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Almost 1/3 of colon cancer patients stop chemotherapy, leading to double the death rate
May 01, 2006First study to look at link between mortality rates from colon cancer & treatment adherence
New research from Columbia University Medical Center has found that as many as 30 percent of patients with stage III colon cancer who were prescribed six months of chemotherapy with a combination of 5-fluorouracil and leucovorin stopped their treatment prematurely. Stopping chemotherapy for colon cancer prematurely was shown to be equivalent to receiving no treatment at all. The findings add to the arsenal of reasons why colon cancer patients, and all cancer patients, need to complete their chemotherapy regimens whenever possible.
Previous studies have shown that not completing chemotherapy regimens for breast cancer is associated with shorter survival. This is the first study to look at a link between mortality rates from colon cancer and treatment adherence.
"The intuitive thinking is that if you complete most of a treatment regimen, you should get most of the treatment benefit. But these findings are significant because they indicate that completing treatment is as critical for colon cancer as it is for breast cancer - and we need to do better to ensure that patients who can, complete treatment as intended," said Alfred I. Neugut, M.D., Ph.D., who led the study along with Dawn L. Hershman, M.D., M.S.
The study will be published in the May 20, 2006 issue of the Journal of Clinical Oncology (published online April 17, 2006).
The research team used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify stage III colon cancer patients who were at least 65 years of age or older, and who received one to seven months of fluorouracil (FU)-based adjuvant chemotherapy treatment.
Among the 1,579 patients who survived eight months or longer, the 1,091 (69.1 percent) who underwent five to seven months of treatment survived nearly twice as long as the 488 (30.9 percent) who received only one to four months of treatment. Patients who were older, unmarried and had comorbid conditions, were more likely to receive less than five months of treatment.
Dr. Neugut is the Myron M. Studner Professor of Cancer Research in Medicine at Columbia University Medical Center. He is also professor of epidemiology at Columbia University's Mailman School of Public Health, as well as head of Cancer Prevention and Control for the Herbert Irving Comprehensive Cancer Center, and co-director of the Cancer Prevention Center of New York Presbyterian Hospital/Columbia.
Dr. Neugut sees patients as an attending physician in medical oncology at NewYork-Presbyterian Hospital/Columbia and Harlem Hospital Center, an affiliate institution of Columbia University Medical Center.
Dr. Hershman, co-lead author, is assistant professor of medicine and epidemiology at the Columbia University College of Physicians and Surgeons in the Division of Medical Oncology. She is co-director of the Breast Program for the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia. Dr. Hershman is an assistant attending physician in medical oncology at New York-Presbyterian Hospital/Columbia specializing in breast cancer.
Additional members of the Columbia University Medical Center research team included: Matthew Matasar, M.D., former instructor in clinical medicine; Xiaoyan Wang, M.A., staff associate in epidemiology, Mailman School; Russell McBride, doctoral student in epidemiology, Mailman School; Judith S. Jacobson, DrPH, assistant professor of clinical epidemiology, Mailman School; Wei-Yann Tsai, Ph.D., professor of biostatistics, Mailman School; and, Victor R. Grann, M.D., MPH, clinical professor of medicine and epidemiology and health policy and management at the College of Physicians & Surgeons and Mailman School of Public Health.
The same research team recently published (Journal of Clinical Oncology, Sept. 20, 2005 issue) the first study to link treatment completion issues with race and poor survival rates. The 2005 study found that black women with early stage breast cancer were more likely than their counterparts of other races to abandon chemotherapy before completing their full course of treatment. The findings shed new light on why breast black cancer patients experience lower survival rates than other women, despite a lower incidence.
Columbia University Medical Center
"The intuitive thinking is that if you complete most of a treatment regimen, you should get most of the treatment benefit. But these findings are significant because they indicate that completing treatment is as critical for colon cancer as it is for breast cancer - and we need to do better to ensure that patients who can, complete treatment as intended," said Alfred I. Neugut, M.D., Ph.D., who led the study along with Dawn L. Hershman, M.D., M.S.
The study will be published in the May 20, 2006 issue of the Journal of Clinical Oncology (published online April 17, 2006).
The research team used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify stage III colon cancer patients who were at least 65 years of age or older, and who received one to seven months of fluorouracil (FU)-based adjuvant chemotherapy treatment.
