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Nation/World

December 12, 2013

Studies: Some cancer treatments can be skipped

SAN ANTONIO — Tens of thousands of women each year might be able to skip at least some of the grueling treatments for breast cancer — which can include surgery, heavy chemo and radiation — without greatly harming their odds of survival, new research suggests.

The research is aimed at curbing overtreatment, a big problem in cancer care. Treatments help many women beat the disease, but giving too many or ones that aren’t really needed causes unnecessary expense, trauma and lifelong side effects, such as arm swelling and heart troubles. Radiation can even raise the risk of new cancers.

Several studies presented yesterday at the San Antonio Breast Cancer Symposium, an international conference on the disease, identify groups of patients who might be able to safely forgo certain treatments.

One found that many older women can skip radiation after surgery for early-stage tumors. Two others suggest that surgery may not help patients whose cancer has already spread widely. A fourth study tested a “light chemo” combination that could become a new standard of care.

The trend is “less and less therapy” for certain cancer types, said one conference leader, Dr. C. Kent Osborne of Baylor College of Medicine.

Breast cancer is already widely spread in 5 to 20 percent of newly diagnosed patients, and at that point is usually incurable. The main treatment is chemotherapy or hormone treatments that attack cancer throughout the body. Sometimes doctors also remove the breast tumor in hope of prolonging survival, but this has not been put to a hard test.

Dr. Rajendra Badwe, director of the Tata Memorial Hospital in Mumbai, India, led a study of 350 women with widely spread cancers that had shrunk after initial chemotherapy. Half were given surgery to remove the breast or the lump plus any cancerous lymph nodes. The rest did not have surgery.

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