Breast Cancer Patients Are Still Not Getting Shorter Chemotherapy Treatment

ByPrimary Researcher

Executive Summary

  • While there is ample evidence for breast cancer patients to get less chemotherapy, patients are still getting too lengthy treatments.

Introduction

In a previous article titled How The Medical Establishment Hides Their Error With Chemotherapy for Breast Cancer, several articles claimed that chemotherapy had become much more targeted due to genetic testing.

In this article, we find evidence that contradicts this claim.

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Evidence of Continuous Overtreatment of Chemotherapy

This is found in the article So Much Care It Hurts: Unneeded Scans, Therapy, Surgery Only Add To Patients’ Ills.

Short Chemotherapy Works as Well as Longer Chemotherapy

Medical research published in The New England Journal of Medicine in 2010 – six years before her diagnosis — showed that a condensed, three-week radiation course works just as well as the longer regimen. A year later, the American Society for Radiation Oncology, which writes medical guidelines, endorsed the shorter course.

In 2013, the society went further and specifically told doctors not to begin radiation on women like Dennison – who was over 50, with a small cancer that hadn’t spread – without considering the shorter therapy.

Once again, they did this treatment for decades.

However, the issue is that the shorter the chemotherapy, the better the outcome — and this would most likely extend to not doing chemotherapy at all — however, the medical establishment can’t admit this.

Disturbing Overtreatment?

“It’s disturbing to think that I might have been overtreated,” Dennison said. “I would like to make sure that other women and men know this is an option.” Yet many patients still aren’t told about their choices. An exclusive analysis for Kaiser Health News found that only 48 percent of eligible breast cancer patients today get the shorter regimen, in spite of the additional costs and inconvenience of the longer type.

The analysis was completed by eviCore healthcare , a South Carolina-based medical benefit management company, which analyzed records of 4,225 breast cancer patients treated in the first half of 2017. The women were covered by several commercial insurers. All were over age 50 with early-stage disease.

The data “reflect how hard it is to change practice,” said Dr. Justin Bekelman, associate professor of radiation oncology at the University of Pennsylvania Perelman School of Medicine.

Because insurers pay doctors for each radiation session, for example, those who prescribe longer treatments earn more money, said Dr. Peter Bach, director of Memorial Sloan Kettering’s Center for Health Policy and Outcomes in New York.

“Reimbursement drives everything,” said economist Jean Mitchell, a professor at Georgetown University’s McCourt School of Public Policy. “It drives the whole health care system.”

It might be disturbing, but it is a fact. And it is many millions of women who were overrated with chemotherapy. And as KHN estimates, around 1/2 of all breast cancer patients are placed on chemotherapy treatments of inappropriate length.