With great fanfare, Gov. Rick Scott last month announced the latest trophy in his campaign to get corporate America to relocate to Florida. Infelicitously calling it a "one-way ticket to the Sunshine State," Scott hailed the Boca Raton arrival of Cancer Treatment Centers of America and the "more than 200 new jobs" the governor says it will create.
We've heard governors bloviate about biotech jobs before. Maybe this time will be different. Even if it is, there's reason to be queasy about Scott's latest BFF.
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A privately held company with an estimated $4 billion in annual revenues, CTCA's founder and CEO, Richard Stephenson, is a Tea Party kingpin, funneling multiple millions of dollars to right-wing superPAC FreedomWorks, including a whopping $12 million in the run-up to the 2012 presidential election and another $8 million to orchestrate an internal coup at the group after the Romney defeat.
What could CTCA hope to gain from GOP control of the White House? One thing could be more lenient treatment from federal regulators. When Bill Clinton was in office, the Federal Trade Commission charged Stephenson's company with fraudulent advertising. The FTC alleged that:
CTCA's promotional brochure, which was disseminated nationwide, represented that the respondents had statistical evidence to demonstrate that their survivorship rate for cancer patients was among the highest recorded and that whole body hyperthermia could successfully treat certain forms of cancer that were previously unresponsive to conventional types of cancer treatment. In addition, the FTC alleged that the brochure had falsely claimed that whole body hyperthermia had been approved for the treatment of cancer by an independent agency or medical organization. According to the complaint, however, the respondents did not have adequate evidence to back up any of these claims. These claims do not appear in the brochure that CTCA currently provides to consumers.The complaint also alleges that, through a print advertisement, respondents represented that, through a procedure identified as brachytheraphy, respondents were able to improve the chances of survival for many lung cancer patients. This representation was also not substantiated adequately, according to the complaint.
Finally, according to the FTC, the respondents represented, without a reasonable basis, that consumer testimonials featured in their ads reflected the typical experience of patients who had undergone treatment at the respondents' treatment centers.
To settle the case, CTCA agreed to monitoring by the feds to see that future ads would
"have competent and reliable evidence -- scientific in certain appropriate instances -- to support any representation."
So it's all good now, right? Or not. According to a recent investigation by Reuters, CTCA has a new way of tweaking its stats on survival rates, which it claims are significantly better than national averages. Reuters reported:
Such claims are misleading, according to nine experts in cancer and medical statistics whom Reuters asked to review CTCA's survival numbers and its statistical methodology.The experts were unanimous that CTCA's patients are different from the patients the company compares them to, in a way that skews their survival data. It has relatively few elderly patients, even though cancer is a disease of the aged. It has almost none who are uninsured or covered by Medicaid -- patients who tend to die sooner if they develop cancer and who are comparatively numerous in national statistics.
Carolyn Holmes, a former CTCA oncology information specialist in Tulsa, Oklahoma, said she and others routinely tried to turn away people who "were the wrong demographic" because they were less likely to have an insurance policy that CTCA preferred. Holmes said she would try to "let those people down easy."
Equally significant, CTCA includes in its outcomes data only those patients "who received treatment at CTCA for the duration of their illness" -- patients who have the ability to travel to CTCA locations from the get-go, without seeking local treatment first. That means excluding, for example, those who have exhausted treatment options closer to home and arrive at a CTCA facility with advanced disease.
Accepting only selected patients and calculating survival outcomes from only some of them "is a huge bias and gives an enormous advantage to CTCA," said biostatistician Donald Berry of MD Anderson Cancer Center in Houston.
The company defends its practices. Spokeswoman Pamela Browner White said CTCA's survival data are in "no way misleading, nor do they deviate from best practices in statistical collection and analysis."
In addition to the allegations of deceptive marketing, charges of quackery haunt CTCA like a duck pond.
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Surgical oncologist and cancer researcher Dr. David Gorski last fall in a "recap and update" on "the nonsensical therapies that CTCA provides" called the company "the very epitome of 'integrative medicine'" that "integrates pseudoscience and quackery with real medicine."
Charitably, Gorski concluded that "tragically," CTCA chief Stephenson:
confused "holistic" care with an openness to quackery like naturopathy and incorporated such quackery into CTCA right from the beginning, "integrating" it with standard, even state-of-the-art, conventional cancer care to the point where you can't always tell where the science ends and the quackery begins.
