On Sunday, June 3rd, 2018, doctors, researchers, and other professionals in the healthcare industry gathered at the annual meeting of the American Society of Clinical Oncology in Chicago to hear presentations on the latest findings and advances made in cancer treatment. One federally funded study revealed that many women with early-stage breast cancer could forgo the traditional course of treatment with chemotherapy following surgery, thereby lessening unpleasant side effects and saving thousands of dollars in costs. Such studies are typically funded by government agencies as the drug makers don’t want to push for fewer or shorter treatments, which would negatively impact their bottom line.
Another recent study funded by the U.K. health institute showed that women’s outcomes did not suffer when a course of treatment with a breast cancer drug Herceptin was reduced to six months from twelve months. Most of these drugs cost more than $12,000 per month. While it may seem that prescribing a medication over a shorter period of time may be cost saving for patients, Dr. S. Vincent Rajkumar, a blood cancer specialist at the Mayo Clinic in Rochester, Minnesota warned that drug companies may be under pressure to raise prices further in order to offset fewer prescriptions.
The new mindset with respect to treatment of breast cancer could have a significant impact on the healthcare industry because the patient pool is so vast. According to the estimates by the American Cancer Society, 266,000 new cases of invasive breast cancer will be diagnosed this year. Close to half of the newly stricken patients will have tumors where the growth is spurred by hormones but they have not spread to the lymph nodes.
Previously, all such patients underwent surgery and then were put on a regimen of chemotherapy and hormonal drugs based on recommendations from the National Institute of Health dating from the year 2000. However, in 2006, the National Cancer Institute commenced a clinical trial by recruiting 10,200 participants to determine if women with medium risk of recurrence could safely skip chemotherapy and just be treated with hormone therapy alone. As part of this trial, the middle-risk group of 6,700 women was either placed on a combination of two treatments or just hormonal drugs. Nine years after the beginning of the study, 83.3% of the women who received hormones alone were cancer free as compared to 84.3% of patients who were given both. The outcome of this trial pointed out that chemotherapy is not always necessary and should not routinely be the first line of defense after the initial diagnosis.
In addition to saving many women from the debilitating side effects, cutting out chemotherapy also led to significant cost savings. While the genetic test to determine the particular type of tumor costs about $4,500 per patient, the approximate total cost of chemotherapy can add up to $80,000. It may take a while for doctors to trust this paradigm shift in treatment, but it is certain that the “less is more” approach has entered the hospital rooms and physicians’ offices and is here to stay.
Feature Image via Wikimedia Commons
