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Disparities in lung cancer treatment

Tuesday, June 15th, 2010



A study published today looks into why some people diagnosed with lung cancer decide not to get surgery — even though it’s the best treatment available.

The study – from researchers in North Carolina – found two things going on. The first is that black patients were less likely to follow a recommendation for surgery than white patients. The second discovery is that patients who opted out of surgery often said their doctor’s communication skills influenced their decision. For early lung cancers, the best cure is surgery, but one third of white patients and nearly one half of black patients surveyed didn’t follow through.

Bowen: In the case of lung cancer it’s very concerning because in stage 1a and 2 lung cancer, the only acceptable treatment is surgery.

Frank Bowen is the head of thoracic oncology at Cooper University Hospital.

Bowen: If those patients do get surgery over 70 percent will survive out to five years. If they don’t the median survival is really less than a year.

Bowen says doctors can be more cognizant of their bedside manner to make sure patients follow through with surgery. Thomas Bauer, the chief of thoracic surgery at Christiana Care, says communication is extremely important.

Bauer: There are so many other things that come into play. And making sure that you’re able to address all their concerns is I think vital to connecting to the patient, establishing trust, making sure that you’re completely comprehensive in what you’re offering the patient.

Bauer says he works with nurses who navigate patients through their treatment and spend extra time with them to address patients’ concerns. Walter Scott, the chief of thoracic surgery at Fox Chase Cancer Center, says the study is an important reminder to physicians.

Scott: If we act in a hurried fashion or as if we don’t seem to be paying attention we could be harming our patients because they’re less likely to take our recommendation. And if they don’t have surgery when they should, that’s a real shame.

The researchers didn’t identify why there was a racial disparity among patients, but suggested that there might be unrecognized bias among surgeons and barriers to access to care.


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