ORLANDO — Many patients with colorectal cancer are willing to undergo adjuvant chemotherapy in the hopes of warding off a recurrence, even though the likelihood of recurrence is slight.
In a survey of 150 patients, just over one-third of those who had received adjuvant chemotherapy with 5-fluorouracil and oxaliplatin said they would go through chemotherapy again to reduce their chance of cancer relapse by 1%, and 57% said they would be treated again for a 3% reduction, said Dr. Neil Love, president of Research to Practice, an oncology education company in Miami, at a symposium on gastrointestinal cancers sponsored by the American Society of Clinical Oncology.
At the other end of the spectrum, even when chemotherapy would result in a 1 in 10 chance that they would avoid relapse, about 10% of patients said they would forgo treatment, he said at the symposium, also sponsored by the AGA Institute, the American Society for Therapeutic Radiology and Oncology, and the Society of Surgical Oncology.
These responses came after the patients were given educational CDs and videos, and had the opportunity to talk with oncologists about adjuvant chemotherapy.
Dr. Love and his associates did a parallel survey of 150 oncologists and clinical investigators who specialized in gastrointestinal cancers, asking them to predict what their patients would choose. The oncologists and investigators thought that far fewer patients, just 19%, would choose to undergo chemotherapy for a 1% reduction in cancer recurrence risk.
More than half the patients in the survey expected to have severe nausea and vomiting and lose their hair as a result of their chemotherapy, despite being told otherwise by their doctors. “Patients seem to be getting a lot of misinformation from friends and relatives about the chemotherapy that is used for colorectal cancer, which usually doesn't cause those side effects because of the medications we have today,” Dr. Love said.
These results suggest that “doctors are not getting the right information across to their patients [and] that patients may be far more willing to receive cytotoxic therapy for what others might view as modest potential treatment benefits,” he said.
'Patients may be far more willing to receive cytotoxic therapy for what others might view as modest … benefits.' DR. LOVE