Confusing Risk Information Leads To Poor Cancer Treatment Choices

Dec 9, 2008 | Posted by: roboblogger | Full story: EMaxHealth

A new study from researchers at the University of Michigan Comprehensive Cancer Center found that a tool commonly used by doctors to estimate the risk of a woman's breast cancer returning after surgery is not ...

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Since: Dec 05

Union, NJ

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#1
Dec 12, 2008
 
It's not a question of doctors spending as little time as possible explaining the numbers to patients. Discussions of risk need to be as thoroughly thought out and presented as much as possible. That is the best way to make sure that each patient can make the right choice for their situation.

Informing cancer patients of the benefits and risks specific to a new or existing medicine helps ensure patients are safely and effectively treated. A trusting partnership between doctor and patient that facilitates informed consent is a goal for many proactive patients.

Such a partnership requires an understanding of all the factors that lead to a treatment recommendation. In light of the precious little in the way of guidance from clinical trials with respect to best empiric treatment, which is based on medical journal articles, epidemiology and economics, a patient's decision based on risk information will incorporate better understanding.
Gail Perry

United States

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#2
Dec 12, 2008
 
"s not a question of doctors spending as little time as possible explaining the numbers to patients. Discussions of risk need to be as thoroughly thought out and presented as much as possible."

No, GDP Read the article!!! It's about how the information is presented because few people are knowledgeable about statistics.

"In light of the precious little in the way of guidance from clinical trials with respect to best empiric treatment,"

This just isn't true, folks. I saw three oncologists and all three had solid research to back up their opinion of what my treatment should be. That's why all three essentially agreed with a little minor tweaking.

Please be careful about where you gather your information, folks. People posting online can say anything they want and never reveal their underlying motivations, but they may not have your best interests at heart.

If you don't understand why your doctor is recommending one approach over another, ASK.

Since: Dec 05

Union, NJ

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#3
Dec 12, 2008
 
Speaking of Gail, people like her do post online and say or make up any kind of flamming commentary they want. She's incredible!
Gail Perry

United States

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#4
Dec 12, 2008
 
It is unfortunate, gdp, that any time someone disagrees with you, you get what you think is personally insulting.

I had breast cancer a little over two years ago. I had a mastectomy, chemotherapy and Herceptin, and now am on an ZI. I also receive Zometa once a year (more and more research is emerging that Zometa may help fight tumors even before they have spread to the bones, by the way).

I did lots of research before I accepted any of those treatments, and I continue to do it. My oncologist always has his ear to the ground for new research and knew that Zometa had great potential before it became publicly known. He knew about the possible extra benefits of Vitamin D before that research was published. He's been on top of it all the way, but I have never just blindly accepted what he had to say.

I stand by what I said. Be careful about agendas online. There's no way to force a person to reveal his or her agenda but such agendas may color the advice they give.

Since: Dec 05

Union, NJ

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#5
Dec 15, 2008
 
It's is all in the presentation. When no alternatives are presented, people will tend to seize what is available. When relative risk numbers that really do not relate to actual risk are given, it makes informed decision making even more difficult.

The method used to present information about chemotherapy influences treatment decisions. In deciding on endorsing chemotherapy, patients understand the information best when presented with data in the absolute survival benefit format, rather than those presented with data in the relative risk reduction information format. Absolute survival benefit is the most easily understood method of conveying the information regarding benefit of treatment.

Discussions between doctors and patients about the risks and benefits of chemotherapy need to be changed. Being told that chemotherapy reduces your risk by 30% of recurrence can be misleading and meaningless, unless you know your risk in the first place. If your risk of recurrence is 15%, you are only reducing it by 5%. And this doesn't even reflect the harm that could be done to those who don't need the treatment.

What is that harm? There are the toxicities that can end your life: leukemia and heart failure. There are toxicities that can ruin your life: loss of libido, loss of cognitive function, severe joint pain, and bone fractures. These harms are usually ignored or understated. One of the reasons is because they are understudied.

Source: Journal of Clinical Oncology, Vol 21, Issue 23 (December), 2003: 4299-4305
Gail Perry

United States

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#6
Dec 16, 2008
 
"It's is all in the presentation. When no alternatives are presented, people will tend to seize what is available. "

Here's how it works, gdp. If you have a chance of surviving, you want to have treatment that has been demonstrated in research to help save lives. I was lucky; there were a bunch of them for me; surgery, three kinds of chemotherapy, Herceptin, AI's and now even Reclast appears to be a significant weapon, along with (possibly) Vitamin D and calcium.

