Anyone Have an Onc that Reads Research?

My onco definitely keeps up on current research.  She reads the onco journals and goes to the national meetings.  She has to, since she works at an NCI-designated Comprehensive Cancer Center where everybody is expected to be involved in clinical research.  Oh, and she's on the NCCN panel that comes up with the treatment guidelines for breast cancer.  I think we've talked about new papers, reports from meetings, or results from clinical trials, at nearly every visit.

But she does not jump on the bandwagon just because there's a new paper out that says "xyz" reduces recurrence risk.  People who are actually involved in research (clinical or otherwise) tend to be more cautious about that stuff, I think.  They understand that a new finding has to be re-tested and re-proven in additional studies before it can be considered "practice-changing".  Just because something works once (or at least breaks the threshold of statistical significance) does not mean it will work if tested again or will work in a slightly different situation.

Results that are presented at meetings and conferences are always suspect.  Those reports seldom get reviewed or evaluated for credibility except by a program section chairman who is trying to fill out the afternoon's session with papers (or posters).  Conference and symposium reports are rarely subjected to the scrutiny that a written manuscript will see when it gets submitted to a journal for publication. That "peer review" by experts in the field of study is one of the things a medical researcher will rely on, to know whether the findings in a report are legitimate or not.

So, yes, my onco reads research papers and symposium abstracts all the time.  But I doubt she'll be recommending that her breast cancer patients all start taking beta blockers any time soon.

otter

My onc also does research, and i'm sure he reads the literature...but i'm not sure he's seen that report. His patients are not limited to bc, and there's an awful lot of literature out there!

Incidentally: my 1st rxn to that beta-blocker news was -- no way! My husband has had hi blood pressure for years, and the day he got off beta-blockers was a wonderful day. Like all drugs, they have serious side effects, and if you are sensitive to them, they're hell. So i tend to be unreasonably leery of beta blockers.

Emotions aside, i agree with Otter -- but fields differ. My DIL sweats blood over her abstracts; in her field, they are reviewed very critically, because each abstract means a full talk. In mine -- not much judging, just enough to be sure there's nothing actionable, because there's lots of room for posters and everyone can put one up. And i once went to a math conference, and there was an abstract that stated a theorem of Einstein's, and went on "Einstein was wrong." People told me this guy kept making stupid claims like that, and then never showed to give the talk -- obviously the organizers weren't paying attention... So it's very variable.

But even the most careful screening doesn't mean the research will hold up. Retrospective studies often don't. Remember when retrospective studies suggested that retinoic acid is anticancer because people who eat lots of veggies have less cancer - but when they fed smokers retinoic acid, they had a higher incidence of lung cancer than the 'controls'. And remember the hormone replacement studies and heart disease? Retrospective studies are really just the beginning of testing a theory - or maybe it's better to say: they can provide a theory to eb tested.

So i wouldn't write off your onc based on a recently presented study.  But if he blows off your concerns  -- that's different.

Yes, well, I left out the part about having taken beta blockers myself (for hypertension) for, oh, the past 20 years or so; and still I got breast cancer.  One anecdote does not constitute a research study (or how does that go?), and one "negative" finding in a medical study certainly does not require that the hypothesis be tossed out.

But, as I think everybody else here has agreed, one symposium paper (or poster) presenting the results of a clinical study is not the sort of thing that changes cancer treatment protocols -- nor should it. 

I agree with AnnNYC and Mouser that the scrutiny given to symposium abstracts can be quite variable.  My comment about "filling out the afternoon session" was based on personal experience as a presenter and as a session chair; but I wasn't running with the big boys at the national onco meetings. That could get really competitive.  As AnnNYC has discovered, abstracts (even at the big-league meetings) seldom contain all the information we would like to see.  It's hard, if not impossible, to reproduce -- or even understand -- most studies just by following what's in the abstract. One would hope the author(s)/presenters fleshed things out a bit more in the actual presentation... you know, gave the actual numbers etc.

Yes, we certainly need to be our own advocates.  But, I've preferred to approach this whole thing as if I have a team helping me -- my PCP (who gave me the referral), my surgeon, my med onco, the osteoporosis doc, and everyone in between.  I actually read a lot of medical articles and meeting abstracts; I have access to a university library's worth of journals; I subscribe to Medscape and OncologySTAT e-newsletters; etc.  I often print things out and take them to my recheck visits with my docs (any of them); and I'm lucky that all my docs find that sort of behavior in a patient perfectly reasonable.

Aug232007, I think we're going to have to agree to disagree about jumping on the bandwagon every time something new and exciting makes headlines.  I'd like to point out that just because something is "posted as big news" on the BCO website (or any other "news" site) does not make it especially significant, much less practice-changing... but I think I said something similar to that already.  So, hugs to you...

otter

I agree with Otter, however, if I were already taking meds for hypertension, I would ask about using a beta blocker instead. That's sort of how I've approached the aspirin thing -- when I would have reached for tylenol in the past, I now consider using aspirin. I wouldn't add a new med based on one study, but I might switch if it looked possible that I could get a cancer prevention benefit out of a different med for something that was already being treated.

Don't you wish they would find something where it wasn't about reducing risk X% but where everybody got well and stayed cancer free? 

I can't add anything to what has already been said here, and said well.  Otter I always enjoy your input.

Speaking for myself, it's essential to my health that my doctors are current on the research, and curious enough to always question 'why'. My oncs are open to my questions and accept any research I find for discussion.  I'd find it hard to trust a doctor who jumped on every nuance that came along because they, more than anyone, know what it takes to vet science. And I'm glad when I find one who isn't married to a theory or therapy.

And Shirley, me too I'm sorry to hear about the mets.   

Marilyn