Patient knowledge of health information influences cancer treatment

A new analysis finds that when colorectal cancer patients seek out health information from the internet and news media, they are more likely to be aware of and receive the latest treatments for their disease. Published in the April 1, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that patients can influence their own treatment, in some cases in inappropriate ways.

In their review, authors led by Stacy Gray, M.D. of the Dana-Farber Cancer Institute in Boston note that in the last several decades, patients have become more involved in their health care as patient autonomy has become increasingly important. That change has been accompanied by unprecedented growth in the amount of health information available to patients. Studies show nearly four out of ten of cancer patients seek cancer information on the internet. But the authors say it is unclear how these phenomena influence a cancer patient's treatment.

Dr. Gray and colleagues from the NCI Center of Excellence in Cancer Communication Research at the University of Pennsylvania Annenberg School designed a study to examine the relationship between information-seeking among 633 colorectal cancer patients chosen at random from the Pennsylvania Cancer Registry and the use of novel new agents for the disease.

The investigators focused on the use of the targeted therapies bevacizumab (Avastin) and cetuximab (Erbitux) because of these drugs' clinical importance, significant media coverage, and recent approval by the U.S. Food and Drug Administration.

Dr. Gray and her team hypothesized that there would be a relationship between information seeking and awareness of these targeted therapies among colorectal cancer patients. They also hypothesized that patients who seek information may ask their physicians about these targeted therapies and may be more likely to receive them than patients who do not seek information.

The researchers found that high levels of information seeking were strongly associated with both awareness of and receiving treatment using targeted therapies. Patients who sought information about treatments for colorectal cancer were 2.83 times more likely to have heard about targeted therapies and 3.22 times more likely to have received targeted therapies than people who did not seek information. These associations were present for patients with advanced disease where use of targeted therapies is FDA approved as well as for patients with early stages of the disease where their use is not FDA approved.

"These findings emphasize the importance of exploring patient influence on physician prescribing patterns and understanding the impact of information seeking on cancer outcomes," the authors write.

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Article: "Colon cancer patient information seeking and the adoption of targeted therapy for on-label and off-label indications." Stacy W. Gray, Katrina Armstrong, Angela DeMichele, J. Sanford Schwartz, and Robert C. Hornik. CANCER; Published Online: February 23, 2009 (DOI: 10.1002/cncr.24186); Print Issue Date: April 1, 2009.