Why would I go with an unproven alternative when I had all that? I'd have to be nuts.

And by the way, if your real personal risk of recurrence drops from 15% to 5%-- YOU SLEEP BETTER AT NIGHT. Your friends and loved ones don't start wondering whether we should all be planning your memorial. You get on with life in a positive way, grateful for your second chance. 5% is a WHOLE lot better than 15%.

Harm? ALL THOSE TREATMENTS and I haven't had a SCRAP of harm from it. It happens, but the risk of harm wasn't nearly as bib as the certainty of death if I didn'tdeal with the cancer. I had no loss of cognitive function; the joint pain was EASILY managed with advil; and bone fractures are now a thing of the past because they know how to prevent bone deterioration. If you read more research in a more unbiased way YOU WOULD KNOW THAT. There's a FAR greater risk of the breast cancer returning than of leukemia appearing. It's a risk/benefit ratio that has to be looked at. There was no cardiac faiure.

Those risks to me were NEVER understated. Both my oncologist and the nurses who work with him worked very hard to make sure that these things were managed.

I can't imagine why you would say these things have been "under-studied." I researched every one of them (and more) and found a wealth of information. This is a good thing to learn to do, because it allowed me to ask my oncologist some hard questions. But in the end, it turned out that his recommendations were all spot-on.

By the way, this is CANCER we're talking about, a field where there has been an explosion of research just in the last two years. A cite from 2003 means the research was done in 2001 and/or 2002. That's VERY old. It does not reflect what's going on.

Why you come into these blogs over and over again and try to scare people away from proven treatments is beyond me, but it is my personal opinion that you will have to answer for it when you leave this world and enter the next.

Since: Dec 05

Union, NJ

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#7
Dec 16, 2008
 
Informing cancer patients of the benefits and risks specific to a new or existing medicine helps ensure patients are safely and effectively treated. It requires an understanding of all the factors that lead to a treatment recommendation.

In light of the precious little in the way of guidance from clinical trials with respect to best empiric treatment, which is based on medical journal articles, epidemiology and economics, a patient's decision based on risk information will incorporate better understanding.

There have been truly minuscule improvements as a result of adjuvant chemotherapy and the net benefit to the community of cancer patients in the real world. The criticism remains: All of the clinical trials resources have gone toward driving a square peg (one-size-fits-all chemotherapy) into a round hole (notoriously heterogeneous disease).

Gail is the nom de blog of a humble pseudonymous person with an ego just big enough to delude herself that someone, somewhere might actually give a rodent's posterior about her miscellaneous verbal meanderings, but just barely small enough to admit to herself that few will.
Gail Perry

United States

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#8
Dec 16, 2008
 
"Informing cancer patients of the benefits and risks specific to a new or existing medicine helps ensure patients are safely and effectively treated."

Yes, indeed. Who do you think isn't told that?

The improvements are not miniscule at all. The survival rates for most types of breast cancer has markedly improved compared to 20 years ago. And in fact his notion that "all the clinical trials" are generic is absurd. Talk to your doctors, folks. Your oncologist will be able to tell you which treatments are most appropriate for you, and why, based on the most current research. He or she won't be giving you scare tactics based on data collected nearly 10 years ago, as we just saw from gdp.

I don't know why gdp has to insult everyone who disagrees with him, but that's what he does.

Since: Dec 05

Union, NJ

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#9
Dec 31, 2008
 
You don't agree with virtually anything, anyone posts on this board Gail. People are going to treat you they same way you treat them.
Gail Perry

United States

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#10
Dec 31, 2008
 
gdp, I couldn't care less how you treat me. You post pontificated imaginings. You over-interpret and over-generalize what you read, and you read the research in a selective and biased way. In my opinion, many of your posts are just plain dangerous. I'm not looking for friendship or even common courtesy from such a person.
Abdullah

UK

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#12
Sep 23, 2013
 
I have ordered 2 times from this website PILLSMEDSHOP. COM . I called yesterday the customer care and asked for a discount as i was about to order twice the regular amount.
Cael

Czech Republic

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#13
Sep 23, 2013
 
I have ordered 2 times from this website PILLSMEDSHOP. COM . I called yesterday the customer care and asked for a discount as i was about to order twice the regular amount.

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