Many desperate patients, often encouraged by their doctors and by media coverage, started suing their insurance companies for payment. And many insurance companies started to cave in to the public and legal pressure. In 10 states, legislatures actually mandated that insurance companies must pay for such treatment. Once insurance payment was guaranteed, many doctors, hospitals and for-profit treatment centers started offering the treatment outside randomized trials. Stem cells, or the precursors to red and white blood cells, are harvested from the woman.
Doctors give high-dose chemotherapy to kill the cancer, but it also kills stem cells.
Stem cells are given back to the patient. That meant that women could get the treatment guaranteed without entering a comparison trial where their chances of getting the high dose treatment were only 50-50, depending on which group they were assigned to. Not surprisingly, many women opted for the sure thing, and it became increasingly difficult to find women willing to enter randomized trials. No wonder that the numbers of women being treated with this still unproven treatment skyrocketed during the 1990s. Now fast forward to last May, when early results of five studies comparing high-dose to conventional therapy were to be announced at the annual meeting of American Society of Clinical Oncology.