What you know can influence your cancer treatment

In this day and age, more and more patients seek information of their health conditions and treatments over the Internet where such information is easily available and usually for free. General information about diseases like cancer can be found on sites of advocacy groups (example: Susan Komen for the Cure, American Cancer Society [ACS]) and medical and research institutions (example: National Cancer Institute [NCI], Mayo Clinic, Dana-Farber Cancer Institute). In addition, information about drugs and treatments are openly available on the websites of regulators bodies and health authorities (example: US FDA, European Medicines Agency). It is estimated that four out of ten of cancer patients look for information about their condition on the Internet.

In addition to large amount of information available, patients have become more aware of health issues, have become more autonomous. More and more patients take a proactive role and want to have a say in the treatment and management of their conditions rather than leaving everything up to the doctor.

But how does this increased level of patient knowledge of health information affect his or her treatment?

An article to be published in the April issue of Cancer, a journal of the ACS reports that “when colorectal cancer patients seek out health information from the internet and news media,… they can influence their own treatment.” They are, for example, are more likely to be informed about the latest treatments for their disease and receive them. However, in certain cases, this knowledge can also influence their treatments in “inappropriate ways.”

Researchers at the NCI Center of Excellence in Cancer Communication Research at the University of Pennsylvania Annenberg School designed a study to examine the relationship between information-seeking among 633 colorectal cancer patients chosen at random from the Pennsylvania Cancer Registry and the use of novel new agents for the disease.

The researchers specifically looked at patient knowledge of targeted therapies such as bevacizumab (Avastin) and cetuximab (Erbitux). The drugs have recently been approved by the US FDA and have had significant media coverage. The researchers investigated whether information seeking activity of patients is correlated to their actual awareness of the said targeted therapies and whether this awareness translates into receiving these therapies. The results of the studies showed that:

· High levels of information seeking were strongly associated with both awareness of and receiving treatment using targeted therapies.

· Patients who sought information about treatments for colorectal cancer were 2.83 times more likely to have heard about targeted therapies and 3.22 times more likely to have received targeted therapies than people who did not seek information.

It is to be noted that these targeted therapies are only approved by the US FDA for advanced colorectal cancer. The abovementioned associations however, were found to be true for patients with advanced as a well as early stage colorectal cancer, indicating that patients and their knowledge may influence their treatments in an inappropriate way.

The authors conclude:

“These findings emphasize the importance of exploring patient influence on physician prescribing patterns and understanding the impact of information seeking on cancer outcomes.”

In my opinion, every patient has the right to seek information and be aware about the latest treatments. However, we should also respect our doctors’ knowledge and expertise and that the decision for a certain treatment should be in agreement with our doctors, and not against doctors’ orders.