The debate over how breast cancer should be treated is constantly changing. Many experts are trying to find the best plan possible, because breast cancer is one of the leading causes of death among American women.
The New York Times reports on a study showing that physicians are giving their patients overly long radiation treatment plans that are superfluous. Apparently these plans can be truncated, and this would benefit the patient financially and emotionally.
Many women receive lumpectomies to prevent traces of cancer from progressing. This is often followed by radiation to eliminate any remaining traces of cancer that might not have been detected during the surgery. But how much radiation is enough?
A new study shows that two-thirds of women are getting radiation for twice as long as what is actually necessary. Many doctors prescribe radiation treatment to women for five to seven weeks.
But new research contradicts this practice. New guidelines (from a leading radiology society) and four detailed studies find that three to four weeks of more intense radiation is just as effective.
The studies also find that women of course prefer the shorter treatment plan, as it is less emotionally taxing. It is also more economical. But the majority of women are not receiving this plan.
Most women do not know about the shorter treatment option.
The New York Times explains, “Even though 60 to 75 percent of women with breast cancer have lumpectomies — a total of about 140,000 to 160,000 women — doctors and health insurers say relatively few are receiving the shorter treatment because it takes time to change ingrained medical practices, especially when a procedure has been used for decades and the new one offers no additional medical benefit. Its advantages are saving time for patients, and money for the health care system and insurers.”
Radiation is important because it decreases the chance of another cancer developing in the breast; this then increases chances of survival. But women do not necessarily have to get radiation for as long as they are currently being prescribed it. The duration could be shorter.
The research found that shorter radiation treatment plans are actually better for women with early stage cancers. When it comes to women with more aggressive cancers, the guidelines do not endorse or negate using less radiation.
Use of the shorter radiation treatment plan has increased over time but experts say it has not increased enough. The studies looked at how much the numbers rose from 2008 to 2013.
“In the group that should have received the shorter therapy under the guidelines, 10.6 percent received it in 2008 and 34.5 percent in 2013. In the group that received no recommendation for or against the shorter treatment, the percentage who used it rose from 8.1 percent to 21.2 percent over that time,” according to The Times.
But in Canada and Britain the majority of women are getting the shorter treatment plan.
What is the difference in costs (between the shorter plan versus the longer plan)? The total medical expenses for the shorter therapy in women for whom it was endorsed were $28,747. Researchers found that for women receiving the longer course of treatment, the cost was actually $31,641.
Experts have found that cosmetic results are just as good with the shorter radiation treatment plans. And the British were the first to realize this by doing clinical trials where they took pictures that were graded by blinded observers. Many American experts hope that the U.S. continues to expand on the shorter treatment plan option as the British have done.
