Some people are being over-treated for cancer.
For many years, the death rate from cancer climbed steadily, and the focus of big cancer meetings was the quest for better treatments to bring malignancies under control. Cancer death rates have been falling in recent decades, and that’s allowed researchers to ask another important question: Are some people getting too much treatment for their cancers?
The answer, from the American Society of Clinical Oncology meeting in Chicago these past few days, is an emphatic yes.
One dramatic example revealed at the meeting relates to the most common form of breast cancer, known as hormone-positive, HER-2 negative disease. For many women who have this diagnosis, but for whom the disease has not spread to lymph nodes, a new study finds that anti-hormone treatment after surgery is enough, and women won’t benefit from rounds of toxic and uncomfortable chemotherapy.
Treatment of breast cancer for this large group of women will become easier. And for the many women who already choose not to undertake chemotherapy, they can be reassured that it’s the right call.
Likewise, researchers from France presented evidence that people with severe colon cancer don’t benefit from a common treatment, which involves heated chemotherapy administered at the time of surgery. This treatment has been in use for 15 years, without good evidence that it actually works. Some doctors were adamant about using it, while others shunned it. The study of 265 patients found that it didn’t work, says Dr. Francios Quenet, at the Regional Cancer Institute on Montpellier, France.
The study is “an excellent example of how less is more,” when it comes to certain cancer treatments, says Dr. Andrew Epstein, an oncologist from Memorial Sloan Kettering Cancer Center who spoke on behalf of ASCO.
Patients with advanced kidney cancer can also be spared surgery, according to another study presented at the meeting. “Based on studies that were done 20-30 years ago, the patients who had their kidneys removed lived a bit longer than the patients who did not,” Dr. Bruce Johnson, the president of ASCO and a cancer doctor at the Dana Farber Cancer Institute in Boston, tells Shots. A study of 450 patients coordinated by researchers in Paris found that the surgery was pointless. Patients who had their kidneys removed did no better than those who got chemotherapy. Those who avoided surgery were spared the trauma and the expense of this operation.
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