Do oncologists treat patients as they would themselves?

ORLANDO—Do oncologists treat their patients with colon cancer the same as they would treat themselves? Usually. A survey presented at the 2008 Gastrointestinal Cancers Symposium probed the secret world of oncologists’ personal preferences (abstract 444).

“The choices regarding adjuvant chemotherapy are challenging for both the patient and physician,” said principal investigator Neil Love, MD. In colon cancer, he noted, there are a number of options, and sometimes the potential benefits may be modest while risks can be substantial.

“Patients in all areas of medicine frequently deal with this by asking their physician, ‘What would you do?’ We wanted to know if patients with colon cancer are doing the same,” said Dr. Love, president and CEO of the Miami-based medical education company Research To Practice. Dr. Love is a medical oncologist but is no longer in clinical practice.

Dr. Love and his colleagues from six major cancer centers were interested in learning whether oncologists’ personal treatment selections for colon cancer differ from standard recommendations, and whether they would treat patients differently than they would treat themselves.

To evaluate these questions, the researchers administered a 10-minute online survey to 150 medical oncologists. Participants were asked how they manage colon cancer for various types of patients, and what adjuvant therapy they would choose for themselves in the described situations.

Five scenarios

The survey presented five scenarios for a hypothetical 55-year-old colon cancer patient:

(1) Stage III disease with 2 of 18 nodes positive.

(2) Stage III disease with 15 of 18 nodes positive.

(3) Stage II disease with 8 of 8 nodes negative and no other high-risk features.

(4) Stage II disease with 18 of 18 nodes negative and no high-risk features.

(5) Scenario #4, but respondents were only provided the odds for 5-year relapse based on Adjuvant! Online data.

The treatment choices included the use of newer agents both on and off protocol for stage III disease.