Cancer survivors follow doc's orders

NEW YORK Fri Nov 19, 2010 8:04am EST

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NEW YORK (Reuters Health) - People who have participated in clinical trials and survived colon cancer are generally better at keeping up with regular cancer screening and other health recommendations, new study findings suggest.

Specifically, survivors more often than cancer-free people had a usual source of healthcare, had received a recent flu shot and got regular cancer screening such as Pap smears, mammograms, and a blood test to check for prostate cancer.

These findings are not surprising, study author Dr. Hiroko Kunitake at Massachusetts General Hospital told Reuters Health. But it may not be a diagnosis of cancer per se that motivates them to stay healthy, she added.

All of the cancer survivors had been enrolled in a clinical trial -- and to get there, they needed to have health insurance and a doctor who encouraged them to try it, Kunitake said.

People who participate in clinical trials also are typically quite motivated, organized and able to navigate a complicated healthcare system, the researcher added. So they might be extra likely to follow doctors' orders about staying healthy, too.

However, even though cancer survivors were better at keeping up with regular screening than people who hadn't had the disease, many still failed to schedule important screenings and flu shots.

"Even though patients do better than the general public, they still are not 100 percent," said Kunitake, whose findings appear in the Journal of Clinical Oncology.

And if this particularly motivated group of cancer survivors isn't keeping up with regular screenings, other survivors "on the opposite spectrum" are likely doing even worse, Kunitake said.

To investigate how well cancer survivors keep up with recommendations about regular screenings, Kunitake and her colleagues reviewed surveys from 708 people who had participated in clinical trials and lived for at least five years after getting sick, along with more than 2,000 people who had never had cancer.

They found that two-thirds of female survivors had received a Pap smear and more than 80 percent a mammogram within the last year. Among those who had never had cancer, only 55 percent had gotten a Pap smear, and 71 percent a mammogram.

Nearly 85 percent of male survivors had received a blood test to check for prostate cancer within the previous year, versus less than 75 percent of those without cancer.

Last month, another study appearing in the same journal found that being part of a clinical trial doesn't guarantee better cancer treatment.

Kunitake explained the new study provides no insight into the benefits of clinical trials themselves, because patients were likely health-conscious and motivated to begin with, and that's why they entered a clinical trial.

However, Dr. Craig Earle at the Institute for Clinical Evaluative Sciences in Ontario, who reviewed the paper for Reuters Health, said there's reason to suspect that people who enter clinical trials might become healthier as a result.

"While there is controversy about whether participation in a clinical trial leads to higher quality care for the phase of care being tested, it does usually result in more medical attention," he said in an e-mail. As a result, "participating in a trial and surviving cancer may turn out to be a good thing for them in the long run."

And simply receiving a diagnosis of cancer may be enough to encourage some people to keep better tabs on their health, Earle added.

"Individually, a health scare like a cancer diagnosis may make patients realize their vulnerabilities and resolve to be more proactive in other areas of their health."

SOURCE: link.reuters.com/xuq26q Journal of Clinical Oncology, November 15, 2010.

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