Are obese patients being shorted needed doses of chemotherapy? That question made the rounds last week when news reports highlighted treatment guidelines adopted by the American Association for Cancer Research (ASCO). The guidelines were first proposed in 2012.
We asked Len Lichtenfeld, M.D., deputy chief medical officer and author of Dr. Len’s Cancer Blog to give us some perspective on the new recommendations, and whether they might help make sure all patients get adequate treatment.
“The question of appropriate chemotherapy dosing for overweight and obese patients treated for cancer is in fact not a new problem. It has been with us literally for decades, when it was first recognized that underdosing patients with chemotherapy may have accounted for inferior results seen in actual oncology practice compared with clinical trials.
“The issue has remained an active question for many years, especially today as doctors treat an increasing number of overweight and obese patients with cancer. The resulting large doses of chemotherapy given to these patients understandably raise concerns among oncologists that they may cause unnecessary harm to their patients.
“This guideline puts that concern to rest, with the exceptions for patients who have other serious medical conditions that may prohibit full doses of chemotherapy. And the guideline does not put aside the clinical judgment of the physician which is an important part of any treatment decision.
“As the authors note, the increasing incidence of obesity—including morbid obesity—in the United States is going to make this question even more relevant in the future. The authors of the guideline make clear that for most cancer chemotherapy drugs getting the dose ‘right’—which is based on carefully designed and executed clinical trials which follow treatment impact carefully—is absolutely necessary if patients are going to get the intended benefits from the chemotherapy drugs they receive.”
Our web site at cancer. org includes a comprehensive section on chemotherapy. For any questions not answered there, please remember our cancer information specialists are available any time, day or night, at 800.227.2345 to help.