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When is a cancer treatment worthwhile?

Article Abstract:

An article in the October 4, 1990 issue of The New England Journal of Medicine reports on the value of a combined chemo- and radiotherapeutic approach to the management of patients with non-small-cell cancer of the lungs. This group of cancers of the lung is associated with a relatively poor survival rate and is not amenable to surgical treatment. The study shows a small but statistically significant improvement in the longevity of patients who received a chemotherapeutic induction (using cisplatin and vinblastine), followed by a standard course of radiotherapy. At two and three years following the therapy, there was an approximate doubling of the number of survivors in the group receiving the combined therapy, compared with those patients who only received the same course of radiotherapy. This study was carried out on volunteers who had advanced stage III cancer, but who were in generally excellent physical status otherwise, and the results present no basis for extension to individuals who have a poorer clinical status. The authors estimate that approximately 25 percent of all stage III patients would meet the eligibility requirements of the study. The survival curves demonstrate that only one individual in seven would be helped by the increased toxicity and expense of a chemotherapy induction. This leads to a question concerning the cost benefit of the combined approach to treatment. The economic concerns are increasingly becoming an important factor in the selection of a specific therapy for a specific patient. It is important to consider the likely course of the patient in determining the cost efficiency of a therapy. If chemotherapy, while adding to the cost of treatment, results in a decrease in other costs, such as days of hospitalization required, than the procedure may be justified on an economic basis. As a result of this clinical trial the possible opportunities for an extended life with a combined therapy should be discussed with patients who meet appropriate criteria. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Finance, Medical care, Cost of, Health care costs, Cancer, Control, Radiotherapy, Chemotherapy, Lung cancer, Non-small cell, Non-small cell lung cancer, editorial

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Removing the primary tumor after the cancer has spread

Article Abstract:

More research is needed to determine if removing a tumor can improve a cancer patient's prognosis even if the tumor has spread to other parts of the body. This seems paradoxical and yet a study published in 2001 found that removing a cancerous kidney in patients with metastatic renal cell carcinoma slightly improved their survival rate.

Editorial, Evaluation, Surgery, Carcinoma, Renal cell, Renal cell carcinoma, Nephrectomy

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Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer

Article Abstract:

Mitoxantrone plus prednisone reduces pain and improves the quality of life in men with advanced, hormone-refractory prostate cancer, but it does not improve survival. The study suggests that docetaxel plus prednisone is the preferred option for most patients with hormone-refractory prostate cancer.

England, Care and treatment, Prostate cancer, Dosage and administration, Prednisone, Docetaxel

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