Breast Cancer Patients, Beware!

Ivanhoe Newswire
Friday, January 19, 2007; 12:00 AM

By Betsy Lievense, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Obese and low-income breast cancer patients receive lower doses of chemotherapy than their trim, high-income counterparts, according to the results of two new studies.

Doctors usually prescribe chemotherapy based on a patient's weight and height, said Jennifer J. Griggs, M.D., M.P.H., an oncologist at the University of Michigan in Ann Arbor. She told Ivanhoe physicians choose to reduce the dose when they are concerned about the patient's ability to get through treatment.

A study published by researchers from the University of Rochester in New York reveals 21 percent of obese and severely obese women received less than 85 percent of the standard dose of chemotherapy. Only 10 percent of lean women received less than 85 percent of the standard dose of chemotherapy.

Doctors can be overly conservative when they administer chemotherapy to overweight patients because they are concerned about the impact it will have on their organs, which aren't necessarily larger than those of an average-size person, Dr. Griggs explained.

"There's some uncertainty about the safety of full, weight-based doses [of chemotherapy]," Dr. Griggs told Ivanhoe. "A very large person would get a very large dose, and the thought is, just because you're twice as big doesn't mean your heart is, or your bone marrow, both of which could be hurt by chemotherapy."

Dr. Griggs said low-income breast cancer patients receive lower doses of chemotherapy because doctors assume a lack of financial resources makes it more difficult to cope with debilitating side effects of the treatment, like nausea and fatigue.

The study published by Dr. Griggs and her colleagues at the University of Michigan also reported reduced chemotherapy dosages for overweight women. They also report income and educational levels had an effect, with poorer women and women with less education more likely to receive reduced doses.

"I don't think physicians are aware that they're systematically dosing people differently," said Dr. Griggs, who stressed dosing decisions should be made more uniform to keep doctors from stereotyping patients. "The same people who have the disparities in treatment are also the ones who have the worst outcomes. So, even though breast cancer is less common among people with lower socioeconomic status, it's more lethal."