U.S. women are increasingly shut out of a breast cancer treatment valued around the world

A breast cancer treatment known as IORT has numerous benefits, surgeons say, but generates less money for hospitals and radiation oncologists.

It’s not uncommon for breast cancer patients in the rural South to travel hundreds of miles to reach the medical practice run by Dr. Phillip Ley, a cancer surgeon in Jackson, Mississippi.

For those who are good candidates, Ley recommends a therapy that delivers a single, targeted radiation dose to a patient’s breast tissue immediately after surgery to remove a tumor. Known as intraoperative radiation therapy, or IORT, it costs patients less in both time and money than traditional radiation treatments, and it is far less grueling.

“For our patient population here, [IORT] has been such a boon because we have so many rural patients,” said Ley, who is the director of oncology services at Merit Health Surgical Oncology. “I have patients that don’t have enough gas money to go to radiation every day.”

But the treatment is not as widely available in the United States as it once was, according to interviews with a dozen breast surgeons. They contend that is because it cuts into the revenue of doctors and hospitals that rely on the far larger sums of money generated by traditional radiation treatments.

Radiation oncologists who perform IORT receive about $525 per treatment, Medicare estimates from 2022 show, far less than the $1,300 they receive performing whole breast radiation with five sessions and the $1,730 generated by 15 sessions. Hospitals also benefit from repeated radiation sessions, which generate facility fees every time a patient returns for care.