 4 Patients Are Never-Smokers

Wear a White Ribbon for Lung Cancer Awareness.

November is Lung Cancer Awareness Month.

November is Lung Cancer Awareness Month.  You’ll hear a lot about stopping smoking.  And there will be much discussion of using low-dose CT scans to screen smokers older than 55 years. But did you know that “never smokers” made up 28% of new diagnosis of early stage non-small cell lung cancer patients in 2013? 

Dr. Eric Lim and colleagues from London looked at 2,170 British men and women who had  lung cancer surgery from March 2008 to November 2014.  The results were presented at the recent World Conference on Lung Cancer. 

The remarkable finding was that “never-smokers” with lung cancer increased each and every year from 13% in 2007 to 28% in 2013.  And the trend was due to a dramatic increase in the absolute numbers of “never smokers” with lung cancer.   Fifty five percent of those patients with lung cancer were found “incidentally.”  That is to say, their lung cancers were found by CT scans, PET-CT scans, X-rays, or MRI’s ordered for other reasons-not because their physicians suspected lung cancer.  Only 14% of patients had symptoms of lung cancer-like coughing up blood or profound shortness of breath. 

Like many good medical studies, Dr. Lim’s article raises more questions than answers.  Were these lung cancer patients who were “never smokers” exposed to second-hand smoke at home or in the workplace?  What about other exposures, like chemical toxins, in the workplace?  Are there differences in “never-smokers” who live in the city versus out in the country?  What about family history?  Do the same trends hold for people in the US? 

So whether it’s family history, genetics, race or just bad luck remains to be seen.  But the good news is that lung cancer caught early is highly curable.  Cure rates are now in the 80-90% range for 5 years.  And you may not need surgery at all.  Many studies have now shown that Cyber Knife radiosurgery is equal to or even better than open surgery for patients with early stage lung cancer.  And Cyber Knife is done as an outpatient-no incision, no pain, and no long hospital stays; eliminating the complications that go along with surgery.

So if you have any questions about your lung cancer, please free to call me, Dr. Edward Hughes, at 855-DAYTON1.