At the recent disparities conference in Omaha there were differences noted
in outcomes using the same cancer therapies.

One of the problems in cancer research is that less than 5% of adult cancer
patients are studied compared to 85% of children.

There are also more dimensions. With complicated treatments that require
education, regular medications, understanding, transportation, family
support, etc., there are likely to be differences.

At a conference given by a pathologist and not publishied involving one
study on amyloid heart disease and chemo, life span increased from 4 months
to 17 months. When the study was moved to 5 other cardiologist offices, the
differences disappeared. The likely explanation is that the initial
cardiologist and office staff did a much better job actually delivering the
complete care and helping patients do all of complicated things that would
maximize the treatment and minimize side effects and drop out rates.

the best answers are that the impacts of all cancer treatments in adults
are poorly studied, subject to great variation in interpretation, and are
likely impacted by significantly different offices, physicians, and patient
populations with the largest gaps in the most different types.

At another conference with a presentation by a respected researcher, there
are also drugs that get FDA approval even though the primary reviewers at
the FDA did not support the release of the drugs. It still pays to be very
conservative about newly released drugs.

Robert C. Bowman, M.D.
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