Obese cancer patients may not be getting adequate dosages of chemotherapy, which often leads to their having higher rates of their cancers recurring, and resultant deaths, according to experts. Their overall prognosis may not be as bright as that of patients who receive a full dose of cancer drugs.
To help remedy this potentially life-shortening situation, guidelines have been developed by the American Society of Clinical Oncology (ASCO). Obese patients should, according to the guidelines, receive full, weight-based chemotherapy doses, as long as they have no other health issues that would contraindicate giving them the full doses.
Doctors don’t always base the dose a patient receives on their size because they are concerned with the ability of some obese patients to handle a larger dose. However, according to research, in general, larger people can bear chemotherapy actually better than people of “normal” or “average” weight.
A larger-sized person, logic would see to dictate, probably requires a larger dose of chemotherapy drugs, But, as too large of a dose of these drugs can result in unpleasant side effects and health complications, doctors worry that an overdose can occur if the amounts of medications their obese patients receive might be larger than the sizes they prescribe to their other patients.
Director of the U.S. Food and Drug Administration’s office of cancer drugs, Dr. Richard Pazdur, has stated that by “capping” the dosage that obese patients receive, they have been, in effect, “undertreated.”
According to the AP, up to 40 percent of cancer patients who are obese get under-prescribed for their weight. They are given “less than 85 percent” of the adequate dose of chemotherapy for their weights.
According to Duke University oncologist Dr. Gary Lyman, this advice by the ASCO amounts to a “right-sizing” of cancer care.
This under prescribing of cancer drugs to obese patients is a very real and growing problem, as more than half of Americans can be classified as being overweight, and over a third are considered to be obese.
The Obesity Action Coalition (OAC), advocates prescribing different doses based on weight. Oncologist Carol Petersen, who is involved with the OAC, says that full doses are usually okay for patients if they are otherwise healthy, and that they “can do quite well” with the full dose.
Patients who are obese, as with any other patients, should take an active role in health issues, and they should ask their doctors about safe dosages, and risks and potential side-effects that a person might experience if given a higher dose of chemotherapy.
According to Lyman, it could be that your doctor might have a “good reason” to not prescribe you a full does; but, still, he adds that “you should have that discussion.”
If you are obese and have cancer, and have concerns about the dosage level of chemo drugs you’re being prescribed, it is highly recommended that you talk over your concerns with your oncologist. If you are otherwise healthy, receiving the full dose may mean a great deal of difference in your overall prognosis.
Written by: Douglas Cobb