The Permanente Federation’s new co-CEO speaks with the AMA about value-based care and how it supports preventive care, and ways to reduce physician burnout.
Oncologists are re-evaluating cancer treatment — which can include surgery, chemotherapy, radiation, or a combination of the 3 — and considering less aggressive approaches to balance quality of life for patients, according to a CNN report.
Cancer specialty care experts quoted in the story, including Permanente physician leader Tatjana Kolevska, MD, discussed the growing trend toward “de-escalation” or optimal treatment that uses fewer of the traditional methods as long as the effectiveness and quality of care is not compromised.
The cancer care specialists noted that treatment should not take a “cookie-cutter” approach for all patients, and the story mentioned studies showing that for some patients removing treatment such as radiation could still achieve favorable outcomes.
For example, one study looking at patients with rectal cancer found that those who received chemotherapy before surgery had similar outcomes for survival and recurrence compared to those who had both chemotherapy and radiation treatment before surgery.
Dr. Kolevska, medical director for the Kaiser Permanente National Cancer Excellence Program, told CNN that some treatments can have side effects, such as damaging healthy cells or organs, and they should be considered when determining a treatment plan. She said an aggressive approach should not always be the default care plan.
“In cancer, the fear and anxiety are huge, so it’s very frequent that we may use more [medicine], which could make people very sick,” she said. “We want to try everything to treat a patient, but in some cases, too much of an aggressive treatment could do more harm than good.”
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The story emphasized that de-escalation is not for everyone, and that physicians should discuss pros and cons with patients for suitability. The story also gave examples of patients whose physicians took a “less is more” approach like reducing medications or having fewer sessions of chemotherapy, and patients saying they felt a better balance in health and quality of life.
Note: Read the full story on CNN.