Researching the obvious: It stinks to have cancer

December 11, 2013

Being poor stinks. Having cancer really stinks. You probably can’t do worse than being poor and having cancer.  

That seems so obvious, I’m not sure why anyone needs a study to confirm it.  But researchers actually looked that this problem and found exactly what anyone might expect: Breast cancer patients with higher incomes were more likely to receive care that followed the guidelines set by the National Comprehensive Cancer Network (NCCN) than patients with lower incomes. 

The NCCN is an alliance of 23 of the world’s leading cancer centers that has put together treatment guidelines that are widely recognized and used as the standard of care.

Specifically, researchers found that breast cancer patients with an annual family income of more than $90,000 were twice as likely to receive care that followed the NCCN guidelines for radiation, compared with those whose with incomes below $50,000. 

The study looked into disparities in chemotherapy treatments, too. It found that lower income patients were almost five times as likely to receive care that did not follow NCCN guidelines for chemotherapy to treat their breast cancer. Again, not very surprising.

These and other findings came from a field of health research called disparity studies. They touch on an important topic — how poverty and other economic factors can make a difference in access to health care. 

But at a time when there are so many vital questions to ask, and research budgets everywhere are under attack,  I wonder why well-meaning researchers pick such obvious questions to ask. 

Why are there so many obvious studies? Is it easier to get funding? Are they cheaper to execute? Is the bar lower? Or, am I just being too critical and harsh? After all, I am a stage 4 lung cancer patient who’s anxious for answers. I want someone to find a cure already! 

I asked Dr. Harlan Krumholz, a Yale physician whose research focuses on improving patient outcomes and health system performance. He is a big wheel in the world of medical research: director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation and the director of the Robert Wood Johnson Clinical Scholars Program at the Yale University School of Medicine.

As far as I know, Krumholz is not sick and he agrees with me. He says that when it comes to medical studies, the pressure may be to produce volume over value. 

“High value articles often take patience and resources, both of which may be in short supply by institutions that employ investigators,” Krumholz tells me. 

“But the biggest problem may be a research culture that is not often enough asking itself whether the information it produces truly has value for others and will contribute to better lives for patients and the public,” he adds. 

The breast cancer treatment study was presented at the American Association for Cancer Research Cancer Health Disparities special conference in Atlanta this past week.

To be sure, there were some important studies presented in Atlanta that would seem to advance cancer care and address health disparities.

One such study looked at potential biological factors contributing to racial disparities in prostate cancer incidence and mortality between African American and non-Hispanic white men in the United States. Another examined the genetics of an inherited predisposition to breast cancer. A third looked at genetic alterations to a specific gene family that may be responsible for survival disparities seen between African-American and non-Latino white men with head and neck cancer.

These strike me as potentially useful to patients.

But there still are far too many obvious studies, in my view. And they are everywhere you turn. 

Scientific American published a list, of the 12 most obvious scientific findings in 2012. According to that list, someone actually spent time and money to determine that calling an ambulance improved heart attack survival. Someone else conducted a study that discovered, amazingly, that smoking pot can make your mind fuzzy. 

With research dollars so hard to come by these days, it seems more important than ever that the medical research community take a critical look at what questions need to be asked and answered in order to best serve patients. 

Follow me on Twitter   @DLSherman


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I agree 100%! Telling us the obvious about the most-publicized cancers (the same ones that seem to attract the most charity dollars as well!) is a WASTE of money…. those funds could be better allocated to support research for other cancers that apparently suffer because of stigma or lack of connection to our sexuality. You’ve ask that question before, but it’s still valid: why does breast cancer gets so much research funding while other cancers do not?

Posted by debussy | Report as abusive

Do we really need all these “awareness” campaigns either? Don’t we already know lots of people have (breast, prostate, lung, etc.) cancer?

Could these studies be because someone needs a job?

Always go back to the sponsor of the study. Chances are there is most likely a reason it was studied. If it will help sell something (anything), it will be “studied”.

I’m sure there was something that needed to be PROVEN regarding the low income/off protocol cancer treatment studies. Perhaps big pharma would like the government to step in and REQUIRE everyone to get the same standard protocol treatment? In some veiled attempt, the goal is to force everyone to get the same standard of care, regardless of bio individuality. Who holds the patents to these standard protocols?

Isn’t this what the current health care mandate is all about? Everyone getting the same insurance/treatment? Why does my 66 year old sister in law need pregnancy and pedaetric care? Not to go totally off subject but the absurdities just keep coming.

Lastly, in these studies regarding low income/standard protocol, was anything reported on or correlated about actual outcomes of patients? Were they any better for those that did not get the “standard care”? Maybe that’s not what the study was about but were those statistics even mentioned? I, for one, would like to know what was gleaned from the study, other than the obvious.

Some study hypotheses do not even correlate to what was actually proven in the study. How far do most people read? Do we require any third party (perhaps the FDA) to interpret actual results or do we just go with the “hypothesized” goals?

Business as usual comes to mind.

Posted by healthylivingtc | Report as abusive

I agree Debra. It stinks to be poor and it stinks to have cancer. Victims with low income should not suffer due to lack of money for treatment.

Posted by chrisparas | Report as abusive