For some cancers, less treatment may be a better approach

Some patients with cervical and pancreatic cancer can doas well with less invasive surgery, according to research presented at the American Society of Clinical Oncology conference in Chicago over the weekend. Other studies at the annual meeting showed some patients with rectal cancer or Hodgkin lymphoma can safely get less radiation.

The findings expand a body of evidence doctors are using to design treatment plans that aim to reduce side effects and costs. Newer therapies and tests are extending patients’ lives and moving cancer treatment away from a blunt, one-size-fits-all approach. Doctors are getting better at determining who needs the most aggressive care and who can get away with less treatment and lesscollateral damage.

“It’s time to look at less toxic approaches," said Dr. Julie Gralow, chief medical officer and executive vice president of the American Society of Clinical Oncology.

In early-stage pancreatic cancer, patients who had laparoscopic or robot-assisted surgery had similar outcomes to patients who underwent more invasive open surgery, one study presented Monday at the conference showed. Another found a simpler hysterectomy that removed just the uterus and cervix can be safe for some low-risk cervical cancer patients, instead of more complex and expensive radical hysterectomy.

Women who got the simpler surgery had fewer bladder problems and reported better body image, pain levels and more sexual activity. Cancer patients have started demanding more emphasis on quality of life, as some cancers have become more curable and people live longer after treatment, said Dr. Marie Plante, a gynecologic-oncologist at CHU de Quebec in Canada and the cervical-cancer trial’s lead investigator.

“How can I provide top of the line treatment while reducing side effects without jeopardizing the outcome?" Plante said. “It’s that fine line."