Tuesday, April 19, 2016

Advanced-Age Breast Cancer Patients Challenge Online Survival Models | Marla Ahlgrimm

ePrognosis is a tool used by doctors when determining if chemotherapy is a desirable treatment option for patients facing a breast cancer diagnosis. It’s lauded for its accuracy when determining survival rates for otherwise healthy women. However, as Marla Ahlgrimm explains, older patients with other health concerns are crushing the tool’s expectations.

Q:  Why is it important to decide for or against chemotherapy? Shouldn’t everyone consider it?

Marla Ahlgrimm: Chemotherapy and other forms of cancer treatment are extremely hard on the body. People with other major health conditions may not recover from chemo and can actually experience unnecessary pain and suffering as a result. For older patients especially, understanding prognosis and life expectancy both with and without chemotherapy can help them determine if the added stress on their bodies is worth the outcome.

Q:  What are the goals of chemotherapy?
Marla Ahlgrimm: Doctors prescribe chemo for three different reasons. The first is the hope of curing the cancer – meaning the cells are destroyed and do not return. If a cure isn’t possible, chemo can be used to control (shrink) and slow the spread of the cancer. Advanced-stage cancer patients may be given chemo as a palliative treatment, meaning it is used to ease symptoms and therefore improve overall quality of life post-diagnosis.
Q: Is ePrognosis a reliable predictor of life expectancy?
Marla Ahlgrimm: Until a recent study conducted by Duke University, ePrognosis was considered highly reliable, and it is in many ways. ePrognosis is an excellent tool when looking at patients with good overall health; its predictions are on-point with observed survival rates of 95% at two years. Patients with other existing health issues scored much lower – 64% – in the tool than in actuality. This group’s survival rate was 81% which is a huge margin.
Q: How then, in your opinion, should doctors use the information obtained from ePrognosis and other available tools when discussing chemotherapy with their patients?
Marla Ahlgrimm: Doctors should ensure their patients are aware of the risks associated with chemo and that of forgoing treatment. Having an accurate estimate of potential survival odds is a critical piece of information for anyone needing to weigh the benefits of therapy.