MENUWall Street Journal: Chemotherapy 'falls out of favor'
An article in the Wall Street Journal looks at efforts to improve how oncologists determine which patients need chemotherapy. What once was a crucial part of cancer treatment might now be best avoided for some patients at low risk. The argument for "de-escalation" is that chemotherapy for some patients might not improve their survival - putting some patients through a grueling treatment with long-term side effects for little benefit.
“Tens of thousands of women were over-treated, they got surgery they didn’t need, they got radiation they didn’t need, and they got chemotherapy they didn’t need,” Steven Katz, M.D., MPH, is quoted saying. Katz is professor of medicine and of health management and policy at the University of Michigan. He added that chemotherapy> “knocks the hell out of people and oncologists have gotten more sensitive to the harm” it can cause.
Katz and colleagues published a paper in December in the Journal of the National Cancer Institute that found use of chemotherapy for early stage breast cancer declined between 2013 and 2015. The study looked at nearly 3,000 women with early stage breast cancer and found use of chemotherapy decreased from 34.5 percent to 21.3 percent over this time. The significant decline in chemotherapy came at a time when treatment guidelines did not change.
“Our study shows how breast cancer is a model for how doctors have driven advances in personalized medicine into the exam room to reduce overtreatment,” Katz says.
The team notes that chemotherapy is still a necessary treatment for patients who are high risk of their cancer returning or spreading to distant parts of the body. Patients should discuss appropriate treatment options with their care teams.