In late October, the American Society of Clinical Oncology (ASCO) issued a “Top 5” list of tests and treatments that are routinely used by oncologists despite a lack of evidence that they are cost effective or beneficial to patients.
Three are particularly relevant to SLL/CLL patients undergoing treatment:
1. Do not give anti-nausea drugs (anti-emetics) to patients starting on chemotherapy regimens that have a low or moderate risk of causing nausea and vomiting.
3. Avoid using advanced imaging technologies (PET, CT, and radionuclide bone scans) to monitor for a cancer recurrence in patients who have finished initial treatment and have no signs or symptoms of cancer.
5. Do not use a targeted therapy intended for use against a specific genetic abnormality unless a patient’s tumor cells have a specific biomarker that predicts a favorable response to the targeted therapy.
Personally I have no issue with these sensible suggestions, but I do have some comments.
1. Controlling any nausea resulting from chemotherapy treatment can make a huge difference to how well you get through the treatment, so make sure you keep a diary of your nausea so you do get anti-emetics if you ned them:
3. When it comes to the right amount and right type of imaging, you do really need to be in the care of a specialist experienced in CLL treatment.
5. I wish! We know that some standard CLL treatments just don't work well for some relatively common genetic abnormalities in CLL cells, yet those tests are not available in many countries and only available via specialist centres in the USA.