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Studies: Some Cancer Patients May Not Need Treatments after Surgery

时间:2022-06-12 23:17:31

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Studies: Some Cancer Patients May Not Need Treatments after Surgery

After surgery, some cancer patients can safely avoid treatments such as radiation or chemotherapy, say two recent studies that explore shorter, gentler cancer care.

Researchers are looking for ways to predict which cancer patients can avoid unneeded treatment to cut down on costs and bad side effects.

One new study used a blood test to study which colon1 cancer patients could skip, or not have, chemotherapy after surgery. Another study suggests some low-risk breast cancer patients might not need radiation after the surgical2 removal of a mass or lump, a surgery known as a lumpectomy.

The research was discussed recently at the yearly meeting of the American Society of Clinical Oncology (ASCO). The colon cancer study, financed by the Australian and U.S. governments and nonprofit groups, was recently published by the New England Journal of Medicine.

The findings let doctors pay careful attention to "the patients we think would truly benefit from chemotherapy and avoid the side effects for patients for whom it's likely unnecessary," said Dr. Stacey Cohen of the Fred Hutchinson Cancer Center. Cohen reviewed the colon cancer findings and was not involved in the research.

Colon cancer study

Many colon cancer patients are given chemotherapy after surgery, even though they may be cured. The drugs can come with bad side effects such as nausea3, anemia4 and memory problems.

But deciding which patients might not need further treatment has been difficult. So, the scientists studied whether a blood test could help doctors make the decision.

The study involved 455 patients who had surgery because cancer had spread into the colon wall. After surgery, one group received a blood test specially5 made for the tumor6's genetic7 information to find any remaining bits of cancer DNA8.

Their care was guided by the blood test. If the test showed no signs of remaining cancer, the patients did not get chemotherapy. Meanwhile, doctors made chemotherapy decisions for the rest of the patients in the usual way, guided by careful study of the tumor and nearby tissue.

Fewer patients in the blood test group got chemotherapy — 15 percent in comparison to 28 percent. But about 93 percent of both groups were still free of cancer after two years. In other words, the blood test group did equally well with less chemotherapy.

Dr. Jeanne Tie of the Peter MacCallum Cancer Center in Melbourne, Australia, led the research. Tie described the findings in terms of cancer relapse - the return of a cancer after a period of improvement.

"In patients where cancer DNA is not detected after surgery, the chance of cancer relapse is very low, suggesting that chemotherapy is very unlikely to benefit these patients," Tie said.

ASCO president Dr. Everett Vokes said that not having chemo makes "a big difference in a person's quality of life if that can be done without having to put them" at risk of the disease coming back.

Breast cancer

The other study followed 500 older women with a common form of early-stage breast cancer and low levels of a protein known as Ki67, a marker for fast-growing cancer.

After surgery, the women took hormone9-blocking pills, a common treatment for this type of cancer. But the women did not get radiation treatment.

After five years, 10 of the women saw cancer return in the same breast, and there was one breast cancer death. The study had no comparison group, but researchers said the results compare well to historical data for similar patients who had radiation.

Dr. Timothy Whelan of McMaster University in Hamilton, Ontario, led the study.

"We estimate the benefits of radiation would be very small in this population compared to the side effects," Whelan said.

Radiation can cause skin problems, tiredness and, less commonly, long-term heart problems and second cancers.

Dr. Deborah Axelrod of NYU Langone Health was not involved in the research.

Axelrod described the study as a "feel-good" message for patients with low-risk tumors. Axelrod added that the data will help doctors understand which of their patients they "can comfortably, with confidence" not give radiation to.

Words in This Story

chemotherapy – n. medical: the use of chemicals to treat or control a disease (such as cancer)

benefit—v. to be useful or helpful to (someone or something)

nausea – n. the feeling you have in your stomach when you think you are going to vomit10

anemia – n. medical: a condition in which a person has fewer red blood cells than normal and feels very weak and tired

tumor – n. a mass of tissue found in or on the body that is made up of abnormal cells

hormone – n. a natural substance that is produced in the body and that influences the way the body grows or develops

detect -- v. to discover or notice the presence of (something that is hidden or hard to see, hear, taste, etc.)

 


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1 colon jqfzJ     
n.冒号,结肠,直肠
参考例句:
  • Here,too,the colon must be followed by a dash.这里也是一样,应当在冒号后加破折号。
  • The colon is the locus of a large concentration of bacteria.结肠是大浓度的细菌所在地。
2 surgical 0hXzV3     
adj.外科的,外科医生的,手术上的
参考例句:
  • He performs the surgical operations at the Red Cross Hospital.他在红十字会医院做外科手术。
  • All surgical instruments must be sterilised before use.所有的外科手术器械在使用之前,必须消毒。
3 nausea C5Dzz     
n.作呕,恶心;极端的憎恶(或厌恶)
参考例句:
  • Early pregnancy is often accompanied by nausea.怀孕期常有恶心的现象。
  • He experienced nausea after eating octopus.吃了章鱼后他感到恶心。
4 anemia joGy3     
n.贫血,贫血症
参考例句:
  • The doctors analyzed the blood sample for anemia. 医生们分析了贫血的血样。
  • I was put on iron tablets for my anemia.我曾因贫血吃补铁药片。
5 specially Hviwq     
adv.特定地;特殊地;明确地
参考例句:
  • They are specially packaged so that they stack easily.它们经过特别包装以便于堆放。
  • The machine was designed specially for demolishing old buildings.这种机器是专为拆毁旧楼房而设计的。
6 tumor fKxzm     
n.(肿)瘤,肿块(英)tumour
参考例句:
  • He was died of a malignant tumor.他死于恶性肿瘤。
  • The surgeons irradiated the tumor.外科医生用X射线照射那个肿瘤。
7 genetic PgIxp     
adj.遗传的,遗传学的
参考例句:
  • It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
  • Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。
8 DNA 4u3z1l     
(缩)deoxyribonucleic acid 脱氧核糖核酸
参考例句:
  • DNA is stored in the nucleus of a cell.脱氧核糖核酸储存于细胞的细胞核里。
  • Gene mutations are alterations in the DNA code.基因突变是指DNA密码的改变。
9 hormone uyky3     
n.荷尔蒙,激素,内分泌
参考例句:
  • Hormone implants are used as growth boosters.激素植入物被用作生长辅助剂。
  • This hormone interacts closely with other hormones in the body.这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。
10 vomit TL9zV     
v.呕吐,作呕;n.呕吐物,吐出物
参考例句:
  • They gave her salty water to make her vomit.他们给她喝盐水好让她吐出来。
  • She was stricken by pain and began to vomit.她感到一阵疼痛,开始呕吐起来。

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