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Chemo’s toll on breast cancer patients underestimated

Rating

5 Star

Chemo’s toll on breast cancer patients underestimated

Our Review Summary

Chemotherapy has been a standard treatment for breast cancer for many years. The story does an excellent job discussing reasons why chemotherapy may offer limited benefit to many women, especially since the incidence of serious side effects is greater than previously estimated.

That there is a higher incidence of serious complications in routine care than when treatments are administered in trials is not new, but this study provides a good estimate for the likelihood of complications in routine care using claims data from many patients.

The story mentions that under-reporting of chemotherapy-related side effects in large clinical trials is due, in part, to the characteristics of women enrolled in these trials. Results from large studies serve only as a guide and may not provide an accurate estimation of individual risk, especially for many younger women or women with co-existing health conditions.

The story discusses the study design and provides evidence of a greater number and seriousness of side effects in younger (<63 years), insured women treated with chemotherapy vs. no chemotherapy. However, the story does not mention that because uninsured women were not represented in this study, these women may have different, and potentially greater incidence of chemotherapy-related side effects. The story provides the estimated annual cost of hospital visits for chemotherapy-related side effects. The story mentions surgery, radiation, hormone therapy and chemotherapy as treatment options for breast cancer, and that a woman might choose different combinations of these therapies. This is a five-star story, and it used only 541 words.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story provides the estimated annual cost of hospital visits for chemotherapy-related side effects.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story explains that chemotherapy may be of limited benefit to many women, especially since the incidence of serious side effects is greater than previously estimated. The story provides balance on the risks and benefits of chemotherapy. There is discussion of informed decision making and the importance of weighing the absolute benefit of more treatment with the risks of experiencing serious side effects.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story mentions underreporting of chemotherapy side effects in large clinical trials is due, in part, to the characteristics of participants in clinical trials. Results from clinical trials serve only as a guide and may not provide an accurate estimation of individual risk, especially for younger women or women with co-existing health conditions.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story discusses the study design and the importance of the results for women making decisions about chemotherapy as part of their breast cancer treatment. The story provides evidence of greater incidence of side effects in younger (<63 years), insured women treated with chemotherapy vs. women who did not undergo chemotherapy.

Does the story commit disease-mongering?

Satisfactory

The story does not engage in disease mongering. The story appropriately does not advocate chemotherapy for all breast cancer patients. The story discusses targeted treatment for those who would benefit most from this therapy.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story discusses the outcomes of the study with study authors and the federal agency that funded this study. A researcher who wrote an editorial in the publishing journal is cited to provide perspective on the results.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions surgery, radiation, hormone therapy and chemotherapy and the option that a woman might choose different combinations of these treatments.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

Chemotherapy has been a standard treatment for breast cancer for many years. The story mentions that for some women the attempt to prevent a breast cancer recurrence may not include chemotherapy, depending on her risk of recurrence.

Does the story establish the true novelty of the approach?

Satisfactory

The idea of individualizing treatment via molecular profiling is new. The idea that some women at low risk of cancer recurrence and higher risk of serious side effects might decide to skip chemotherapy is also a newer approach to treatment. That there is a higher incidence of serious complications in routine care than when treatments are administered in trials is not new, but this study provides a good estimate for the likelihood of complications in routine care using claims data from large population of patients.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The article does not appear to rely on a press release.

Total Score: 10 of 10 Satisfactory

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