Cancer Care Revolution: Less Treatment May Be More Effective for Some

Researchers show that scaling back cancer treatments can benefit patients without compromising outcomes at a major conference.

In a significant shift towards optimizing cancer care, researchers presented compelling evidence at the world’s largest cancer conference suggesting that scaling back treatment for certain cancers can benefit patients without compromising outcomes. This approach, which involves less surgery, chemotherapy, or radiation, was highlighted in studies involving ovarian and esophageal cancer and Hodgkin lymphoma.

Historically, cancer treatment focused on aggressive interventions. For instance, thirty years ago, women with advanced breast cancer endured high doses of chemotherapy and bone marrow transplants, a method that proved no more effective than chemotherapy alone and led to considerable suffering. This trend is now reversing as researchers explore the efficacy of less invasive treatments.

“Do we need all that treatment that we have used in the past?” This crucial question, emphasized by Dr. Tatjana Kolevska, medical director for the Kaiser Permanente National Cancer Excellence Program, encapsulates the ongoing efforts to balance effective cancer care with quality of life.

Dr. William G. Nelson from Johns Hopkins School of Medicine noted, “The good news is that cancer treatment is not only becoming more effective, it’s becoming easier to tolerate and associated with less short-term and long-term complications.” Both Kolevska and Nelson were not involved in the latest studies but acknowledge the importance of this research direction.

Ovarian Cancer

A study led by French researchers investigated whether avoiding the removal of healthy-looking lymph nodes during surgery for advanced ovarian cancer could be a safe approach.

Involving 379 patients, the study split participants into two groups: one had their lymph nodes removed, and the other did not. After nine years, survival rates were similar between the groups, but those who avoided lymph node removal experienced fewer complications, such as the need for blood transfusions. This study was funded by the National Institute of Cancer in France.

Esophageal Cancer

In another study, German researchers examined treatments for a type of esophageal cancer that can be managed with surgery. The study included 438 patients, with one group receiving chemotherapy and surgery on the esophagus, and the other group receiving chemotherapy, surgery, and radiation. After three years, 57% of patients who received chemotherapy and surgery were alive, compared to 51% of those who underwent the additional radiation therapy. This research was supported by the German Research Foundation.

Hodgkin Lymphoma

A study spanning nine countries compared two chemotherapy regimens for advanced Hodgkin lymphoma. The findings revealed that a less intensive treatment was more effective and resulted in fewer side effects. After four years, 94% of patients receiving the less intense chemo had their disease under control, compared to 91% of those who received the more intense regimen.

This trial, involving 1,482 participants from Germany, Austria, Switzerland, the Netherlands, Denmark, Sweden, Norway, Australia, and New Zealand, was funded by Takeda Oncology, the manufacturer of one of the drugs used in the study.

These studies underscore a significant trend in cancer treatment: the potential to improve patient outcomes and quality of life by reducing the intensity of interventions. This approach is driven by advancements in medical research and drug development, allowing for more precise and effective treatments with fewer side effects.

As researchers continue to explore the benefits of less invasive treatments, the medical community remains optimistic about the future of cancer care. By continually reassessing and refining treatment protocols, the goal is to ensure that patients not only survive cancer but also maintain a better quality of life during and after treatment.