Breaking News
January 23, 2019 - New certified reference material for testing residual solvents in cannabis
January 23, 2019 - Gene-edited chickens could prevent future flu pandemic
January 23, 2019 - Cardiovascular disease risk begins even before birth
January 23, 2019 - Younger patients receiving kidney transplant more likely to live longer, shows data
January 23, 2019 - Skin samples hold early signs of prion disease, research suggests
January 23, 2019 - Researchers discover how body initiates repair mechanisms that limits damage to myelin sheath
January 23, 2019 - Fecal transplant from certain donors better than others
January 23, 2019 - Risk for Uninsurance in AMI Patients Reduced With Medicaid Expansion
January 23, 2019 - Readmissions reduction program may be associated with increase in patient-level mortality
January 23, 2019 - Fostering translation and communication in medicine and beyond
January 23, 2019 - To Fight Fatty Liver, Avoid Sugary Foods and Drinks
January 23, 2019 - TPU scientists develop new implants that double the rate of bone lengthening in kids
January 23, 2019 - New sessions at Pittcon 2019
January 23, 2019 - Insilico to present latest findings in AI for Drug Discovery at 3rd Annual SABPA FTD Forum
January 23, 2019 - Opioid overdose patients can be safely discharged an hour after administration of naloxone
January 23, 2019 - Scientists find bacterial extracellular vesicles in human blood
January 23, 2019 - Researchers gain new insights into development of necrotizing enterocolitis in preemies
January 23, 2019 - Medical expert advises people with epilepsy not to stockpile medicines
January 23, 2019 - Bedfont to exhibit NObreath FeNO monitor at Arab Health 2019
January 23, 2019 - Nicotinamide riboside supplementation confers significant physiological benefits to mothers and offspring
January 23, 2019 - Increasing temperatures may help preserve crop nutrition
January 23, 2019 - Many Oncologists in the Dark About LGBTQ Health Needs
January 23, 2019 - Epigenetic change causes fruit fly babies to inherit diet-induced heart disease
January 23, 2019 - Erasing memories could reduce relapse rates among drug addicts
January 23, 2019 - African Americans who smoke cigarettes are more likely to develop peripheral artery disease
January 23, 2019 - Unique data combination helps FinnGen researchers to fund links between genetic factors and health
January 23, 2019 - Parents’ mental health problems associated with reactive attachment disorder in children
January 23, 2019 - Graphene Flagship project studies impact of graphene and related materials on our health
January 23, 2019 - The connection between the Pope and contraceptive pills
January 23, 2019 - Prior dengue infection could protect children from symptomatic Zika
January 23, 2019 - Previous dengue virus infection associated with protection from symptomatic Zika
January 23, 2019 - VISTA checkpoint implicated in pancreatic cancer immunotherapy resistance
January 23, 2019 - The Tiny Camera That Could Revolutionize Cardiovascular Surgery
January 23, 2019 - Peptide isolated from soil fungi has antitumor and antibacterial properties
January 23, 2019 - TGen identifies polio-like virus as potential cause of Acute Flaccid Myelitis outbreak
January 23, 2019 - Migrants and refugees do not bring disease and are at greater health risk themselves says WHO
January 23, 2019 - Examing the effects of menopause in workplace
January 23, 2019 - Enemy number 1 – Air pollution and climate change top of WHO agenda
January 23, 2019 - Two Positive Phase III studies of Tafenoquine for the Radical Cure of Plasmodium vivax Malaria Published in The New England Journal of Medicine
January 23, 2019 - World Trade Center responders at increased risk for head and neck cancers
January 23, 2019 - Low-sugar diet leads to significant improvement in nonalcoholic fatty liver disease in boys
January 23, 2019 - Chaos in bodily regulation can optimize our immune system, finds study
January 23, 2019 - Short, text-based exercises can increase happiness for adults recovering from substance use disorders
January 23, 2019 - Body size may have greater influence on women’s lifespan than men
January 23, 2019 - Groundbreaking tool helps visualize neuronal activity with near-infrared light
January 23, 2019 - Prior dengue immunity in children may be protective against symptomatic Zika
January 23, 2019 - Holocaust survivors with PTSD and their offspring exhibit more unhealthy behavior patterns
January 23, 2019 - Scientists discover new genetic mutations causing inherited deaf-blindness
January 23, 2019 - UC team designs new naloxone-dispensing smart device
January 23, 2019 - Torrent Pharmaceuticals Limited Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium and Hydrochlorothiazide Tablets, USP
January 23, 2019 - Brain activity shows development of visual sensitivity in autism
January 23, 2019 - Two hour gap between dinner and sleep is overrated says Japanese research
January 23, 2019 - Fear and embarrassment are causing smear test numbers to plummet
January 23, 2019 - Protein-secreting device implanted in epileptic rats reduces seizures, improves cognition
January 23, 2019 - Reintroduction project recovers current wild population of green turtle in Cayman Islands
January 23, 2019 - Cancer survivors face greater financial burden related to medical bills
January 23, 2019 - PSA screening reduces prostate cancer deaths by 30%
January 23, 2019 - LSTM receives grant to help improve health of people living in informal settlements
January 23, 2019 - Hemochromatosis Mutation Linked to Other Morbidity
January 23, 2019 - Why early diagnosis of autism should lead to early intervention
January 23, 2019 - Aspirin May Lower Stroke Risk in Women with History of Preeclampsia
January 23, 2019 - Exposure to certain chemicals may be linked to decrease in blood pressure during pregnancy
January 23, 2019 - Bowel cancer on the rise among younger Australians
January 23, 2019 - Scientists have reversed memory loss in a mouse model of Alzheimer’s
January 23, 2019 - Defective molecular master switch could lead to age-related macular degeneration
January 23, 2019 - Researchers identify how concussions may contribute to seizures
January 23, 2019 - Short interval between last meal of the day and bedtime may not affect blood glucose levels
January 23, 2019 - Still Too Many Highway Deaths Tied to Speeding
January 23, 2019 - Prenatal valproate exposure linked to increased ADHD risk
January 23, 2019 - Compound identified that may help treat heart failure
January 23, 2019 - Undiagnosed Asthma in Urban Adolescents May Be Common
January 23, 2019 - Study describes metabolism of intestinal microbiota in babies for the first time
January 22, 2019 - Study links concussions to development of epilepsy
January 22, 2019 - Specialist-led hospital bereavement service may help restrain legal action after difficult deaths
January 22, 2019 - Genetic study reveals possible new routes to treating osteoarthritis
January 22, 2019 - Blood test may detect early signs of lung-transplant rejection
January 22, 2019 - Blood marker could aid in early prediction of Alzheimer’s progression
January 22, 2019 - Orthodontic treatment does not guarantee future dental health
January 22, 2019 - Rutgers researchers discover cause of bone loss in people with joint replacements
January 22, 2019 - Diversity among rural Africans extends to their gut microbiomes
Study finds racial, socioeconomic barriers to accessing life-saving treatment for metastatic cancer

