Chemotherapy Holiday

In the past, a diagnosis of cancer was considered a death sentence. With the progression of medical technology and cancer research, many cancers are curable and many others are incurable, but survivable. In many, their disease is considered to be stable and not an immediate threat to their lives (progression-free survival). Many may deemed this as having a "chronic" disease as those in this position will likely be on some form of therapy for the rest of their lives. With such long-term treatment possible, a "chemotherapy holiday" may become a necessity in an attempt to balance quality of life and the toxicities of chemotherapy.

A chemotherapy holiday may be defined as  a complete break or a chemotherapy free interval (intermittent therapy). A chemotherapy holiday will more than likely lead to an improvement in the quality of life, a possible reduction or cessation of side effects, and complications, but there is also a risk of relapse or recurrence.Studies have shown that there is no difference in the survival rates in those who take a chemotherapy holiday, but there is an improved quality of life versus those who do not take the chemotherapy holiday.

We must all understand that each situation is unique and the individual must consider their condition, the risks, and the benefits in making a decision regarding a chemotherapy holiday.

Unfilled Prescriptions

A study done by the Journal of General Internal Medicine shows that a significant number of prescriptions go unfilled. In this study, researchers found that among more than 75,000 Massachusetts patients given drug prescriptions over one year, 22 percent of the prescriptions were never filled. The rate was even higher -- 28 percent -- when the researchers looked only at first-time prescriptions.

Letting prescriptions go unfilled is called "non-adherence." Such "non-adherence," the study found, was common even among patients prescribed drugs for chronic conditions that can have serious health consequences.

The big question is why?  Exactly why many patients did not fill their prescriptions is unclear, but several reasons are possible.

1. The patient does not know why they are taking the medication
2. The patient's condition does not cause any symptoms
3. The patient cannot afford the medication(s)
4. The patient has concern about side effects
5. The patient doesn't want to take any medications

When health problems cause few or no symptoms -- as with high blood pressure or high cholesterol -- people may not see the need for a medication. Although there are many diagnoses that have no symptomotology, your disease is causing damage. When symptoms do occur, it will be more difficult to control and treat.

"If they do not fully understand the reason that they are being prescribed the medication, they may be less likely to take it," lead researcher Dr. Michael A. Fischer, of Brigham and Women's Hospital in Boston, told Reuters Health.  If you don't know why you are taking a medication, ask your doctor. It is our job to educate you about your diagnosis and advise you regarding all treatment options.

Cost could also be an issue, Fischer added -- particularly when people are unsure of why a drug is being prescribed.   All of the patients in the study had health insurance. But even with coverage, people may have high co-payments for medications or may be prescribed a drug not covered by their plan, Fischer and his colleagues note.

No matter what the reason, patients should not hesitate to talk with their physicians regarding their concerns. We especially need to know if you encounter side effects.

What's really scary about this study, though, is that these numbers reflect the behavior of people with health insurance (Massachusetts has a 97 percent insured rate). The numbers are undoubtedly higher among the uninsured.

Check out Trisha Torrey's blog as she takes the patients perspective. She gives the patient's responsibilty regarding prescriptions.