ASCO: Less Can Be More For Cancer Treatment : Shots - Health News Are some people getting too much treatment for their cancers? The answer, from the American Society of Clinical Oncology meeting in Chicago, is an emphatic yes.
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Doctors Scrutinize Overtreatment, As Cancer Death Rates Decline

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Doctors Scrutinize Overtreatment, As Cancer Death Rates Decline

Doctors Scrutinize Overtreatment, As Cancer Death Rates Decline

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  • <iframe src="https://www.npr.org/player/embed/617104810/617250190" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
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MARY LOUISE KELLY, HOST:

An enormous meeting of cancer doctors wrapped up today in Chicago, and the biggest news was not about exciting new treatments but about current treatments that turn out to be all pain and no gain. NPR's Richard Harris mingled with the 40,000 or so attendees at the American Society of Clinical Oncology meeting, and he brought us back this report.

RICHARD HARRIS, BYLINE: The most notable story from the meeting was about breast cancer. A major study found that for women with the most common form of breast cancer, a round of toxic chemotherapy just to be safe actually doesn't make sense. Doctors already knew that in this group, the chemotherapy provided at best a small advantage. But Dr. Harold Burstein says they have now identified a whole bunch of women for whom it provides no benefit at all.

HAROLD BURSTEIN: You know, there's a huge difference between saying, well, you might benefit a little bit and saying there's no benefit for you.

HARRIS: Burstein, at the Dana-Farber Cancer Institute in Boston, was speaking on behalf of ASCO, the Oncology Society. The study was presented Sunday and is being published in The New England Journal of Medicine. And that wasn't the only study that found less is more when it comes to cancer treatment.

In kidney cancers that have spread throughout the body, surgeons routinely remove the diseased organ in addition to giving a patient chemotherapy. But speaking to a crowd of thousands of doctors, Arnaud Mejean from the Georges Pompidou European Hospital of Paris announced the results of a study showing that surgery didn't help kidney cancer patients and might even make matters worse. And then at the end of his talk, he disclosed his conflict of interest.

(SOUNDBITE OF ARCHIVED RECORDING)

ARNAUD MEJEAN: I am a surgeon mostly involved in kidney surgery.

HARRIS: He then flashed on the screen a cartoon character who has shot himself in the foot.

(SOUNDBITE OF ARCHIVED RECORDING)

MEJEAN: I know that it is - yes, I know nobody's perfect. Thank you for your applause.

HARRIS: But he went on to point out that doctors throughout the room should face up to the truth of their own practices even if it isn't in their own self-interest.

(SOUNDBITE OF ARCHIVED RECORDING)

MEJEAN: Thank you very much.

HARRIS: There were other studies presented at the meeting that pointed to treatments that don't work at all or to toxic medicines that are just as effective at lower doses. These studies had a common feature. They were funded primarily by governments. Dr. Bruce Johnson, president of ASCO, noted a worrying trend in this regard.

BRUCE JOHNSON: One of the things about our meeting is that a number of studies that are presented that are sponsored by the government have dropped from about 575 to 143 over the last decade. It's cut in a fourth.

HARRIS: And instead of government funding, clinical trials are mostly funded by drug companies pushing to develop new, high-priced medications. Dr. Otis Brawley, chief medical officer of the American Cancer Society, is concerned that there are now too many of these studies happening all at once, particularly for immune-boosting therapies. Most of these are very similar to what's already on the market, and drug companies are simply jockeying to get a piece of the action.

OTIS BRAWLEY: They're actually slowing down the development of immunotherapy drugs by having too many drugs that are very similar out in clinical trials.

HARRIS: Patients are a scarce resource, he notes, and it's a shame to see so many of them enrolled in studies that aren't breaking any new ground.

BRAWLEY: This is a huge problem. We sometimes wish that we had a policeman who could sort of direct traffic when it comes to drug development.

HARRIS: But Brawley admits that it would be tough to figure out a way to make that happen. Richard Harris, NPR News.

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