Chemo that's easier to take
As millions of people know firsthand, cancer survival often comes with a price. New therapies can extend patients' lives, in many cases to an extent unimagined a generation ago, but the treatment itself -- particularly chemotherapy -- can be grueling.
The accompanying nausea, vomiting, fatigue and hair loss have become synonymous with cancer treatments. Some patients who are recommended for chemotherapy actually decline it, even when doing so decreases their chances of a cure.
The recent advance in ovarian cancer therapy highlights the paradox of today's treatments. Earlier this month, the National Cancer Institute announced that a chemotherapy regimen for women with ovarian cancer greatly improved survival rates. Buried in the good news, however, was the fact that only two of every five women in the study were able to complete the treatment because of side effects.
"You can understand why chemo has a bad reputation," says Dr. Edward Trimble, chief of gynecological cancer therapeutics at the National Cancer Institute. "You lose your hair, and you're sick as a dog."
But the effort to ameliorate chemotherapy's side effects is showing some signs of progress. With cure rates improving for many types of cancer, says Dr. Julie Gralow, an associate professor of medical oncology at the University of Washington, doctors have grown more comfortable trying to mitigate side effects. They're using three basic strategies: administering less-toxic drugs, adjusting the chemo regimen and providing better "supportive care," meaning medications to stave off nausea and other side effects along with advice on exercise, nutrition and emotional support.
The ovarian cancer study offers an example of the changes that are possible when doctors focus on reducing side effects. In that study, the women received the chemotherapy through a port directly into their abdomen -- a delivery method even tougher than traditional intravenous chemotherapy. But doctors familiar with the study point out that intra-abdominal therapy -- as well as traditional chemotherapy -- can be made easier.
"We've been able to dramatically decrease the incidence of side effects and help people live fuller lives during the time they're getting chemo," Trimble says. "Some patients are able to continue working and continue with all of their family responsibilities."
The first step is to complain. Many patients feel they most soldier on stoically, that misery is par for the course. If that's the case, speak up, Trimble suggests.
