This story gives a glimpse of some of the nuances for treatment of cancers that will be begin to be available sometime in the future. One strength of the article was that it pointed out some of the current tumor-specific treatment decision-making dilemmas – that currently there are a number of women with early breast cancer who are given unnecessary chemotherapy which contrasts with the situation of lung cancer patients, many of whom might benefit but currently do not receive chemotherapy. But the article missed a golden opportunity to educate readers that not all types of cancer are similarly aggressive or hazardous. While a spokesperson for the American Cancer Society was quoted, it would have been more helpful to have insight provided about what the study results mean in terms of breast or lung cancer treatment decisions that patients could face sometime in the future.
Overall, this wire service story covered a lot of the bases in only 385 words.
Presumably this genotyping is for research purposes only and not ready for public use, and thus no estimates of cost are yet available. This could have been explicitly stated.
The article did present quantitative estimates for the accuracy of the test for lung cancer and by including the measures on two different samples, provides the reader with a glimpse into the kind of variability that exists. The story mentions that it can be predicted that 1/3 of lung cancer patients will get worse and die but that few get chemo because doctors currently can’t distinguish between this third and the two thirds that won’t get worse. And it mentions that many women with early breast cancer get chemo even though the majority don’t benefit from it . But no quantitative estimates are given about how many might benefit from these tests.
There was no discussion about the burden of treatment decisions based on the results of the tests or the possibility of insurance coverage ramifications based on the results of the tests. These are significant potential harms.
The article explained that the information was derived from two articles published in the most recent issue of the New England Journal of Medicine. However, there was no discussion about the current study design or the prospective clinical trials that will be needed in order to evaluate the value of these genetic screens.
The article did not actively disease monger about cancer or cancer risk. However, it painted a perhaps unnecessarily dismal picture for treatment of cancer, stating that “treatment guidelines for cancer are relatively crude — based on a tumor’s size, whether it has spread, and other characteristics” when in fact not all cancers are managed in this way and there are already a number of lymphomas and leukemias, for example, for which treatment is determined by the biology of tumor.
The article did mention possible financial conflicts of interest present for one of the two groups of investigators. Although a spokesperson for the American Cancer Society was quoted, it would have been more helpful to have insight provided about what the study results mean in terms of breast or lung cancer treatment decisions that patients could be facing sometime in the future.
Although these genetic screens appear to provide information on which to base clinical treatment decisions, prospective clinical trials have yet to be conducted. This was not mentioned in the article. However in presenting the problem of potential over-treatment of early breast cancer and under-treatment of lung cancer, the article provided valuable information for individuals with these conditions to think about when facing treatment decisions for these conditions even with only the widely available treatment options.
Atlhough the article did not explicitly mention how widely available the two genetic screens discussed are, or when patients might expect to see analysis such as this in common use, it did state that the tests might “someday” be able to predict which patients should get chemotherapy.
With the advent of the human genome project, there are a number of panels of genes being investigated to see whether they can be used to better match treatment to the precise disease of the patient. Although the article failed to put these two new reports within this context, the article also did not make claims about novelty of the approach.
Does not appear to rely solely on a press release.