The simple tool that gives cancer patients 5 months longer to live

Cancer patients who used a simple online tool to alert their providers to side effects in "real time" lived about five months longer than those who did not, according to a study published Sunday in JAMA.

How to build a high-value cancer care team

Methods

The study—lead by Ethan Basch, an oncologist at Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill—involved 766 cancer patients receiving outpatient chemotherapy at Memorial Sloan Kettering Cancer Center. The cancer types included prostate, breast, and lung.

The patients were split into two groups: One group of patients was asked to report any side effects of their chemotherapy treatment using an online tool, accessible via computer or electronic tablet, at least once a week, or more frequently if they experienced a problem. The tool included a list of common side effects, such as loss of appetite, constipation, fatigue, and nausea. According to the Washington Post's "To Your Health," physicians would be able to access the results during visits, and nurses would receive an email alert if patients reported severe or worsening side effects.

The control group reported side effects during their monthly meetings with their oncologists, or by telephone if the need arose between visits.

Results

The researchers found median survival for the group who used the online tool was 31 months, compared with 26 months for those in the control group.

According to the researchers, patients in the online tool group received quick attention from the nurses monitoring their symptoms and were able to have their medications adjusted based on their symptoms. "Almost 80 percent of the time, the nurses responded immediately," Basch said.

And as a result of that quick attention, according to Basch, patients in the online tool group made fewer visits to the ED, could tolerate their chemotherapy treatment for a longer amount of time (an average of eight months, rather than six in the control group), and were more active—all factors that in turn contributed to their longer life expectancies, according to "To Your Health."

Discussion

"I was floored by the results," Basch said, adding that with the online reporting tool, providers "are proactively catching things early."

And Richard Schilsky—CMO of the American Society of Clinical Oncology—said that quick notification was key in cancer treatment, because certain side effects, such as shortness of breath, might indicate that the treatment isn't working and should be altered. "You want to be able to reach your provider as early and easily as possible," he said.

Separately, Scott Ramsey, director of the Hutchinson Institute for Cancer Outcomes Research at the Fred Hutchinson Cancer Research Center in Seattle, said Basch's approach could be a "promising, low-cost way to reduce suffering and save millions of dollars in preventable emergency-department visits."

Ramsey, who wasn't involved in the study, explained that most oncology practices rely on their patients to report any problems they have during chemo, "but unfortunately, most patients don't know when to call for help and often wait until it's too late."

According to "To Your Health," Basch is now leading a nationwide study involving 1,000 different patients using a tool that works on cell phones. "We have limited time to see a lot of people as oncologists," said Basch. "But we can harness technology to improve the quality of how we practice and to bring us closer to our patients" (McGinley, "To Your Health," Washington Post, 6/4; Marchione, AP/Sacramento Bee, 6/4).

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