Less intensive treatments for three types of cancer can make life easier for patients without compromising outcomes, doctors told the world’s largest cancer conference.
This study is part of a long-term trend to determine whether doing less ― less surgery, less chemotherapy, or less radiation ― can help patients live longer and feel better. The latest studies have focused on ovarian cancer, esophageal cancer and Hodgkin’s lymphoma.
Thirty years ago, cancer research was about doing more, not less. In one sobering example, women with advanced breast cancer were pushed to the brink of death with massive doses of chemotherapy and bone marrow transplants. This approach did not provide better results than chemotherapy and patients suffered.
Today, in an effort to optimize cancer care, researchers are asking: “Do we need all the treatments we have used in the past?”
It’s a question “that needs to be asked again and again,” said Dr. Tatjana Kolevska, the medical director of the Kaiser Permanente National Cancer Excellence Program, who was not involved in the new research.
Often, doing less works through improved medications.
“The good news is that cancer treatment is becoming not only more effective, but also easier to tolerate and associated with fewer short- and long-term complications,” explained Dr. William G. Nelson of the Johns Hopkins School of Medicine. Medicine, which was also not involved in the new research.
Studies demonstrating this trend were recently discussed at an American Society of Clinical Oncology conference in Chicago. Here are the highlights :
OVARIAN CANCER
French researchers have found that it is prudent to avoid removing lymph nodes that appear healthy during surgery for advanced ovarian cancer.
The study compared the results of 379 patients, half of whom had lymph nodes removed and half of whom did not. After nine years, there was no difference in how long the patients lived, and those who had less extensive surgery had fewer complications, such as the need for blood transfusions. The research was funded by the National Cancer Institute in France.
ESOPHAGUS CANCER
This German study involved 438 people with a type of esophageal cancer that can be treated with surgery. Half of them received a treatment plan that included chemotherapy and surgery on the esophagus, the tube that carries food from the throat to the stomach. The other half benefited from another approach that also included radiation. Both techniques are considered standard. The choice of one or the other may depend on where the patient is being treated.
After three years, 57% of patients who received chemotherapy and surgery were alive, compared to 51% of patients who received chemotherapy, surgery and radiotherapy. The study was funded by the German Research Foundation.
HODGKIN’S 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 had fewer side effects.
After four years, the least severe chemotherapy made it possible to control the disease in 94% of patients, compared to 91% for the most intensive treatment. The trial involved 1,482 people in 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 milder chemotherapy treatment that has been studied.