Study finds racial, socioeconomic barriers to accessing life-saving treatment for metastatic cancer

image_pdfDownload PDFimage_print

Increasing use of a potentially life-saving treatment for metastatic cancer is leaving too many vulnerable patients behind, according to a new study from Yale Cancer Center/Smilow Cancer Hospital published in JNCCNJournal of the National Comprehensive Cancer Network. The researchers looked into use of stereotactic radiosurgery (SRS) following radiotherapy (RT) to treat brain metastases in patients with melanoma, lung, breast, or colorectal cancers. They found that the use of SRS has increased dramatically, but unevenly, in recent years.

“The upfront costs, infrastructure, and multidisciplinary expertise needed for SRS delivery compared with traditional whole-brain radiation may be contributing to racial and socioeconomic barriers to access,” according to lead researcher, Benjamin H. Kann, MD, Yale University School of Medicine. “Investment in a dedicated radiosurgery system, whether using Gamma Knife Radiosurgery or linear accelerator-based modifications, can cost several millions of dollars upfront. Additionally, physician, physicist, and therapist training is required, which involves time commitment and often off-site course attendance.”

More than 20% of patients with cancer develop brain metastases. This study examined data from the National Cancer Database (NCDB) between 2004 and 2014, focusing on people over age 18, who were treated with radiation to the brain for one of the four malignancies most associated with brain metastases in the United States. 75,953 patients met the criteria for inclusion, 12,250 (16.1%) of whom received SRS.

They found the overall utilization rate for SRS increased from 9.8% in 2004 to 25.6% in 2014, with the rate of uptake accelerating after 2008. SRS use increased more for patients with income levels of $63,000 and above, as well as those treated at academic facilities, living in areas with higher percentages of high school graduates, or possessing private insurance. There were lower rates of SRS among patients with Medicare, Medicaid, or no insurance. Moreover, patients of black race or Hispanic ethnicity were less likely to be treated with SRS even when the researchers excluded the melanoma data (which has a predominantly white population).

“Increased education surrounding SRS for referring providers and patients, networking and relationship-building between community practices and larger cancer centers, as well as offering SRS training programs for providers may help to improve access for minority patients and those in lower income regions,” said Kann. “Transportation to an SRS facility may also be challenging for underprivileged patients, so it could be helpful to strengthen social programs that help patients travel to SRS centers.”

The study found that from 2004-2013, one-year actuarial survival improved from 24.1% to 49.6% for patients selected for SRS, but only from 21.0% to 26.3% for non-SRS patients. However, it’s not clear whether SRS-receipt itself improves survival, or if this association is due to the favorable prognosis of the patients selected.

“Over the past decade, advances in cancer treatment offering better control of systemic disease have increasingly led to patients living longer following a diagnosis of metastatic disease,” said Christine Tsien, MD, a radiation oncologist at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. Dr. Tsien is a member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Central Nervous System cancers, and a contributor to the NCCN Radiation Therapy Compendium™. “Recent randomized studies have also demonstrated that treatment of a small number of brain metastases (1-3) with stereotactic radiosurgery showed a decrease in neurocognitive decline compared to whole brain radiotherapy without compromising overall survival. Based on these results, there has been a recent, dramatic shift towards the use of stereotactic radiosurgery instead of whole brain radiotherapy in patients diagnosed with brain metastases of limited volume. How SRS technology is being made available, including any sociodemographic disparities, is of significant interest not only to oncologists but also to the greater community.”

Further research is needed, in order to determine the reasons for these worsening disparities and their clinical implications on intracranial control, neurocognitive toxicities, quality of life, and survival for patients with brain metastases.

Tagged with:

About author

Related Articles