Washington D.C, Jun 6: A new study has revealed that giving chemotherapy after radiotherapy delays further growth of a rare type of brain tumour, increasing the number of patients alive at five years from 44 per cent to 56 per cent.
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“That’s probably patient-driven, going to the emergency room or the hospital”, he said.
The results were presented Saturday at the annual meeting of the American Society of Clinical Oncology in Chicago and published online in JAMA Oncology. “In essence what we’re doing is we’re giving patients side effects without giving them the benefits of the treatment, and that’s really the fundamental problem with aggressive care at the very end of life”.
For patients with incurable colorectal cancer or breast cancer, the percent receiving aggressive care in their last month (71 percent and 74 percent, respectively) was essentially unchanged after ASCO’s 2012 recommendation from before. The patients lived across 14 different states, and had been diagnosed with advanced lung, colon, breast, pancreatic or prostate cancer. Such interventions at the end of life “are widely recognized to be harmful”, Chen said. Most patients never undergo a second tissue biopsy during treatment to check their progress, “unless there’s a compelling therapeutic option available”, he said.
Trish Pangilinan with Mission Delivery says they serve cancer patients who don’t always have a ride to their appointment.
Rates of radiation therapy ran between 9 percent and 21 percent. “There is some degree of what we’d call “appropriate care” at the end of life”.
Ronald C. Chen, MD, MPH, a UNC Lineberger member and associate professor in the UNC School of Medicine Department of Radiation Oncology and the study’s first author, said that physicians should be having earlier discussions with their patients about palliative care, which is treatment that focuses on relieving pain or other symptoms. “We need to be able to match the right patient with the right therapy so we don’t waste our health care dollars”. Only a handful got comfort-based hospice care instead.
For instance, one study cited by ASCO’s so-called Choosing Wisely recommendations found that in patients with non-small-cell lung cancer, only 2 percent responded to third-line chemo and none to the fourth-line drugs doctors tried.
Dhakshila Paramanathan, data scientist at COTA and the study’s lead investigator, commented that young cancer patients appear particularly concerned about financial toxicity.
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Chen said there were limitations of the study including the fact that they could not determine the intent of the treatment delivered in their study of aggressive care. “Through the smarter use of data – precision analytics guided by our COTA Nodal Address classification system – we are working to reduce the financial toxicities of cancer care that are distressing our patients”.
