Warning: Stay Away
The Lancet recently identified a set of treatment practices that are best avoided in cancer care
By Christina Tom Jose
A team of nine doctors recently published an article in The Lancet, a popular medical journal, which identified a number of treatment practices that are better avoided in cancer care. Their research was conducted with input from doctors, patients, and caregivers alike. The list compiled describes why ten clinical practices, some even considered the backbone of cancer care, should be avoided in order to treat with a more “patient-centered approach.” The National Cancer Grid, a network of cancer institutes and charities across the country, has also backed this list, which can even be considered a ‘cancer care myth-buster.’
According to the research, the very first error to amend is avoiding the delay in making palliative care available for patients with metastatic cancer, which is stage four of cancer when it has spread to other parts of the body. Palliative care has been found effective in controlling symptoms and reducing pain, while significantly bringing down the cost of treatment. It also increases survival rates as the effects of treatment are enhanced by providing palliative care.
Another reform the article calls for is to avoid chemotherapy for patients with advanced cancer, especially those having solid organ tumors and difficulty in performance. Their bodies are less likely to react to chemotherapy, making symptom relief and palliative care better options for them. Titled ‘Choosing Wisely India,’ the article takes after the Choosing Wisely initiative which began in the US and Canada, with the intention of helping patients say no to unnecessary medical procedures which increase cost and are often counterproductive. The authors of the article are members of a task force put together by the National Cancer Grid. While seven of the nine-member panel are doctors themselves, two belong to patient advocacy groups in the country. The NCG works towards standardizing cancer care in different parts of the country and has roped in 164 cancer centers into its network.
The most striking suggestion put forward by the grid is that treatment, even for curable cancers, be decided after consulting a multi-disciplinary team of oncologists with the diagnosis. Advanced radiotherapy techniques are often going to treatment methods, even when they can be substituted by conventional radiotherapy. “Do not deliver care in a high-cost setting when it could be delivered just as effectively in a lower-cost setting,” is what the authors have to say about reducing the costs of treatment, which could greatly reduce the burden on the family of the ailing.
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