Among the 1,579 patients who survived eight months or longer, the 1,091 (69.1 percent) who underwent five to seven months of treatment survived nearly twice as long as the 488 (30.9 percent) who received only one to four months of treatment. Patients who were older, unmarried and had comorbid conditions, were more likely to receive less than five months of treatment.
Dr. Neugut is the Myron M. Studner Professor of Cancer Research in Medicine at Columbia University Medical Center. He is also professor of epidemiology at Columbia University's Mailman School of Public Health, as well as head of Cancer Prevention and Control for the Herbert Irving Comprehensive Cancer Center, and co-director of the Cancer Prevention Center of New York Presbyterian Hospital/Columbia.
Dr. Neugut sees patients as an attending physician in medical oncology at NewYork-Presbyterian Hospital/Columbia and Harlem Hospital Center, an affiliate institution of Columbia University Medical Center.
Dr. Hershman, co-lead author, is assistant professor of medicine and epidemiology at the Columbia University College of Physicians and Surgeons in the Division of Medical Oncology. She is co-director of the Breast Program for the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia. Dr. Hershman is an assistant attending physician in medical oncology at New York-Presbyterian Hospital/Columbia specializing in breast cancer.
Additional members of the Columbia University Medical Center research team included: Matthew Matasar, M.D., former instructor in clinical medicine; Xiaoyan Wang, M.A., staff associate in epidemiology, Mailman School; Russell McBride, doctoral student in epidemiology, Mailman School; Judith S. Jacobson, DrPH, assistant professor of clinical epidemiology, Mailman School; Wei-Yann Tsai, Ph.D., professor of biostatistics, Mailman School; and, Victor R. Grann, M.D., MPH, clinical professor of medicine and epidemiology and health policy and management at the College of Physicians & Surgeons and Mailman School of Public Health.
The same research team recently published (Journal of Clinical Oncology, Sept. 20, 2005 issue) the first study to link treatment completion issues with race and poor survival rates. The 2005 study found that black women with early stage breast cancer were more likely than their counterparts of other races to abandon chemotherapy before completing their full course of treatment. The findings shed new light on why breast black cancer patients experience lower survival rates than other women, despite a lower incidence.
Columbia University Medical Center
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NC State Is First University in Nation to Offer Canine Bone Marrow Transplants
Dogs suffering from lymphoma will be able to receive the same type of medical treatment as their human counterparts, as North Carolina State University becomes the first university in the nation to offer canine bone marrow transplants in a clinical setting.
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Scientists have detected previously unnoticed chemical signals that individual cells in the immune system use to communicate with each other over short distances.
Barrow researchers identify a new approach to detect the early progression of brain tumors
Researchers at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center recently participated in a pilot study with the Montreal Neurological Institute that suggests a certain type of MRI scanning can detect when a patient is failing brain tumor treatment before symptoms appear.
Variation of normal protein could be key to resistance to common cancer drug
Researchers at the Moores Cancer Center at the University of California, San Diego (UC SD) in La Jolla have found evidence explaining why a common chemotherapy drug, cisplatin, may not always work for every cancer patient. They have shown that when a variant version of a key protein that normally causes cell death is active, patients may be resistant to the cancer-killing drug.
Normalizing tumor vessels to improve cancer therapy
Chemotherapy drugs often never reach the tumors they're intended to treat, and radiation therapy is not always effective, because the blood vessels feeding the tumors are abnormal-"leaky and twisty" in the words of the late Judah Folkman, MD, founder of the Vascular Biology program at Children's Hospital Boston.
UTMB researchers test new vaccine to fight multiple influenza strains
A universal vaccine effective against several strains of influenza has passed its first phase of testing, according to Dr. Christine Turley of the University of Texas at Galveston.
Drugs to inhibit blood vessel growth show promise in rat model of deadly brain tumor
In a landmark study, Medical College of Wisconsin researchers in Milwaukee report that drugs used to inhibit a specific fatty acid in rat brains with glioblastoma-like tumors not only reduced new blood vessel growth and tumor size dramatically, but also prolonged survival. The study is the featured cover story of the August, 2008 Journal of Cerebral Blood Flow & Metabolism.
Bowel cancer indicator should lead to better treatment
STEM cell scientists have developed a more accurate way of identifying aggressive forms of bowel cancer, which should eventually lead to better treatment and survival rates.
Stem cell indicator for bowel cancer should lead to better survival rates
Stem cell scientists have developed a more accurate way of identifying aggressive forms of bowel cancer, which should eventually lead to better treatment and survival rates. Bowel cancer is the third most common cancer in the UK.
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