![](https://www.plusonline.nl/sites/plusonline/files/styles/pol_carousel/public/gettyimages-1056341218.jpg?itok=9Lkg04-u)
A new treatment for metastatic colon cancer received all thumbs up. The heavy chemotherapy can prolong life by about 5 months in these patients. Yet he is hardly prescribed after five years. How is that possible? Dutch researchers looked it up and wrote about it in the JAMA.
The researchers wanted to know how often the new course was prescribed. As quickly as possible. They therefore carried out a ‘flash mob study’, which means that the participating doctors dropped everything from their hands and supplied the required data very quickly. Such as a ‘flash mob dance’ that you sometimes see on the internet, in which a group of people suddenly start doing the same dance or movement. In that record time of five days, 282 patient data from 47 hospitals were collected and 101 oncologists were interviewed. The results are in JAMA.
Little prescribed
The result: the heavy chemotherapy for metastatic colorectal cancer was indeed relatively little prescribed. Only one in seven eligible patients got it. The course of FOLFOXIRI-B consists of the drugs fluorouracil, folinic acid, oxaliplatin and irinotecan with bevacizumab. The cure does not cure metastatic colon cancer, but can extend life by almost five months. For some people, this can outweigh the serious side effects such as diarrhea, neuropathy, fatigue and hair loss.
Well discussed
Most participating oncologists (86 percent) had discussed the FOLFOXIRI-B course with the patient. Yet they often opted not to go for the cure. The study showed that oncologists mainly considered the FOLFOXIRI-B course in patients who still needed surgery, younger patients and patients with a more aggressive cancer. The patients who did not opt for it were given another, less effective, course of treatment. Many oncologists (at least half) were not well aware that the cure was in the guideline, so there was still room for improvement, the researchers said.
Officially, doctor and patient make that choice jointly, but one of the researchers remarked in de Volkskrant that the oncologists must have been freely guiding in the conversation with the patient. There is room for improvement there too, because medical organizations have just started a campaign to make medical decisions together.