Study: Less treatment for some brain cancers

CHICAGO — A major study could change care for many of the hundreds of thousands of people each year who have cancer that spreads to the brain from other parts of the body. Contrary to conventional wisdom, radiation therapy to the whole brain did not improve survival, and it harmed memory, speech and thinking skills, doctors found.

“This is the classic question: Which is worse, the disease or the treatment?” said one study leader, Dr. Jan Buckner of the Mayo Clinic. Radiation helped control the cancer, “but at the cost of cognitive decline.”

For patients, the study is not necessarily the bad news it may seem. It shows that in this case, quality of life is better with less treatment, and many people can be spared the expense and side effects of futile care.

It was one of three studies discussed Sunday at an American Society of Clinical Oncology conference in Chicago that question long-standing ways that patients are treated. A study found that removing lymph nodes when oral cancers are first diagnosed — not routinely done now — dramatically improves survival. Another found the opposite was true for people with the skin cancer melanoma that had spread to a few lymph nodes.

The first study affects the most patients by far. An estimated 400,000 patients in the U.S. each year have cancer that spreads to the brain, usually from the lungs, breast or other sites. That is different from tumors that start in the brain, like the one that killed Joseph “Beau” Biden III, the vice president’s son.