Lowering Cancer Care Costs by Limiting Chemotherapy in Patients Who Aren’t Responding

This is the sixth post on Bending the Cost Curve in Cancer Care, based on the 10 suggestions put forth by Drs. Smith and Hillner in the May 26 NEJM.  We’re up to number 5 on the list for changing oncologists’ behavior: by limiting further chemotherapy to clinical trial drugs in patients who are not responding to three consecutive regimens.

They’re right.

Giving one drug or combination regimen, and then another, and another, and another, to cancer patients whose tumors resist multiple regimens is more likely to cause harm than good. Oncologists need be realistic with themselves and with their patients, in a kindly way, when treatments fail.

Options to consider, besides chemo, include palliation (which can be started at any time, including before and during chemotherapy), alternative approaches (such as hormonal or immune-based therapy, for some tumors), hospice care and participation in a clinical trial, as the authors suggest, based on the patient’s condition and preferences.

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Related Posts:

• Reducing Cancer Care Costs: Oncologists Need to Get a Grip on Reality, and Talk about Dying
• Reducing Costs by Holding Back on Chemotherapy for Cancer Patients Who are Frail
• How Much Do You Want Your Doctors To Say About Risks of Treatment?
• Reducing Costs by Better Integration of Palliative Care in Cancer Treatment
• On Reducing Cancer Care Costs by Resetting Expectations, and Hope