Should a healthy older woman with breast cancer be denied the best chemotherapy possible just because of her age? Not according to Hyman Muss, MD, VCC member and professor of medicine. Muss authored a March 2 Journal of the American Medical Association article that analyzed the results of four major clinical studies on chemotherapy treatment in older versus younger women with breast cancer between 1975 and 1999 and found that healthy older women who underwent the stronger chemotherapy derived the same benefit—they had similar reductions in breast cancer recurrence and lived as long as the younger women.
"With today's life expectancy, a healthy 65-year-old woman can expect to live another 20 years," says Muss. "If a doctor has a 75-year-old patient who has advanced breast cancer with lots of positive lymph nodes and is in good health, we now have evidence, based on the results of this study and others, that she should be offered the best chemotherapy available to help improve her life and reduce the risk that she will die of breast cancer."
So why are physicians hesitating to offer these stronger chemotherapy treatments to their older breast cancer patients? "It's physician bias," says Muss, who explains that doctors are often protective of older patients and reluctant to subject them to the debilitating side effects that sometimes result from intensive chemotherapy regimens.
For the study, Muss led the analysis of data from four randomized clinical trials from the Cancer and Leukemia Group B (CALGB) arm of the National Cancer Institute. These trials compared more aggressive with less aggressive chemotherapy regimens for the treatment of lymph node-positive breast cancer cases between 1975 and 1999. A total of 6,487 women with lymph node-positive breast cancer were included in the trials. A startlingly small number—8 percent—of the patients were 65 years or older and only 2 percent were 70 years or older. Muss and his colleagues hope that their study's conclusions will encourage clinicians to offer healthy older patients both the best treatment available, as well as the opportunity to participate in newer clinical treatment trials. Muss recommends that older breast cancer patients, or their family members or loved ones, ask their doctors if chemotherapy treatment is appropriate for them. The key to ensuring older breast cancer patients get the best treatment, says Muss, is open communication between patients and physicians.
To find out more about current cancer studies taking place through the VCC, call Holli McFadden, Clinical Trials Office, at (802) 656-2178, or click here.