If you haven’t seen the TV ads for Cancer Treatment Centers of America, then you probably don’t watch TV.

The cancer treatment group — a network of five hospitals in major cities — spent almost 60 percent of all cancer center advertising dollars in 2014, according to an analysis of cancer treatment ad dollars by a team of university researchers. Their data was published in The Journal of the American Medical Association this week.

CTCA’s $102 million in advertising expenditures outdistanced by far the next two on the list: MD Anderson Cancer Center ($14 million) and Memorial Sloan Kettering Cancer Center ($9 million). And while the study noted that 20 centers accounted for 86 percent of the total spend, CTCA emerged as the biggest believer in advertising’s power to persuade.

The analysis reveal that CTCA’s ad breakdown focused on a national audience and budgeted plenty for internet advertising — an area of growth for all cancer center ad campaigns. CTCA spent nearly $59 million to reach a national audience — well over twice what it spent in the five metropolitan markets where its centers are located. Of the total, nearly $19 million targeted an internet audience.

The national spending reflects CTCA’s focus on prospective patients who can afford an expensive treatment program and who are able to travel for that treatment. The ads often emphasize that a patient has searched widely for help, often looking for a second opinion, and concluded that CTCA’s expertise in treating cancer is worth traveling for. Images of adults approaching a gleaming CTCA facility with buoyed spirits are a hallmark of the ads.

Interviewed by the medical news service Stat, CTCA’s Peter Yesawich said the ad campaign has been a huge success in promoting the center’s brand and, more important, drawing in new patients. Patient count is projected to be 7,400 next year, compared to 6,000 in 2013.

But the study’s lead author, Laura Vater, told Stat that patients and their families should be cautious about selecting a treatment provider based largely on such compelling advertising material as CTCA produces.

“Cancer centers with the highest spending are not necessarily centers that provide the highest standards of care,” says Laura Vater, a fourth-year medical student at Indiana. “It’s very important for patients to view cancer center advertisements with scrutiny.”

As Stat reported, CTCA has been criticized for selecting patients who fit a certain profile: wealthy, early-stage cancer patients who are more likely to have a positive treatment outcome. Several federal regulators have reviewed its operations and its claims of high success rates, and Reuters challenged its success rate claims in a 2013 report.

But so far, the for-profit, privately held company with the generous advertising budget has survived the critics and is winning perhaps the most important battle for its investors: the battle for more patients.

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.