Doctors often unfamiliar with long-term chemo risks

Wed May 16, 2012 6:52pm EDT

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* Few doctors could name main risks from common drugs-study

* US survey shows need for better primary doctor education

By Julie Steenhuysen

CHICAGO, May 16 (Reuters) - Many of the 12 million Americans who have beaten cancer get routine care from primary care doctors, but a new survey suggests the vast majority of these physicians have very little knowledge about the long-term side effects these patients face.

The survey of more than 1,000 primary care doctors - internists, family practitioners and gynecologists - found that few were aware of the key side effects such as heart problems, nerve damage and early menopause caused by four standard chemotherapy drugs used to treat breast and colorectal cancers.

The findings, released on Wednesday ahead of the American Society of Clinical Oncology (ASCO) meeting next month, underscore the need for better communication between cancer specialists and primary care doctors.

"This is really a problem created by our successes," Dr. Michael Link, president of ASCO, told reporters by telephone.

Link said the 12 million U.S. survivors of cancer are largely the result of better cancer treatments, but these survivors now return to their primary care physicians, who may not know what risks these patients face.

For the study, Dr. Larissa Nekhlyudov of Harvard Medical School surveyed 1,072 primary care doctors and 1,130 cancer specialists by mail in 2009.

The doctors were asked which of five side effects they had observed most often in their practices or seen reported for each of four widely used chemotherapy drugs: doxorubicin, paclitaxel, oxaliplatin and cyclophosphamide.

The researchers found that only 6 percent of primary care doctors were able to identify the main long term side effects of all four of the chemotherapy drugs, compared with 65 percent of oncologists.

That finding was not a surprise, Nekhlyudov said, but it underscores the need for better communication between cancer specialists and primary care doctors.

"It is clear there is a lot of work to be done," Link said.

He said patients need to be given treatment summaries and guidelines to give to their doctors for follow-up care.

The findings also make a strong case for electronic medical records, Link said, which would give primary care doctors access to patient history of the drugs they have taken and might even give warnings about their side effects.

"Obviously, education of primary care physicians is essential, but we need to be aware of the needs of our survivors so the ball does not get dropped," Link said.

For more stories on the ASCO meeting, click. (Reporting By Julie Steenhuysen; Editing by Tim Dobbyn)

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