Nav: Home

Time to initiating cancer therapy is increasing, associated with worsening survival

June 05, 2017

Monday, June 5, 2017, Chicago, Ill.: After reviewing nearly 3.7 million patient records, Cleveland Clinic researchers have shown that newly diagnosed cancer patients are having to wait longer to begin treatment, a delay that is associated with a substantially increased risk of death.

This research was presented today at the ASCO Annual meeting and is abstract 6557: http://abstracts.asco.org/199/AbstView_199_185804.html.

The researchers used prospective data from the National Cancer Database and examined the number of days between diagnosis and the first treatment for those newly diagnosed with early-stage solid-tumor cancers from 2004 to 2013. The study population of 3,672,561 patients included breast, prostate, colorectal, non-small cell lung, renal and pancreas cancers.

The median time between diagnosis and treatment - referred to as "time to treatment initiation," or TTI - has increased significantly in recent years, from 21 days in 2004 to 29 days in 2013. Delays were more likely if patients changed treatment facilities or if they sought care at academic centers.

Longer delays between diagnosis and initial treatment were associated with worsened overall survival for stages I and II breast, lung, renal and pancreas cancers, and stage II colorectal cancers, with increased risk of mortality of 1.2 percent to 3.2 percent per week of delay, adjusting for comorbidities and other variables.

Prolonged TTI of greater than six weeks was associated with substantially worsened survival. For example, five-year survival for stage I non-small cell lung cancer was 56 percent for TTI of less than or equal to six weeks, versus 43 percent for TTI greater than six weeks, and for stage I pancreas cancer was 38 percent versus 29 percent, respectively.

"In addition to its impact on outcomes, delayed TTI can cause unnecessary stress and anxiety for patients," said Dr. Brian Bolwell, chairman of Cleveland Clinic Taussig Cancer Institute and senior author of the research. "Coordinating care is challenging, particularly in academic cancer centers, but once you take the time to identify all the hurdles, and address each of them, progress in TTI is attainable."

Cleveland Clinic cancer programs have made reducing TTI for cancer patients a priority, an effort that began two years ago. Overall TTI initially was similar to other major cancer centers, and it has decreased 17.5 percent overall, with its largest cancer programs (breast, colorectal and lung) showing the greatest reduction. The organization's goal is to reduce TTI further, to less than 20 days.

"Physicians need to commit to multidisciplinary care and create integrated practice units that focus on patients," said Dr. Alok Khorana, gastrointestinal oncologist at Cleveland Clinic and first author of the research. "TTI needs to be measured and emphasized, and we must understand what is significant to each individual patient and not assume we already know."
-end-
About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual "America's Best Hospitals" survey. Among Cleveland Clinic's 51,000 employees are more than 3,500 full-time salaried physicians and researchers and 14,000 nurses, representing 140 medical specialties and subspecialties. Cleveland Clinic's health system includes a 165-acre main campus near downtown Cleveland, 10 regional hospitals, more than 150 northern Ohio outpatient locations - including 18 full-service family health centers and three health and wellness centers - and locations in Weston, Fla.; Las Vegas, Nev.; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2016, there were 7.1 million outpatient visits, 161,674 hospital admissions and 207,610 surgical cases throughout Cleveland Clinic's health system. Patients came for treatment from every state and 180 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic.

Editor's Note: Cleveland Clinic News Service is available to provide broadcast-quality interviews and B-roll upon request.

Cleveland Clinic

Related Cancer Patients Articles:

The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.
The art of cancer caregiving: How art therapies benefits those caring for cancer patients
A recent Drexel University study showed coloring and open-studio art therapy benefits stressed caregivers of cancer patients.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer tissue-freezing approach may help more breast cancer patients in lower income countries
A new reusable device created by the Johns Hopkins University can help women with breast cancer in lower income countries by using carbon dioxide, a widely available and affordable gas, to power a cancer tissue-freezing probe instead of industry-standard argon.
Lots of patients with cancer, cancer survivors use but don't report complementary/alternative medicine therapies
This study used data from a nationwide survey to estimate how many patients with cancer and cancer survivors use complementary and alternative medicines (CAMS) in addition to or instead of conventional therapies, and how many don't disclose that to their physicians.
Colorectal cancer in patients with early onset is distinct from that in older patients
New research indicates that colorectal cancer diagnosed at an early age has clinical and genetic features that are different from those seen in traditional colorectal cancer diagnosed later in life.
Comparable risk of recurrent venous thromboembolism between patients with unprovoked venous thromboembolism and patients with cancer
Patients with venous thromboembolism (VTE) carry a high risk of recurrence.
Personalized cancer vaccine may increase long-term survival in patients with deadly brain cancer
An international Phase III study led by researchers at UCLA has found that a personalized GBM vaccine may increase long-term survival in some patients.
Ovarian cancer drug shows promise in pancreatic cancer patients with BRCA mutation
A targeted therapy that has shown its power in fighting ovarian cancer in women including those with BRCA1 and BRCA2 mutations may also help patients with aggressive pancreatic cancer who harbor these mutations and have few or no other treatment options.
Patients with blood cancer precursor at risk of developing cancer even after 30 years
Patients with monoclonal gammopathy of undetermined significance are at risk of progressing to multiple myeloma or a related cancer -- even after 30 years of stability.
More Cancer Patients News and Cancer Patients Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

TED Radio Wow-er
School's out, but many kids–and their parents–are still stuck at home. Let's keep learning together. Special guest Guy Raz joins Manoush for an hour packed with TED science lessons for everyone.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.