Scaling down treatments for three types of cancer could make patients’ lives easier without compromising outcomes, doctors reported at the world’s largest cancer conference. (Read this also | Early detection of ovarian cancer: Symptoms women shouldn’t ignore,
It’s part of a long-term trend to study whether fewer surgeries, less chemotherapy or less radiation can help patients live longer and feel better. The latest studies involved ovarian and esophageal cancers and Hodgkin lymphoma.
Thirty years ago, the goal of cancer research was to do more rather than less. In one grim example, women with advanced breast cancer were pushed to the brink of death with heavy doses of chemotherapy and bone marrow transplants. This approach worked no better than chemotherapy and the patients suffered.
Now, in an effort to optimize cancer care, researchers are asking: “Do we need the treatments we’ve used in the past?”
Dr. Tatyana Kolevska, medical director of the Kaiser Permanente National Cancer Excellence Program, who was not involved in the new research, said it’s a question “that needs to be asked again and again.”
Often, better medications work less effectively.
“The good news is that cancer treatments are becoming not only more effective but also easier to tolerate and with fewer short- and long-term complications,” said Dr. William G. Nelson of the Johns Hopkins School of Medicine, who was not involved in the new research.
Studies showing this trend were discussed at the American Society of Clinical Oncology conference in Chicago over the weekend. Here are the highlights:
ovarian cancer
French researchers found it is safe to avoid removing healthy-looking lymph nodes during surgery for advanced ovarian cancer. The study compared outcomes for 379 patients – half the patients had their lymph nodes removed and half did not. After nine years, there was no difference in patients’ survival and patients who had less severe surgery had fewer complications, such as needing blood transfusions. The research was funded by France’s National Institute of Cancer.
esophageal cancer
This German study looked at 438 people who had a type of cancer of the esophagus that could be treated with surgery. Half the people were given a common treatment plan, which included chemotherapy and surgery on the esophagus, the tube that carries food from the throat to the stomach. Half the people were given another method, which also included radiation. Both techniques are considered standard. Which technique patients get depends on where they get treatment.
After three years, 57% of people who got chemo and surgery were alive, compared with 51% of those who got chemo, surgery and radiation. The German Research Foundation funded the study.
Hodgkin Lymphoma
A comparison of two chemotherapy regimens for advanced Hodgkin lymphoma found that the less intensive treatment was more effective for the blood cancer and caused fewer side effects.
After four years, the less aggressive chemo kept the disease under control in 94% of people, compared with 91% of those with the more intense treatment. The trial involved 1,482 people from nine countries – Germany, Austria, Switzerland, the Netherlands, Denmark, Sweden, Norway, Australia and New Zealand – and was funded by Takeda Oncology, the maker of one of the drugs used in the mild chemo studied.
