Researchers Develop Guidelines For Treating Side Effects To Cancer Therapy
New York, NY May 2001 -- An international group of researchers who met at Columbia in late April is developing guidelines widely applicable for the use of antinausea medications for cancer treatment’s side effects. A lack of practical, clear guidelines has led many physicians to use cumbersome or less effective strategies. Often, patients are over- or undertreated with medications for this purpose. The group is presenting its initial findings on Monday, May 14, at the American Society of Clinical Oncology (ASCO) annual conference in San Francisco. Cancer treatment with chemotherapy can produce side effects such as nausea and vomiting, which patients rate as most distressing. Studies published in the past few years report effective and simple ways to ease these problems. But many patients aren’t receiving the full benefit of these findings, said Dr. Richard J. Gralla, M.D., chairman of the research group and president of the Multinational Association for Supportive Care of Cancer. Dr. Gralla is also Director of Clinical Research at the Herbert Irving Comprehensive Cancer Center at Columbia. “Six worldwide organizations have created guidelines for helping doctors and nurses prevent these side effects. Each set was similar, but not identical. The role of this group was to try to pull these guidelines together” into one set of straightforward, accurate guidelines that work for most patients, Dr. Gralla explained. The group also aims to develop ways to make the guidelines internationally available using web pages, translations, or pocket cards. This way, “any doctor or nurse around the world would be able to use this easily, to get the maximum potential benefit,” said Dr. Gralla. At the ASCO meeting, the researchers will present preliminary information on the guidelines under development. The group plans to report that several anti-nausea and anti-vomiting medications, used properly, are particularly effective. These can usually be taken in a one-time dose of pills on the day of chemotherapy, Dr. Gralla said. “That is very different from the standard practice even a few years ago,” when doctors usually prescribe medications intravenously and several times daily, he explained. Taking oral medications regularly for a few days after chemotherapy also usually prevents another problem called delayed nausea. The three medicines that most effectively control the side effects are dolasetron (trade name Anzemet), granisetron (Kytril) and ondansetron (Zofran). These work best when given in combination with dexamethasone, a drug related to the hormone cortisone. The research effort, chaired and organized by Columbia and supported by the Multinational Association for Supportive Care of Cancer, is unusual in that it’s collaboration of physicians, nurses, and pharmacists from institutions in the United States, Canada and Europe.