In the business-friendly pages of Forbes, biologist and computer scientist Dr. Steven Salzberg has written:
Cancer patients are facing some of the most difficult decisions in their lives, often while suffering through painful treatments, not to mention the fear that their cancer will kill them. When a cancer hospital offers an "integrative" treatment with the promise that it may help, the patient is highly likely to try it, regardless of the cost. These are extremely vulnerable patients, and CTCA is taking advantage of them to sell ineffective therapies. CTCA and its owners, including Richard Stephenson, are profiting from their unsuspecting patients.
(Cancer patients and their families and caretakers are well-advised to consider the informative survey of "questionable cancer therapies" provided by Dr. Stephen Barrett's invaluable Quackwatch website. Alternative medicine may have a role to play but demands as much skepticism as any other form of medicine.)
A tantalizing enigma in the CTCA story concerns Lynette Bisconti, a former company executive who was sued by CTCA for extortion and later sued them for a variety of frauds.
As CTCA's case against Bisconti was reported last February in Modern Healthcare:
Ms. Bisconti was placed on paid leave on Sept. 24 [2012] after she told [CTCA CEO] Stephenson that she would "sing like a bird to the newspapers, radio and television" with false accusations about the company if he didn't pay her millions of dollars, the lawsuit alleges. Within hours of being placed on leave, Ms. Bisconti accessed more than 200 confidential documents and materials, the lawsuit alleges. She was fired on Dec. 31, the lawsuit says.
Court records show the extortion case was decided in CTCA's favor in May 2013. But the case was re-opened in December, exhibits were impounded and case information sealed.
We don't know how that flurry of activity relates to the fact that, also in December, Bisconti sued CTCA right back. According to the Chicago Sun-Times:
A former spokeswoman for Cancer Treatment Centers of America is suing the corporation, saying it uses false advertising to make huge "profits at the expense of many desperate patients and their families."Rockford resident Lynette Bisconti represents herself in the federal lawsuit filed Tuesday in U.S. District Court in Chicago, which seeks $500 million from the company to be donated to charities of her choice, and more than $75,000 for herself.
Bisconti claims that, contrary to the organization's publications, as an insider she discovered CTCA "cherry-picks" well-insured, late-stage cancer patients while rejecting 90 percent of patients; and incentivizes physicians to provide costly, unnecessary treatments in terminal cases.
The suit also alleges CTCA founder and chairman Richard Stephenson and his family illegally funneled millions of dollars to a conservative super PAC and other "shell companies" to dodge taxes...
[CTCA] representatives denied Bisconti's claims in a written statement.
"While it is not the policy at Cancer Treatment Centers of America to comment on legal matters, in this instance we feel compelled to state that the allegations in this filing are without merit," the statement said.
"We are at a loss to understand why Ms. Bisconti, a former valued member of the CTCA leadership team, would make such accusations," the statement said.
Bisconti, 50, is a breast cancer survivor who was treated at a CTCA hospital in 1998 and then volunteered for 15 years as a spokeswoman while undergoing further treatment. She appeared in commercials, marketing publications and on national television on behalf of the organization, the suit says.
In 2008 she began working for the company as president of Gateway for Cancer Research, one of CTCA's non-profit affiliates, according to the suit.
As an employee, Bisconti says she became "increasingly concerned about CTCA's moral and ethical obligations to cancer patients" and the organization's "unstable and unethical business model."
Bisconti claims executives placed her on administrative leave in September 2012 when she approached Stephenson with her concerns about "legal and ethical issues."
She claims she was fired in December 2012 after rejecting a cash payout from CTCA executives "to keep saying nice things" about the organization.
When she informed them she would report the issues to federal authorities, she says she was threatened and intimidated, according to the suit. Bisconti also claims she was repeatedly sexually harassed by her CTCA physician and several executives.
Weirdly, within one week of Bisconti's filing suit, she and CTCA settled the case and placed Bisconti's complaint and accompanying exhibits undcr seal, unavailable to public review. One can only speculate...
Bottom line, though: Who cares? CTCA's arrival may mean a few more jobs for job-starved Florida and some additional tax revenues for the City of Boca Raton. Best of all, though, it's another talking point for Rick Scott's reelection campaign, no matter how questionable some cancer patients' care may be.
Fire Ant -- an invasive species, tinged bright red, with an annoying, sometimes-fatal sting -- covers Palm Beach County. Got feedback or a tip? Contact [email protected].
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