After surgery, some cancer patients can safely avoid treatments such as radiation therapy or chemotherapysay two recent studies that explore shorter, gentler cancer care.
Researchers are looking for ways to predict which cancer patients can avoid unnecessary treatment to reduce costs and harmful side effects.
A new study used a blood test to determine which colon cancer patients could skip or not receive chemotherapy after surgery. Another study suggests that some low-risk breast cancer patients may not need radiation therapy after a lump or lump has been surgically removed, a surgical procedure known as a lumpectomy.
The research was discussed recently at the annual meeting of the American Society of Clinical Oncology (ASCO). The colon cancer study, funded by the Australian and US governments and non-profit groups, was recently published by the New England Journal of Medicine.
The results allow physicians to pay particular attention to “patients who we believe would really be benefit to chemotherapy and avoid side effects for patients who probably don’t need it,” said Dr. Stacey Cohen of the Fred Hutchinson Cancer Center. Cohen reviewed colon cancer findings and did not participate in the research.
Colon cancer study
Many colon cancer patients receive chemotherapy after surgery, even though they can be cured. Medicines can have bad side effects such as nausea, anemia and memory problems.
But deciding which patients might not need further treatment has been difficult. So, scientists investigated whether a blood test could help doctors make a decision.
The study involved 455 patients who underwent surgery because the cancer had spread into the wall of the colon. After surgery, one group received a specially designed blood test for the tumor genetic information to find any remaining pieces of cancerous DNA.
Their care was guided by the blood test. If the test showed no signs of remaining cancer, the patients did not receive chemotherapy. Meanwhile, doctors made chemotherapy decisions for the rest of the patients in the usual way, guided by careful study of the tumor and surrounding tissue.
Fewer patients in the blood test group received chemotherapy – 15% versus 28%. But about 93% of both groups were still cancer-free after two years. In other words, the blood test group also did well with less chemotherapy.
Dr Jeanne Tie from the Peter MacCallum Cancer Center in Melbourne, Australia led the research. Tie described the results in terms of cancer relapse – the return of cancer after a period of improvement.
“In patients where the cancerous DNA is not detected after surgery, the risk of cancer relapse is very low, suggesting that chemotherapy is very unlikely to benefit these patients,” Tie said.
ASCO President Dr Everett Vokes said not having chemo makes “a big difference in a person’s quality of life if it can be done without having to put them” at risk of returning from disease.
The other study followed 500 older women with a common form of early-stage breast cancer and low levels of a protein known as Ki67, a fast-growing cancer marker.
After the operation, the women took hormone-blocker pills, a common treatment for this type of cancer. But the women did not receive radiation therapy.
After five years, 10 of the women saw the cancer come back in the same breast and there was one death from breast cancer. The study did not have a comparison group, but the researchers said the results compare well with historical data from similar patients who underwent radiation therapy.
Dr. Timothy Whelan of McMaster University in Hamilton, Ont., led the study.
“We estimate that the benefits of radiation would be very small in this population compared to the side effects,” Whelan said.
Radiation can cause skin problems, fatigue and, less commonly, long-term heart problems and secondary cancers.
Dr. Deborah Axelrod of NYU Langone Health was not involved in the research.
Axelrod described the study as a “feel good” message for patients with low-risk tumors. Axelrod added that the data will help doctors understand which of their patients they “can comfortably, confidently” not administer radiation to.
I am John Russell.
Carla K. Johnson reported this story for The Associated Press. John Russell adapted it for VOA Learning English.
words in this story
chemotherapy – medical nm: the use of chemicals to treat or control a disease (such as cancer)
benefit to—v. to be useful or helpful to (someone or something)
nausea – nm the feeling in your stomach when you think you are going to vomit
anemia – medical nm: a condition in which a person has fewer red blood cells than normal and feels very weak and tired
tumor – nm a mass of tissue found in or on the body that is made up of abnormal cells
hormone – nm a natural substance that is produced in the body and influences how the body grows or develops
detect –v. to discover or notice the presence of (something that is hidden or difficult to see, hear, taste, etc.)
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