A recent study published in the Lancet has investigated the effects of starting chemotherapy on patient survival, according to the UK Government website.

It was found that many factors can influence survival rates following the start of chemotherapy, including weight, disease progression, age, and general wellbeing.

The large-scale observational study examined the 30-day mortality rates of patients from the start of their chemotherapy treatment. Researchers used the records of patients with breast cancer or the most common form of lung cancer that were using the National Health Service (NHS) for their treatment. Almost 25,000 patients were involved in the study, all of which were treated in England in 2014.

The study, carried out by Cancer Research UK and PHE, found that the thirty-day mortality risk was higher for patients receiving palliative chemotherapy designed to improve quality of life, rather than curative chemotherapy. In total, 720 lung cancer and 569 breast cancer patients receiving palliative chemotherapy and included in the study died within thirty days of beginning their treatment. The numbers were lower for patients receiving chemotherapy as a cure: 41 people with breast cancer and 53 with lung cancer. One doctor involved in the study, Dr Jem Rashbass, said that chemotherapy is essential for treating cancer, and is one of the main causes of the increased survival rates seen over the last 40 years. However, he said, it also has strong side effects and

“getting the balance right on which patients to treat aggressively can be hard.”

He emphasised the importance of studies like this one to help doctors understand where the best balance for patients is.

The study also found that peoples’ individual circumstances play a role in the 30-day survival rate after starting chemotherapy. According to the study, patients who were older and those with a more advanced stage of cancer were more at risk, particularly if they suffered from other illnesses.  A low body mass index (BMI) was also associated with an increased risk. There was also a correlation between patients undergoing chemotherapy for the first time and increased mortality.

The nature of the study makes it difficult to draw causative links; the patients were only observed, so the most that can be said is that there is an association between the factors, not that one necessarily caused the other. However, the study is suggestive that certain factors increase the risks of chemotherapy, and the study’s lead clinical author, Prof. David Dodwell, recommends that doctors and patients discuss them when making treatment plan decisions.

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