New research has found that reporting side effects from cancer treatment can boost survival by almost six months, longer than most of the latest drugs.
Led by Dr. Ethan Basch, a researcher at the University of North Carolina-Chapel Hill and Memorial Sloan Kettering Cancer Center in New York, the study included 766 participants suffering from various types of advanced cancer.
Some were provided with an online tool that enabled them to quickly and easily report any problems with medication to their doctor, without the need to wait for an appointment, while other patients were given the usual care and rest.
The median age of the patients was 61, with some patients as old as 91. However, Dr. Basch noted that using a computer proved relatively easy for most, commenting, “The older patients really grabbed onto it very quickly.”
Those in the online group were asked to report symptoms at least once a week—even sooner if they had a problem—and given a list of common ones to look out for, including loss of appetite, constipation, cough, diarrhea, shortness of breath, fatigue, hot flashes, nausea or pain.
The online reports were seen by doctors during office visits, and nurses got email alerts when patients reported severe or worsening problems.
“Almost 80 percent of the time, the nurses responded immediately,” calling in medicines for nausea, pain or other problems, Dr. Basch said.
The study had set out to use the online reporting as a way of improving patients’ quality of life, and the team did find that six months later, health-related quality of life had improved for more of those in the online group who were also making fewer trips to an emergency room.
However, they were surprised and excited to find survival rates also improved, with median survival in the online group 31 months versus 26 months for the other participants.
“I was floored by the results,” said Dr. Basch, “We are proactively catching things early” with online reporting.
Dr. Basch explained that by reporting their symptoms, such as nausea and fatigue, these side effects could then be treated, helping patients to stick with the treatment for longer, with those in the online group able to stay on chemotherapy longer, eight months versus six, on average.
People shouldn’t assume that symptoms are an unavoidable part of cancer care, commented Dr. Richard Schilsky, chief medical officer of the American Society of Clinical Oncology, with some patients just putting up with a problem until their next exam.
Dr. Basch agreed, “The spouse will say, ‘My husband was laid up in bed, exhausted or in pain,’ and I’ll say ‘Why didn’t you call me?'”
“You want to be able to reach your provider as early and easily as possible,” added Dr. Schilsky, explaining that symptoms such as shortness of breath could be a sign that treatment isn’t working and needs to be changed.
A larger study will now test the online reporting system nationwide. The study was featured at the cancer group’s annual meeting in Chicago on Sunday and can be found published online in the Journal of the American Medical Association. JB
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