Half of the patients with advanced lung cancer, America's deadliest, reject treatment, study says

Fifty-two percent of metastatic lung cancer patients fail to get life-extending treatments, a new study finds.

According to a recent story by Simar Bajaj in The New York Times, the reason they skip such treatments as chemotherapy, immunotherapy. and targeted therapy is, experts suggest, because of "access issues, fatalism, and shame."

The Times article reports that the study, published in JAMA Oncology, "analyzed more than 250,000 people on Medicare between 2006 and 2021, with an average age of 73, and found that the proportion of patients who received these treatments increased only slightly over time, to 48 percent from 45 percent."

More than 110,000 Americans are annually diagnosed with metastatic lung cancer, the deadliest cancer in the United States.

Dr. Carolyn J. Presley

But over the past 15 years, Dr. Carolyn J. Presley, chief of thoracic medical oncology at Ohio State University (who wasn't involved in the study ), is quoted, dozens of promising new drugs have come to market. For some patients, a pill can hold the disease in check for years, "so the fact that so many older adults are not getting treatment is really, really sobering."

Some patients who smoked "might feel like they brought this disease upon themselves," Bajaj's story says,  and — according to Dr. Adam Fox, pulmonologist at the Medical University of South Carolina, who led the study — the stigma not only contributes to diagnostic delays but also to patients feeling unworthy of care.

Fatalism, the lingering belief that metastatic lung cancer is hopeless and treatment is unlikely to help, might be adopted by some primary care and emergency medicine doctors, the article suggests.

As for access issues, "one of the biggest barriers to treatment is not being diagnosed in time. Screening can catch tumors early, but it remains widely underutilized, largely because most people don't know it's available and complicated eligibility criteria make it difficult for docs to figure out who qualifies," Bajaj's piece notes.

More information on Stage 4, metastasized disease can be found in Rollercoaster: How a man can survive his partner's breast cancer, aVitalityPress book that I, Woody Weingarten aimed at male caregivers. My other books are MysteryDates — How to keep the sizzle in your relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter. Check out my other website at https://woodyweingarten.com for details.

Will FDA obey Trump, take step backward?

Researcher warns of using under-tested drugs, cites futile treatment on his father 

Dr. Cary Gross

Can some cancer treatments do more harm than good?

Absolutely, indicates Cary Gross, professor of medicine and cancer researcher at the Yale University School of Medicine, in a recent article in The Washington Post.

Gross cites the case of his own 80-year-old father, who'd been treated for Hodgkin's disease and couldn't walk because of weakness when his oncologist suggested a new, expensive, risky drug that was covered by insurance.

The oncologist was afraid chemo might do more harm than good but believed the "targeted therapy" treatment that used antibodies to kill only cancer cells would work.

Although the tumors shrunk at first, and Gross' father regained some strength, he experienced mild pain in his feet after a few months, followed by more severe shooting pains through his legs. Those side effects, Gross wrote in his article, again prevented him from walking and kept him bed-bound.

He subsequently died.

"The Food and Drug Administration had approved the treatment based only on a small study of about 100 patients, one-third of whom demonstrated complete remission," Gross reported.

"Although side effects were rare, the average age of patients in the study was 31. This is typical of cancer-treatment studies, which most often test new drugs in younger and healthier people — not older people with lots of medical conditions."

Gross expresses fear that "unfortunately, our government's commitment to evaluating new drugs is about to take a step backward. At a recent meeting with pharmaceutical company executives, President Trump announced he would be cutting regulations 'at a level nobody's ever seen before.'"

The FDA, he contends, "shouldn't shy away from requiring thorough evaluation of new drugs. The same level of enthusiasm and funding that goes into developing new treatments should be invested in testing whether they are safe and effective in patients outside of the initial small trials. Under-tested drugs with unclear safety profiles and efficacy should not be given to broad swaths of the population."

Other illustrations of clinic trials and their aftermath can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.