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Apr 7

The old saying goes is that a little information can be dangerous. But in terms of increasing your odds of winning the battle against cancer the more information the better according to the latest research.

A new review study (Gray et al., 2009) examined the question of did the amount of information the patient knew had an influence of what type of cancer treatment they received. In theory you would say it shouldn’t matter the doctor would proscribe the best treatment under the specific patient’s medical needs.

The paper reports that 4 out of 10 patients had gathered information about their cancer using the net. I was startled by how low the number was, but I am guessing the on average older age of the population that comes down with cancer might be an influencing factor. But obviously this will change and I would predict it will not be long before almost everybody that gets cancer will have thoroughly researched about it on the net.

The researchers concentrated on colorectal cancer because there are a couple high profile targeted therapies that have received a good deal of media coverage. The two treatments are Avastin (bevacizumab) and Erbitux (cetuximab). I give the marketed name of the drug followed by the actual drug name in brackets.

But the real interesting results of the study was that those patients that had high levels of seeking out information about potential treatments were 3.22 times more likely to receive targeted treatment than those that had a lower seeking of information.

3.2 times more is a pretty high number - so you can see what a little bit of knowledge can do. I guess the other question then is are the targeted treatments more effective?

Does the information seeking and different treatment lead to better outcome:

As for Avastin in the treatment for colorectal cancer the drug is reported to increase the life of these cancer patients by 4.7 months - with controls (check what control are in the study) living 15.6 months and treated 20.3 months (Hurwitz et. al., 2004).

Interestingly, Avastin seems to be a potential cash cow for the pharmaceuticals as it is one the most expensive drugs $ 42,800 to 55,000 (via wiki):

Bevacizumab (Avastin) is one of the most expensive drugs widely marketed. Doctors and editorials have criticized the high cost, for a drug that doesn’t cure cancer but only prolongs life. In the U.S., insurance companies have refused to pay for all or part of the costs of bevacizumab, and in countries with national health care systems, such as the UK and Canada, the health care systems have restricted its use because of the low ratio of benefits to cost. Genentech argues that the benefit is worth the cost, and the high cost pays for the expensive and risky research needed to develop new drugs. Genentech has adjusted the price for patients in certain circumstances.

For breast and lung cancer Avastin treatment is reported to increase the patients life for ’several’ months at a cost of $ 100,000 per year.

The clinical evidence for the use of Erbitux appears controversial based on all the comments on Bonner et al., 2006 NEJM paper. The drug treatment is FDA approved for head and neck cancer, and the Bonner et al., paper indicates that those patients (with stage III, IV head and neck cancer) receiving Erbitux (cetuximab) lived on average 49 months, while those just receving radiation therapy lived 29.3 month. However, one big problem with this study is that is did not compare Erbitux (cetuximab) against plantinum based radiochemotherapy treatment, which is the current standard for this type of cancer. So really they were comparing apples with oranges. The cost of a 8 week treatment regimen is $ 30,000.


I have no real conclusion, but I think when you have a health issue you increase your odds of getting the best treatment if you are well informed. But I do not think it is easy for the lay consumer to always make sense of all the results and controversy of the various treatment options (I don’t even think it is easy for the scientists in the particular field in question).

Being an informed cancer patient did lead to them being 3.2 times more likely to receive the newer, more targeted cancer treatment. 3.2 times is a big difference - knowledge is power, but use it very wisely.

And there is always the question is does your medical insurance cover the newer more expensive treatment, and is it even available in the country you live?

see also: Our cancer track record over the last 50 years.

Terry Fox, Cancer, Hope and my reflections on the summer/fall of 1980.