Adverse effects and costs of chemotherapy greater than previously thought

BOSTON--Researchers at Dana-Farber Cancer Institute and Harvard Medical School have found that breast cancer patients 63 years of age or younger may experience more chemotherapy-related serious adverse effects than reported in clinical trials, according to a new study in the August 16 issue of the Journal of the National Cancer Institute.

Led by Michael J. Hassett, MD, MPH, of Dana-Farber, researchers studied a database of medical claims made by women with newly diagnosed breast cancer who had employer-provided health insurance between January 1998 and December 2002.

"This is the first study, to our knowledge, of chemotherapy-related serious adverse effects in a population-based sample of younger women with breast cancer," said Hassett, who is also an instructor in medicine at Harvard Medical School. "We found that eight chemotherapy-related serious adverse effects may be more common than reported in large clinical trials, and, therefore, these adverse effects may be responsible for more patient suffering and higher health care expenditures than currently predicted."

Doctors often prescribe chemotherapy to eliminate residual cancer cells in women who have undergone surgery for breast cancer. Women who received chemotherapy were more likely to be hospitalized or visit emergency rooms for problems that are typically related to chemotherapy, including fever or infection, low white blood cell or platelet count, nausea, diarrhea, malnutrition, or dehydration.

Researchers studied 7,052 women from a database of claims made to health plans that contract with large employers in the U.S. The group was equally divided into two cohorts of 3,526: those who received chemotherapy within 12 months of their first breast cancer diagnosis, and those who did not.

In addition to more incidents of chemotherapy-related adverse effects, women undergoing chemotherapy for breast cancer also experienced increased healthcare costs: $1,271 more per year for hospitalizations and emergency room visits and $17,617 more per year for ambulatory care than women who did not receive chemotherapy.

Additional contributors of the report are from Dana-Farber and the Harvard School of Public Health.

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The research was funded by grants from the Agency for Healthcare Research and Quality and the National Institutes of Health.

Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.


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