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Media Influences Cancer Care
Date:2/23/2009

Patients who search Web, other media more likely to get newer treatments, study finds

MONDAY, Feb. 23 (HealthDay News) -- Cancer patients who research their disease on the Internet and in other media are more likely to get the latest treatments from their doctors, a new study suggests.

Although studies have found that about 40 percent of cancer patients look to the Internet for medical information, it hasn't been clear just how that information influences their choice of treatments, the researchers noted.

"We looked at how colon cancer patients used health information to try to make decisions about things related to their treatment," said lead researcher Dr. Stacy Gray, from the Dana-Farber Cancer Institute in Boston.

To start with, the team found that 69 percent of the colon cancer patients they interviewed said they actively looked for treatment information.

"These high levels of treatment information-seeking were very strongly associated with both awareness of new novel therapies for colon cancer, and also [the] patient's report of receiving those therapies," Gray said. "Information-seeking may have the potential to influence the treatments patients receive, and potentially their medical outcome."

The report is published in the April 1 issue of Cancer.

For the study, Gray's team collected data on 633 patients with colon cancer from the Pennsylvania Cancer Registry. The researchers looked specifically at the use of two targeted therapies for the disease, bevacizumab (Avastin) and cetuximab (Erbitux), among these patients.

The researchers found that people who used the media to get information about colon cancer and its treatment were 2.8 times more likely to have heard about these newer treatments and 3.2 times more likely to have gotten these treatments, compared to those who did not research their disease.

The association between information-gathering and choosing these treatments remained strong when the treatments were used in advanced colon cancer, as approved by the U.S. Food and Drug Administration, or when used for early disease, where the use of these drugs is not FDA-approved, the researchers noted.

Whether patients are suggesting these treatments to their doctors or whether they are researching treatments their doctors prescribe remains an open question, however, Gray added.

Some patients looked for information on the Internet to prepare for doctor visits, while others heard about a TV program on cancer and made sure to watch it, Gray said. "Other people are getting pamphlets from their doctors, and some people are seeking second opinions from other physicians," she said.

People researching their medical problems through the media is a growing trend, Gray said. "Over the last 30 years, people have been assuming a greater role in their health care. We see a lot more health consumerism, where people are expected to, and want to, be an active part of the decision-making process," she said.

Although this study was limited to colon cancer, Gray assumes that patients with many other medical problems are engaged in active research about their condition and treatment.

Gray cautioned, however, that not all sources of medical information are credible.

"I recommend that patients talk to their doctor about high-quality sources of information. There are also some very good Web sites for cancer information, such as the National Cancer Institute or the American Society of Clinical Oncology or the American Cancer Society," she said.

For other diseases, Gray recommends the National Institutes of Health and foundation or association Web sites devoted to specific diseases, such as the American Heart Association.

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, wondered if what this study really uncovers is another barrier to care unrelated to whether a patient has information or not, namely money and health insurance.

"But what if there was another factor, such as insurance -- could patients afford the drug? Are people who have inadequate insurance more likely not to be information-seekers? Or are we ignoring a factor we know is a significant predictor of health-care outcomes," Lichtenfeld said. "If you have good insurance and you have the money, your outcomes are better."

The implication of the study is that patients' knowledge about new treatments influenced whether they got these treatments or not, Lichtenfeld said. However, these drugs are expensive, and since Medicare covers only 80 percent of the costs of these drugs, many patients have to find a way to pay the additional 20 percent.

For example, Erbitux costs an estimated $17,000 a month, so a Medicare patient would have to come up with $3,400 a month, or more than $40,000 a year, unless the patient could afford supplemental coverage, he said.

In any case, he said that patients, particularly those with cancer, need to be informed about their medical conditions. "People need to get information. They need to get it from reputable sources," he said. "The Internet can provide that. There is valid, valuable information out there. At the same time, they need to be cautious about getting so much information that they are overwhelmed."

More information

For more information on colon cancer, visit the American Cancer Society.



SOURCES: Stacy Gray, M.D., Dana-Farber Cancer Institute, Boston; Len Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; April 1, 2009, Cancer


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