Chemotherapy and radiation are the standard of care for small-cell lung cancer that hasn't spread to other parts of the body. But many patients don't receive these treatments, a new study indicates.
This less-than-optimal care is reducing survival rates, according to researchers from the University of Texas MD Anderson Cancer Center.
"In order to improve access to care and address related disparities, it is critical to understand the barriers patients face when getting treated for lung cancer," said the study's senior author, Dr. Stephen Chun. He's an assistant professor of radiation oncology.
Small-cell lung cancer is a fast-growing malignancy that accounts for up to 15 percent of lung cancers, according to the American Cancer Society.
Hoping to shed light on those treatment barriers, the researchers analyzed information in a national cancer database on more than 70,200 patients with small-cell lung cancer. They focused on the social and economic obstacles the patients faced when seeking treatment. They also evaluated their survival rates.
Of these patients, about 56 percent received chemotherapy and radiation as their initial therapy. About 20 percent received only chemo, and 3.5 percent just got radiation. Another 20 percent received neither treatment, the study found.
Half the patients who received chemotherapy and radiation survived more than 18 months. Receiving just chemotherapy reduced median survival to almost 11 months, and radiation alone carried a median survival of a little more than 8 months.
Not receiving either form of treatment resulted in worse outcomes.
"Among the group of patients who received neither chemotherapy nor radiation, prognosis was dismal with a median survival of only 3-4 months," Chun said in a cancer center news release.
The researchers found that treatment at a non-academic center, lack of insurance or Medicare/Medicaid insurance were linked to less than optimal care.
Patients with Medicare or Medicaid received chemotherapy just as often as those with private insurance but they were much less likely to undergo radiation therapy, the study found.
And uninsured patients were less likely to receive either chemo or radiation.
"There are targeted access programs that provide competitive reimbursement for the administration of chemotherapy, and our findings suggest that these programs have improved chemotherapy access," Chun said. "However, these programs give no financial assistance for radiation therapy, which could, in part, explain why patients with Medicare and Medicaid were less likely to receive radiation."
The study authors stressed that proper treatment is critical for patients with small-cell lung cancer. They urge patients to advocate for themselves to ensure they receive the best treatment possible.
The study was published Jan. 4 in JAMA Oncology.
The American Cancer Society provides more on small-cell lung cancer.
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