The programme produces easy-to-read reviews of different treatment options and also forecasts the individual's chances of ten-year survival. It is based on international studies of treatment options and data from US tumour registries highlighting the risk of dying from particular types of breast cancer. This risk is calculated by assessing the nature and size of the tumour and whether or not it shows signs of early spread to lymph nodes.
Dr. Peter Ravdin, of the University of Texas Health Sciences Center (UTHST) explained: "In prior work, we found that even after talking with their doctors, many women seemed to lack information about the relative benefits of various therapies".
In a related study, respondents said providing and receiving this type of information was useful in the decision making process. Research shows that new treatments tend to improve the outlook for patients by a few percentage points - but often at the expense of side effects. The patient has to determine what is known as the "risk-benefit ratio" - or "the pain versus the gain".
"Weighing up the options can be made easier by giving the patient information so that she can be a true participant in selecting what is best for her, " said Dr. Ravdin. "Treatment guidelines have great value, but they do not supersede the importance of informing patients about the implications of individual treatment choices.
"We believe there is also great potential to use this approach to help patients with other forms of cancer".
The programme's development coincides with radical changes in the doctor-patient relationship in Europe - and the emergence of the so-called "expert patient" or "informed patient". Ever increasing numbers of patients are demanding more information about the implications of treatment. Being an informed patient and playing an active role in determining treatment is not a soft option. It can involve serious decisions resulting in aggressive treatment with traumatic side effects.
Specialists also want cancer patients to be better informed about therapy related problems that may occur during or after treatment. There is a great emphasis on patients reaching the so-called "all clear" five years after treatment, but there are seldom any warnings about common problems in the first months and years after treatment.
Dr. Ravdin said: "Taking into consideration the short and long term consequences of therapy is crucial. Examples of long term consequences of chemotherapy can be early menopause and a heightened risk of leukaemia. Even tamoxifen, a low toxicity hormone therapy, can result in a small but heightened risk of blood clots and endometrial cancer".
The programme was developed by an UTHST team led by Dr. Ravdin, in collaboration (for evaluation and refinement) with a team from Case Western Reserve University headed by Dr. Laura Siminoff.
Abstract No 493
Further information: Maria Maneiro
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