The release focuses on recent research published in the journal JAMA Otolaryngology – Head and Neck Surgery. The research assessed the effectiveness of a treatment technique for laryngeal cancer that exposed patients with advanced (stage 3 or 4) cancer to a one-time chemotherapy treatment that, theoretically, would allow physicians to determine whether patients were responding well to chemotherapy. The idea was that patients who responded well could be treated with chemotherapy and radiation, whereas patients who did not respond well would have surgery to remove the voice box immediately, rather than trying chemotherapy and radiation first. The goal was to improve the five-year survival rate of patients. The researchers reported that this technique — called “induction chemotherapy” — was effective, leading to 79 percent survival rates for patients with advanced laryngeal cancer — which is markedly better than the 66 percent survival rate for those patients who did not receive induction chemotherapy.
The release does a nice job describing the historical context of these therapies, how available the techniques are and how the study was conducted, with one exception. The release doesn’t mention that this was a retrospective, observational study, not a clinical trial, which is an important limitation. Correlation does not equal causation. Nor does the release provide any costs associated with any approach.
People don’t want to lose the power of speech. Whether it’s reading bedtime stories to one’s children or talking about your day with loved ones, speech is an important part of interpersonal communication. Our voices are part of who we are and how we connect with others. What’s more, being able to talk can be a key part of professional life for everyone from teachers and salespeople to reporters and, well, doctors. For that reason, many patients dealing with laryngeal cancer want to do whatever can be done to spare their larynx, or voice box, from surgery. If new techniques can help patients make more informed decisions about the trade-off between survival rate and laryngeal surgery, that’s important news for patients and medical personnel. The release does a fair job of addressing the new findings responsibly. It stresses that there are many options and no one-size-fits-all treatment.
This is the one area the release fails to address at all. Cost is simply not addressed.
The release explains the benefits for patients with stage 3 and stage 4 laryngeal cancer: “Average disease specific survival at five years for the induction chemotherapy patients was 79 percent – equivalent to the results in patients with early stage disease, and significantly better than the 66 percent survival for patients who had chemo-radiation without the induction strategy.” However, there were some shortcomings here.
According to the study, surgery achieved the best survival results. It may not be possible to conclude anything about the “chemo trial” group because the study was observational – taking a retrospective look at 10 years of patient charts – which does not prove cause and effect.
In each of the 153 cases, patients and doctors chose which treatment type they preferred; 71 were given a test dose of chemotherapy and then had further treatment decided based on the response. The release doesn’t tell us how many were then treated with surgery due to lack of response and how many completed chemotherapy/radiation treatment.
The release states: “Even that single [initial] dose of chemotherapy can be debilitating and toxic for some patients.” That’s enough to earn it a marginal satisfactory mark here. The release would have been better if it had noted that radiation, surgery and chemotherapy all carry serious side effect risks.
The release does a good job of explaining the study design. It would have been even better if it had placed the work in the context of what is known from the literature about five-year survival rates for specific types of laryngeal cancer, which vary widely. It would also have been better to spell out the study limitations, the main one being its observational design
No disease mongering here.
Funding sources are clearly noted in the release and there do not appear to be relevant conflicts of interest.
Our main take-away from the release is that there are many treatment alternatives and room for patient and physician joint decision-making.
It’s clear that this approach to determining the best course of treatment could be implemented at any point — there are no new technologies or drugs involved. But the release does a particularly good job of addressing this, since it highlights a relevant challenge: “The induction approach can be done anywhere, but requires intense collaboration among surgeons, medical oncologists and radiation oncologists. All three must be involved to assess the patient and refer to the appropriate therapy.” Communication between all of the practitioners involved in the case of any given patient can be a significant challenge, and is well worth mentioning.
The release makes clear what is novel about this approach and lays out the history and development of the approach over the past 10 years. That’s good context.
We give this a satisfactory rating, but want to make two notes — one on something we particularly like to see, one on something that we don’t. First, kudos to the headline on the news release. It clearly conveys the relevance of the finding without overselling it. The headline doesn’t tell us that the technique picks the best course of treatment; instead, the headline tells us that the new technique helps patients and doctors make a decision about what course of action is best. That’s good to see. Lower down, the story refers to a survival rate as “unheard of.” What does that mean? People say and hear all kinds of things. Are they referring to clinical trial results? Longitudinal study findings? Hearsay? When possible, we discourage the use of this sort of vague language; it offers readers little insight, and does more to confuse a subject than to clarify it. The language in this instance was not sufficiently hyperbolic to warrant a “not satisfactory” rating, but it’s close.