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Chicago – In a groundbreaking development presented at the world’s largest cancer conference, doctors reported that scaling back treatment for three types of cancer can improve patients’ quality of life without compromising their outcomes. This finding is part of a growing trend toward evaluating whether less-intensive treatments—less surgery, less chemotherapy, and less radiation—can lead to better patient experiences.
The latest studies, focusing on ovarian and esophageal cancer and Hodgkin lymphoma, reflect a significant shift from past practices. Thirty years ago, the approach was often to increase the intensity of treatment, as seen with the extreme example of massive chemotherapy doses and bone marrow transplants for advanced breast cancer, which ultimately did not improve outcomes and caused significant suffering.
Today, researchers are questioning the necessity of extensive treatments used in the past. “Do we need all that treatment that we have used in the past?” is a question that should be asked repeatedly, according to Dr. Tatjana Kolevska, medical director for the Kaiser Permanente National Cancer Excellence Program.
The encouraging trend is partly due to the advent of improved drugs that make less-intensive treatment viable. “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,” said Dr. William G. Nelson of Johns Hopkins School of Medicine.
Here are the highlights of the recent studies discussed at the American Society of Clinical Oncology conference in Chicago:
Ovarian Cancer
A study led by French researchers found that avoiding the removal of healthy-appearing lymph nodes during surgery for advanced ovarian cancer is safe. The study involved 379 patients, split into two groups—one undergoing lymph node removal and the other not. After nine years, survival rates were similar between the groups, but those who had less-extreme surgery experienced fewer complications, such as the need for blood transfusions. This research was funded by the National Institute of Cancer in France.
Esophageal Cancer
A German study examined 438 patients with a type of esophageal cancer treatable with surgery. Participants were divided into two groups—one receiving a treatment plan of chemotherapy and surgery, and the other receiving chemotherapy, surgery, and radiation. Both approaches are standard, with the choice often depending on treatment location. After three years, 57% of those who received chemo and surgery were alive, compared to 51% of those who underwent the additional radiation. The German Research Foundation funded this study.
Hodgkin Lymphoma
In a comparison of two chemotherapy regimens for advanced Hodgkin lymphoma, researchers found that a less-intensive treatment was more effective and had fewer side effects. After four years, the disease was controlled in 94% of patients receiving the gentler chemotherapy, compared to 91% of those receiving the more intense regimen. This trial involved 1,482 participants across nine countries and was funded by Takeda Oncology, the manufacturer of one of the drugs used in the study.
These studies highlight the potential benefits of less-aggressive cancer treatments, marking a pivotal shift in cancer care that prioritizes patient well-being without sacrificing efficacy.
