Alzheimer’s patients get less breast cancer therapy
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Women with Alzheimer’s disease receive less treatment for breast cancer than do comparable female Medicare beneficiaries, the results of a new study indicate. However, this pattern is not necessarily inappropriate, the authors note in the Journal of the American Geriatrics Society.
Dr. Sherri Sheinfeld Gorin and colleagues from Columbia University, New York, examined the use of breast cancer treatment in patients with Alzheimer’s disease based on data from the Surveillance, Epidemiology, and End Results cancer registry and Medicare billing records.
A total of 50,460 breast cancer patients were included in the study population. Of these, 3.8 percent had a diagnosis of Alzheimer’s disease before or up to 6 months after cancer diagnosis.
Women with Alzheimer’s disease were more likely to be diagnosed with later-stage breast cancer than other female Medicare patients and to have larger tumors. Women with Alzheimer’s disease also had a higher probability of lymph node involvement.
The Alzheimer’s group was less likely to undergo surgery, radiation or chemotherapy than other patients.
The team reports that the greatest differences in treatment occurred between the ages of 80 and 89 years. “There are insufficient data to make chemotherapy recommendations for patients aged 70 and older, so treatment may be individualized” depending on the presence of other diseases, Gorin’s team explains.
“Even in the face of accepted clinical guidelines, healthcare providers may appropriately offer less-aggressive care to their patients with Alzheimer’s disease,” they note.
“Factors that influence these decisions may include life expectancy, quality of life, and the risks of treatment or treatment-related” side effects, they add.
However, the general pattern of offering less-aggressive breast cancer treatment for women with Alzheimer’s disease suggests that opportunities for treating co-existing diseases in these women may be underutilized.
SOURCE: Journal of the American Geriatrics Society, November 2005.
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