Can early breast cancer patients pass on chemo?

Well, this was certainly a long time coming. (And quite frankly, way overdue, since it’s long been my recommendation to many of the women who come to my office.)

At last, research has confirmed that most patients with the most common form of early breast cancer may not need post-surgery chemotherapy. Which is great news for women… and really bad news for Big Pharma. (But you won’t be seeing me shed any tears for them.)

This is the conclusion of the largest trial ever conducted on the subject. And I must say, I’m really excited. So let’s take a closer look at the details…

70 percent of patients could pass on chemo

Starting in 2006, researchers recruited more than 10,000 early-stage breast cancer patients, across the U.S. and five other countries, and followed them through treatment after surgery.

Using a test called the Oncotype DX, they analyzed the tumors to assess the activity of 21 different genes that can predict recurrence risk over the next decade. (By the way, Medicare is now covering this kind of genomic testing!)

While previous research has focused on low-risk women, these latest results dealt with patients in the intermediate risk category. Researchers randomly assigned more than 6.700 women with this profile to two different groups: One received chemo and endocrine therapy (like tamoxifen). The other received endocrine therapy alone.

And sure enough, years later, data revealed that chemo didn’t make a difference for women over 50. (However, younger women still benefited.)

As I mentioned above, research already shows that low-risk women who have their tumors genetically sequenced can opt out of chemotherapy. Include intermediate risk women in this category, and we’re talking about 70 percent of all women with the most common type of early breast cancer.

That adds up to more than 85,000 patients per year, who could be spared the ravages of chemo — and that’s just in the U.S.

Good medicine saves the day

The type of cancer that we are discussing here is:

  • hormone receptor positive — meaning the tumor consists of cells that express receptors for certain hormones
  • has not spread to the lymph nodes
  • HER2 negative — meaning tests show no abnormality in the human epidermal growth factor receptor 2 gene

And in these cases, all you’ll really need in the way of treatment is an estrogen blocker that cuts off the cancer’s hormonal supply (again, like tamoxifen) to block its spread.

So it’s not hard to see why I am currently dancing in my chair as I type this.

But I’m also sure Big Pharma is going to have a response to this — and probably not a charitable one, either — because there’s no question that this shift is going to adversely affect their bottom lines. And ultimately, it will likely lead to even more bank-busting new chemo drugs.

But that’s a discussion best saved for another time. Because I refuse to let a cabal of crooked drug companies take the wind out of my sails today.

This is going to save so many women from unneeded and unwanted chemotherapy. It will also spare them the psychological stress of having to make the choice under pressure — hopefully, with fewer doctors clamoring for patients to start treatment immediately.

Emphasis on the “hopefully.” Because the truth is, there’s already been some groaning about this, with docs claiming that dialing back treatment standards could prove dangerous. I wonder, how much money do you think they make from Big Pharma each year?

As it is, the federal government had to foot the bill for this study, because drug companies wanted no part in sponsoring research that might lead to more conservative treatment. But for once, big business didn’t win. I’m thrilled to say that this is one instance where a major women’s health issue got some unbiased scrutiny for a change.

And that, folks, is what good medicine is all about.