Chemotherapy can do more harm than good, study suggests

November 19, 2008

Anybody surprised?

http://www.timesonline.co.uk/tol/news/uk/health/article5138033. ece Chemotherapy can do more harm than good, study suggests David Rose Doctors have been urged to be more cautious in offering cancer treatment toterminally-ill patients as chemotherapy can often do more harm than good, astudy suggests. Patients with incurable cancers were promised much greater access to thelatest drugs which could offer them extra months or years of life by aDepartment of Health review last week. Such medicines are often taken or injected as part of a “cocktail” ofchemotherapy drugs. But the National Confidential Enquiry into Patient Outcome and Death(NCEPOD) found that more than four in ten patients who received chemotherapytowards the end of life suffered potentially fatal effects from the

drugs,and treatment was “inappropriate” in nearly a fifth of cases.. About 300,000 patients now receive chemotherapy in the UK each year, a 60per cent increase compared to 2004. But in a study of more than 600 cancer patients who died within 30 days ofreceiving treatment, chemotherapy probably caused or hastened death in 27per cent of cases, the inquiry found. In only 35 per cent of these cases was care judged to have been good by theinquiry’s advisors, with 49 per cent having room for improvement and 8 percent receiving less than satisfactory care. More than one fifth of patients were already severely debilitated at thetime the decision to treat with chemotherapy was taken, while that manycould not make an informed consent to treatment, the report said. Mark Lansdown, surgical oncologist at Leeds General Infirmary, and aco-author of the report, said that it is usual for patients to suffer

someside-effects following chemotherapy, but that very few patients die as aconsequence. “The majority of patients in this study were receiving palliative treatmentwhere the aim is to alleviate symptoms of cancer with the minimum of sideeffects,” which represented a small proportion (2 per cent) of all patientsreceiving the treatment, he said. “Yet 43 per cent of all patients in the study suffered significanttreatment-related toxicity.” The proportion of deaths attributed to chemotherapy “is of particularconcern for the 14 per cent of patients for whom [it] was intended to curethem of their cancer,” he added. Co-author Diana Mort, of Velindre NHS Trust, Cardiff, said that treatmentcan also result in life-threatening infections or patients may simply die oftheir cancer. “[but] patients must be made aware of the risks and side effects ofchemotherapy as well as the potential

benefits. They should be given time toreflect on their decision and must always be free to change their minds.” The Government’s national cancer director, Professor Mike Richards, saidthat he was “very concerned” by the report’s findings. The National Chemotherapy Advisory Group will publish a full response to theNCEPOD report today, “to bring about a step change in the quality and safetyof chemotherapy services for adult patients,” he added. “I am asking all chemotherapy service providers to consider these reportsurgently and to reassess their own services immediately against the measureswe have set nationally.” Katherine Murphy, director of the Patients Association, commented: “too manyclinicians have a cavalier attitude to providing information on canceroutcomes, when they should be doing everything in their power to raisestandards and give full information to their patients.”

Jane Maher, Chief Medical Officer at Macmillan Cancer Support added:“Doctors and nurses need to be much better at helping patients understandthe pros and cons of such powerful treatments in the last year of life. “Some patients may not be getting the right information and support beforedeciding whether to start chemotherapy and even more importantly, whenenough is enough. “Something clearly needs to be done - I welcome a prompt response by the National Chemotherapy Advisory Group.”

..

November 19, 2008

Surprised ? Hell no !!!

Mary

-

Maracuja

OS

Thursday, November 20, 2008 12:22 AM

Chemotherapy can do more harm than good, study suggests

Anybody surprised?

http://www.timesonline.co.uk/tol/news/uk/health/article5138033. ece Chemotherapy can do more harm than good, study suggests David Rose Doctors have been urged to be more cautious in offering cancer treatment toterminally-ill patients as chemotherapy can often do more harm than good, astudy suggests. Patients with incurable cancers were promised much greater access to thelatest drugs which could offer them extra months or years of life by aDepartment of Health review last week. Such medicines are often taken or injected as part of a “cocktail” ofchemotherapy drugs. But the National Confidential Enquiry into Patient Outcome and Death(NCEPOD) found that more than four in ten patients who received chemotherapytowards the end of life suffered potentially fatal effects from the drugs,and treatment was “inappropriate” in nearly a fifth of cases.. About 300,000 patients now receive chemotherapy in the UK each year, a 60per cent increase compared to 2004. But in a study of more than 600 cancer patients who died within 30 days ofreceiving treatment, chemotherapy probably caused or hastened death in 27per cent of cases, the inquiry found. In only 35 per cent of these cases was care judged to have been good by theinquiry’s advisors, with 49 per cent having room for improvement and 8 percent receiving less than satisfactory care. More than one fifth of patients were already severely debilitated at thetime the decision to treat with chemotherapy was taken, while that manycould not make an informed consent to treatment, the report said. Mark Lansdown, surgical oncologist at Leeds General Infirmary, and aco-author of the report, said that it is usual for patients to suffer someside-effects following chemotherapy, but that very few patients die as aconsequence. “The majority of patients in this study were receiving palliative treatmentwhere the aim is to alleviate symptoms of cancer with the minimum of sideeffects,” which represented a small proportion (2 per cent) of all patientsreceiving the treatment, he said. “Yet 43 per cent of all patients in the study suffered significanttreatment-related toxicity.” The proportion of deaths attributed to chemotherapy “is of particularconcern for the 14 per cent of patients for whom [it] was intended to curethem of their cancer,” he added. Co-author Diana Mort, of Velindre NHS Trust, Cardiff, said that treatmentcan also result in life-threatening infections or patients may simply die oftheir cancer. “[but] patients must be made aware of the risks and side effects ofchemotherapy as well as the potential benefits. They should be given time toreflect on their decision and must always be free to change their minds.” The Government’s national cancer director, Professor Mike Richards, saidthat he was “very concerned” by the report’s findings. The National Chemotherapy Advisory Group will publish a full response to theNCEPOD report today, “to bring about a step change in the quality and safetyof chemotherapy services for adult patients,” he added. “I am asking all chemotherapy service providers to consider these reportsurgently and to reassess their own services immediately against the measureswe have set nationally.” Katherine Murphy, director of the Patients Association, commented: “too manyclinicians have a cavalier attitude to providing information on canceroutcomes, when they should be doing everything in their power to raisestandards and give full information to their patients.” Jane Maher, Chief Medical Officer at Macmillan Cancer Support added:“Doctors and nurses need to be much better at helping patients understandthe pros and cons of such powerful treatments in the last year of life. “Some patients may not be getting the right information and support beforedeciding whether to start chemotherapy and even more importantly, whenenough is enough. “Something clearly needs to be done - I welcome a prompt response by the National Chemotherapy Advisory Group.”

..