New Study Shows Many Lung Cancer Patients May Be Under-Treated

A new study published January 18th in the Journal of Thoracic Oncology has brought to light some discrepancies in the treatment of lung cancer over the past twenty years. Specifically, the study, performed at the University of California Davis’ Comprehensive Cancer Center, looked at the treatment (or lack-thereof) of non-small cell lung cancer (NSCLC) between the years of 1998-2012. The data collected from the study came from the US National Cancer Database and indicated that over 20% of patients with NSCLC, the most common form of lung cancer, did not undergo any treatment. Typical treatments, especially for this date range, included chemotherapy, radiation therapy and surgery.

Disparities in Patient Populations

The researchers didn’t find any rhyme or reason to why certain patients were excluded from care, but noted that many of these patients were minorities, low-income, uninsured, women, and/or elderly. Researchers found that many of these patients were statistically similar to others who did receive treatment, and experienced better outcomes. On average, those with stage 3 NSCLC who were underwent chemotherapy and radiation survived an additional 16.5 months, as compared to only 6.1 months without treatment. Similarly, those with stage 4 NSCLC who received treatment survived an additional 9.3 months on average, and those who received no treatment only survived an additional 2 months.

There are cases where treatment isn’t appropriate; however, many traditional treatments have become more effective and more tolerable in recent years. The large number of individuals who didn’t receive treatment may not have been aware of such advances, or may have been subjected to a plethora of negative stigmas from their condition and demographics, that led to a decrease in availability of proper care. With incomplete data, it is hard to paint an accurate picture of what has been going on over the past couple decades, but it is important to utilize these results when it comes to your own care, and make sure you find an experienced oncologist who is well-versed in all of the potential methods of treatment for your lung cancer.

Increasing Awareness of Under-Treatment Among Clinicians

Additionally, reviewers of the study point to biologics for the potential discrepancies in the data. Biologics are drugs that are different from standard chemotherapy. As of 2003, biologics have become more wide-spread in their usage, and this study may not have accounted for individuals who forewent typical treatment in favor of new biologic methods. Regardless of the exact reason for the under-treatment of certain individuals with lung cancer, or the discrepancies in the data, the authors hope it will be an eye-opening study for physicians and healthcare providers everywhere and serve as a reminder to them to make sure they are providing all potential options to all patients. Assistant Professor of Surgery, Dr. Elizabeth David notes of the findings: “My hope is that this study will raise awareness among physicians and encourage them to reconsider fundamental decisions such as whether patients may be candidates for treatment or not. While it is not realistic to expect every patient to get treatment, we may be too easily deciding not to treat.” 1

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