Aggressive Cancer Treatments Are Buying More Time

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Last updated: November 12, 2008
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When finally, after many tests and appointments, my dad received his prognosis, it wasn't good: stage IV esophageal cancer, inoperable. The doctor estimated he had four to six months left, and it turned out to be a very fast four. What would my stepmom, my sisters, and I have given for another year or two with him? The answer is simple -- almost anything.

This concept of time remaining is often unspoken when we talk about cancer, and yet to many cancer patients and their families it's all we think about. When doctors tell us a tumor is inoperable or a cancer incurable, it often feels like those are the defining terms. Yet, in fact, once we find out that there's little chance of someone being cured or becoming "cancer free," the question of how much time we can buy becomes the central issue when making treatment decisions.

Two studies published this month have made this point explicitly by looking at the outcomes of aggressive treatment protocols for cancers with poor prognoses. And the results have been very impressive.

Imagine, for example, a group of 146 colorectal cancer patients whose tumors were considered "unresectable" -- which means inoperable. As reported in this month's Annals of Surgery, a team of doctors experimented with a very aggressive combination of surgery, external beam radiation, internal radiation, and chemotherapy and achieved remarkable results.

At the end of the "multimodal" therapy, 100 patients out of the 146 were found to have no cancer remaining in the margins. After five years, 52 percent were still alive and 43 percent were disease free -- this in patients whose cancer was considered too advanced to operate.

Another study published in this month's Cancer, Journal of the American Cancer Society, looked at the outcomes of 1,500 patients treated for kidney cancer over a 15-year period at UCLA's leading edge kidney cancer program. The program focused on identifying patients whose cancers were likely to metastasize and treating their tumors with an aggressive program of surgery, radiation, and immunotherapy, an approach known as "aggressive personalized treatment." The end result? A quarter of those with metastatic kidney cancer lived 5 to 15 years after treatment, much better than would normally be expected with this very serious form of cancer.

Of course, arguments rage over whether it's worthwhile to pursue expensive, risky treatments for patients who are likely to die of their cancer anyway. But ask most patients -- and their families and friends -- what they'd choose to do if an aggressive experimental treatment could buy them an extra year, or two, or five, and the answer would be pretty clear.

If it were my father or mother, I'd certainly roll the dice for these odds.

Image by Flickr user Wrhowell. Used with permission under the Creative Commons Attribution License .

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3 Comments So Far. Add Your Wisdom.

about 3 years ago

June 2006 diagnosed w/esophageal cancer (stage 3) (age 56) October 2006 completed radiation an chemotherapy (aggressive) therapy. March 2009 Still "enjoying" LIFE...w/no signs of cancer!(age 59)


Anonymous said over 3 years ago

how can we cut through the length of time it takes when dealing with a place like MD Anderson?


Anonymous said over 3 years ago

Very interesting. But what ages/health condition were the people in these studies who did so well...and what about quality of life in this equation? Can't say I'd really have wanted the extra few weeks or even months with my ailing parent that aggressive treatments would promise given that she would still be in pain, in hospital, and still terminal; and in fact we reached a point where we decided against them. curious what others think.


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