Correcting the cure

To diagnose and treat the most serious diseases, such as cancer, patients sometimes have to endure some tough love. Radiotherapy and chemotherapy can take a serious toll on a person, even if the reward of being rid of their cancer is worth the risk.

Fortunately, researchers are constantly looking to lessen the risks involved in treatment, and we saw several examples of this in the week’s top stories.

A pair of studies published online Nov. 11 in The Lancet and The Lancet Oncology examined alternatives to the standard multi-week course of external beam radiotherapy (EBRT) following lumpectomy to treat breast cancer. The two treatments evaluated by the studies were both targeted radiation doses delivered in a single session either during surgery or shortly thereafter. TARGIT, the treatment from The Lancet study, reduced overall mortality while offering similar recurrence control to EBRT. ELIOT, an electron beam radiotherapy technique evaluated in the Lancet Oncology study, was not able to prevent recurrence as well as EBRT, though the authors noted that the single-shot treatment may still be preferable to some patients compared with a lengthy course of EBRT.

The Choosing Wisely campaign is working to provide relief to patients by curtailing unnecessary testing and treatments. It prompts professional associations to create lists of procedures that should be especially scrutinized for appropriateness, and this week the American Society of Clinical Oncology (ASCO) released its Top Five list.

ASCO recommended that anti-emetic drugs only be given to patients starting chemotherapy who are at a high risk of nausea and that combination chemotherapy should not be used instead of one-drug chemo for treating metastatic breast cancer except in certain exceptional cases. ASCO also suggested that PET scanning for routine follow-up, PSA testing for asymptomatic men not expecting to live longer than ten years and targeted therapies used against genetic aberration should all be questioned and used only in special circumstances.

Check out the rest of the week’s top stories, and as always, we’d love to hear what your practice is working on to improve patient care.

-Evan Godt
Editor – Health Imaging