Patients Face Debilitating Challenges Related to Toxicities in Cancer Treatment

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By Charles Cleeland, Ph.D., chair, Symptom Research, MD Anderson

The research goals of MD Anderson's Department of Symptom Research are focused on finding ways to lessen and even eradicate the symptoms produced by cancer and its treatment.

The immediate and late effects of symptoms and toxicities of cancer treatment include:

  • Fatigue
  • Neuropathy
  • Pain
  • Mood changes
  • Cognitive deficits
  • Damage to several organ systems
These symptoms and toxicities cause great distress to patients, limiting their functioning during and after treatment, and sometimes causing premature termination of treatment or reductions in dose. Therapy-related toxicities also can limit the development of new treatment options.

At least one-third of cancer survivors have significant residual post-treatment symptoms. Unfortunately, there is little recognition at all levels of the large numbers of patients and survivors affected by severe symptoms. Also, there is insufficient pharmaceutical industry interest in developing and testing agents that can address these problems.

Changes around the corner
The regulatory approval pathway for evaluating symptom benefit is evolving, with funding review panels recognizing it. However, it is ill-defined and hard to demonstrate.

As a step toward addressing these issues, we convened a working panel in March 2011 at a colloquium, co-sponsored by Friends of Cancer Research, that included stakeholders in cancer research, industry, regulatory agencies and advocacy groups. The participants came together in Houston to identify the challenges that have prevented progress in reducing treatment-related symptom burden. We also developed a list of strategic steps to address these challenges, and identified stakeholders and agencies that could implement them.

The panel was a broad representation of people who could make a difference in this area. A crucial voice in these discussions came from patient advocates including Robert Warriner, M.D., chief medical officer of Diversified Clinical Services.

Warriner was diagnosed with multiple myeloma in 2006 and, after induction chemotherapy, underwent autologous stem cell transplantation at MD Anderson. He eloquently shared his story at the colloquium and will soon present his experiences to a panel at the National Cancer Institute

The colloquium aims to be a catalyst for change -- to engender a broader recognition of the treatment-related challenges our patients face, and to encourage increased funding toward research that could alleviate the distressing symptoms and toxicities they experience.

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