Many Lung Cancer Patients Aren't Getting Best Treatment: Study

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WEDNESDAY, Jan. 10, 2018 (HealthDay News) -- Chemotherapy and radiation are the standard of care for small-cell lung cancer that hasn't spread to other parts of the body. But many patients don't receive these treatments, a new study indicates.

This less-than-optimal care is reducing survival rates, according to researchers from the University of Texas MD Anderson Cancer Center.

"In order to improve access to care and address related disparities, it is critical to understand the barriers patients face when getting treated for lung cancer," said the study's senior author, Dr. Stephen Chun. He's an assistant professor of radiation oncology.

Small-cell lung cancer is a fast-growing malignancy that accounts for up to 15 percent of lung cancers, according to the American Cancer Society.

Hoping to shed light on those treatment barriers, the researchers analyzed information in a national cancer database on more than 70,200 patients with small-cell lung cancer. They focused on the social and economic obstacles the patients faced when seeking treatment. They also evaluated their survival rates.

Of these patients, about 56 percent received chemotherapy and radiation as their initial therapy. About 20 percent received only chemo, and 3.5 percent just got radiation. Another 20 percent received neither treatment, the study found.

Half the patients who received chemotherapy and radiation survived more than 18 months. Receiving just chemotherapy reduced median survival to almost 11 months, and radiation alone carried a median survival of a little more than 8 months.

Not receiving either form of treatment resulted in worse outcomes.

"Among the group of patients who received neither chemotherapy nor radiation, prognosis was dismal with a median survival of only 3-4 months," Chun said in a cancer center news release.

The researchers found that treatment at a non-academic center, lack of insurance or Medicare/Medicaid insurance were linked to less than optimal care.

Patients with Medicare or Medicaid received chemotherapy just as often as those with private insurance but they were much less likely to undergo radiation therapy, the study found.

And uninsured patients were less likely to receive either chemo or radiation.

"There are targeted access programs that provide competitive reimbursement for the administration of chemotherapy, and our findings suggest that these programs have improved chemotherapy access," Chun said. "However, these programs give no financial assistance for radiation therapy, which could, in part, explain why patients with Medicare and Medicaid were less likely to receive radiation."

The study authors stressed that proper treatment is critical for patients with small-cell lung cancer. They urge patients to advocate for themselves to ensure they receive the best treatment possible.

The study was published Jan. 4 in JAMA Oncology.

More information

The American Cancer Society provides more on small-cell lung cancer.

SOURCE: University of Texas MD Anderson Cancer Center, news release, Jan. 4, 2018

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2 Comments

Thu Jan 18, 2018 07:00 PM

Has a study been done to see how many people that had radiation or chemo developed other cancers later on or died from the cancer they were being treated from? In my family, my dad had colon cancer, with only surgery to remove the tumor, no treatments. He lived to be almost 93, no other cancer and died from Aspiration Pneumonia from vomit inhaled when he was sick with his gallbladder. My mom had breast cancer, with removal of the breast and the two or so lymph nodes, no other treatments. She lived to be 96, no other cancers and died from heart failure. My aunt on my mom’s side had colon cancer over 50 years ago. She had the cancerous tumor removed, no other treatments. She has regular blood tests and colonoscopies and has had no other cancers and she is still living and is 104. Her birthday is in August. On the other hand, my uncle had bone cancer, had chemo til it was burning him and they had to stop, passed away. Two more uncles with prostrate cancer had surgery and chemo and only lived for a short time. My sister had breast cancer, surgery and chemo, had it return in her liver, endured chemo for eight years never getting better, but existed, then passed away. Two of my nephews, her sons, died from liver and stomach cancer, both had chemo. Her daughter had breast cancer at the same time she did, breast removal and lymph nodes, lots of chemo, it returned in her other breast, same thing again, then last year she had kidney cancer, had a kidney removed and chemo again. She is not doing well. Her sugar is way out of control. She has infections and her other kidney is bothering her. My oldest brother was diagnosed with esophageal cancer. They told him at Vanderbilt that he needed three months of radiation to shrink the tumor, then they needed to remove his esophagus. He did it. During the surgery, when the doctor was removing the esophagus, he apparently didn't use a camera because If he had he would have seen that the radiation had caused his esophagus to attach to his aorta. When he pulled it, the aorta tore, and he didn’t even know it until the blood started to come out of his mouth and nose. It took a long time to figure out what caused it. His heart stopped before they found the cause and stopped the bleeding. They revived him. His 4 hour surgery had turned into an 8 hour surgery and we were not told what happened until he was in recovery. Later that night in ICU, the bleeding started again, and his heart stopped again before they could get it under control. Again, they revived him and again we knew nothing about this until the next morning. 10 days after the surgery, he was going to be released to go home that day and his wife was walking him and he told her her needed to go back to pee. She took him back to the room and he fell back into a chair, dead from a blood clot from all the bleeding. Chemo and radiation have not been friends to my family.

Thu Jan 18, 2018 07:09 PM

I never posted that comment to discourage people from taking treatments that may or may not save their life. I am asking for answers. I am asking for more tests to be done to make certain chemo and radiation are safe for using for cancer treatments for millions of people. We know radiation exposure can cause cancer. Why is it used to treat Cancer then? You can't say it is a targeted treatment if it is administered as a pill that goes into your whole body. Please, please focus not only on killing a tumor but saving a person.
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