Cancer patients often do better with less intensive treatment, study finds

Reducing treatment for three types of cancer can make life easier for patients without compromising outcomes, doctors reported at the world’s largest cancer conference.

It’s 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 focused on ovarian and esophageal cancer and Hodgkin 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 worked no better 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 should be asked again and again,” said Dr. Tatjana Kolevska, medical director of the Kaiser Permanente National Cancer Excellence Program, who was not involved in the new research.

Often, doing less work is due to 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,” said Dr. William G. Nelson of the Johns Hopkins School of Medicine. Medicine, which was also not involved in the new research.

Studies showing this trend were discussed this weekend 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 had their lymph nodes removed and the other half did not. After nine years, there was no difference in how long patients lived, and those who underwent less extreme surgery had fewer complications, such as the need for blood transfusions. The research was funded by the National Cancer Institute in France.

Esophageal cancer

This German study included 438 people with a type of esophageal cancer that can be treated surgically. Half received a common treatment plan that included chemotherapy and surgery on the esophagus, the tube that carries food from the throat to the stomach. Half had another approach that also included radiation. Both techniques are considered standard. Patients’ choice may depend on where they receive treatment.

After three years, 57% of those who had chemotherapy and surgery were alive, compared to 51% of those who had chemotherapy, surgery and radiation. The German Research Foundation funded the study.

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 caused fewer side effects.

After four years, the mildest chemotherapy controlled the disease in 94% of people, compared with 91% of those who received the most intense 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 manufacturer of one of the drugs used in milder chemotherapy. studied.