Obese cancer patients losing out on adequate chemo dosage: Experts

23 Sep 2013

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Obese cancer patients might be losing out on adequate dosages of chemotherapy, which often led to their having higher rates of their cancers recurring, and resultant deaths, according to experts, Las Vegas Guardian Express reported.

Their overall prognosis might not be as bright as that of patients receiving a full dose of cancer drugs, the report said.

The American Society of Clinical Oncology (ASCO) had framed guidelines to help remedy this potentially life-shortening situation.

Under the guidelines obese patients needed to receive full, weight-based chemotherapy doses, as long as they had no other health issues that would contraindicate giving them the full doses.

However, doctors did not always base the dosage for patients based on their size, as they were concerned with the ability of some obese patients to handle a larger dose. However, research showed, larger-built people could generally bear chemotherapy actually better than people of ''normal'' or ''average'' weight.

Logic would dictate, that a larger-sized person would probably require a larger dose of chemotherapy drugs, but as an extra large dose of these drugs could result in unpleasant side effects and health complications, doctors worried that an overdose could occur if the amounts of medications their obese patients received might be larger than the sizes they prescribed to their other patients.

However doctors ended up reducing chemo therapy doses on obese patients by not basing the dose on size, out of fear about how much treatment an obese patient could tolerate. 

Even a little less chemo could mean worse survival odds, and studies suggested that as many as 40 per cent of obese cancer patients had been getting less than 85 per cent of the right dose for their size.

According to Gary Lyman, a Duke University oncologist who led the panel that wrote the rules, there was little doubt that some degree of under treatment was contributing to the higher mortality and recurrence rates in obese patients.

US Food and Drug Administration's cancer drug chief Richard Pazdur said, by minimising the dose or capping the dose, obese patients were being under treated.

The dosing issue is applicable to all types of cancer treated with chemo - breast, colon, lung, ovarian and even blood diseases such as leukemia, with a lot of people being affected, because under the new ''normal'' 60 per cent Americans were overweight and more than a third of them were obese.

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