Cancer Treatment Centers of America

July 25th, 2016

Rosie Painter’s stage 4 colon cancer had spread to her liver. That’s when, she says in the above Cancer Treatment Centers of America (CTCA) YouTube video, she “needed a second opinion.” She found one at CTCA, where a doctor proposed a surgery where both the colon and liver would be operated on simultaneously. She and her husband, Scott, now say the caregivers at the cancer center are “saints.”

Rosie’s testimonial is typical of the survivor stories CTCA regularly features in ads (and ads there are aplenty; the for-profit company with five hospitals throughout the U.S. spent more than $100 million on advertising in 2014 — more on this to come). But is Rosie’s survival story typical of the outcome of most late-stage cancer patients who receive treatment at the center? A disclaimer that appears on screen for 15 seconds in the one-minute video says no:

CTCA disclaimer

You may be wondering: How can CTCA, on the one hand, use Rosie’s experience as an example of the type of experience one can expect to have at the cancer center and, on the other hand, acknowledge through a disclaimer that her experience is not the norm? Good question.

The disclaimer may have met the conditions of a recently expired 1996 FTC consent order that CTCA entered into with the agency after the company failed to back up a claim that its patients had among the highest recorded 5-year survival rates. The order required that CTCA ensure that testimonials the center used in marketing did not misrepresent the typical experience of their patients and that its treatment efficacy claims were properly substantiated.

But does the disclaimer comply with current guidelines governing the use of testimonials that the FTC adopted in 2009? The 2009 FTC guidelines were issued after research indicated similar disclaimers did not reduce misleading perceptions and that consumers still believed that testimonials represented typical experiences. The guidelines state that ads with endorsements by consumers must reflect the typical experience of consumers and not the experience of just a few satisfied customers. Under the guidelines, if an endorsement doesn’t reflect users’ typical experience, the ad must clearly disclose either what consumers can expect their results to be or the limited application of the endorser’s experience. The FTC specifically notes that disclaimers in endorsements stating “Not all consumers will get these results” or “Your results may vary” are not sufficient.

More scrutiny over survival rates

Nearly 20 years after the FTC took action against CTCA, Reuters published a report, in 2013, that found that CTCA rejected certain patients including the elderly and uninsured or those covered by Medicaid in order to boost and advertise survival rates higher than national averages. The report, entitled “Behind a cancer-treatment firm’s rosy survival claims,” also found that CTCA excluded from survival statistics patients who arrive at the center with advanced disease.

Moreover, while the CTCA’s current advertising refers consumers to its website where it compares its survival statistics against national averages, a recent editorial published in JAMA Internal Medicine along with a study about top cancer care spenders questioned the comparisons, stating that there’s no reliable way to compare these figures.

CTCA told TINA.org that it uses national media for educational purposes and that “All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with FTC guidelines.”

But cancer care advertisements, said the authors of the JAMA Internal Medicine opinion piece, highlight a conundrum that the hope the ads promise can turn into hype. Yet, the marketing of cancer care is growing significantly.

A $100 million advertising budget

The JAMA study named CTCA as the top ad spender among U.S. cancer centers in 2014. And it wasn’t even close. CTCA accounted for a whopping 59 percent of the $173 million that was spent on advertising that year by cancer centers, or roughly $102 million. The study reviewed ad spending by 890 cancer centers, analyzing data from Kantar Media across six media outlets: TV, radio, magazines, newspapers, billboards, and the Internet.

The majority of CTCA’s 2014 ad budget — 58 percent — went toward national advertising, the study found.

Perception versus reality

Thanks in no small part to its glowing testimonials, CTCA led all U.S. hospitals and ranked sixth among all U.S. companies in a mid-2016 BrandIndex survey of best perceived brands.

But what consumers need to remember is that a testimonial about cancer care you see on the TV, hear on the radio or read online may not represent the typical patient’s experience, or what will happen to you.

The JAMA editorial noted:

The advertisements of many institutions implicitly or explicitly state that patients with cancer will live longer or better if treated at their hospital. Yet these claims cannot be substantiated because valid methods are lacking to compare cancer survival statistics (unlike cardiac surgery complications) or quality of life across hospitals. Cancer survivors selected because of their striking response to treatment are by definition atypical.

Take time to research beyond the ad claims.

Find more of our coverage on cancer care ads here.

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