Doctors Often Miss Side Effects Of Radiation Treatment For Breast Cancer: Study

The findings of a new study suggest doctors often miss side effects of radiation therapy, which afflict patients undergoing cancer treatment, particularly among those who are younger or Black.

Researchers from the University of Michigan found a tendency among doctors to lowball the severity of symptoms of radiation therapy in those two groups, resulting in a failure to diagnose their level of pain, as well as signs of fatigue and swelling. Their findings were presented at the San Antonio Breast Cancer Symposium on Wednesday, according to a press release issued by the symposium on December 9.

The study is considered preliminary until published in a peer-reviewed journal.

Radiation therapy involves exposing cancer cells to radiation which damages their DNA. If the radiation damages the cells enough, they eventually stop dividing into new cancer cells and die, after which they are disposed of by the body’s natural regenerative processes. However, the radiation often kills other, healthy cells as well, which can lead to pain, fatigue and other symptoms.

Oncology specialists attempt to fine tune the procedure to damage as few healthy cells as possible, and often the healthy cells can repair the damage caused by radiation exposure.

In this latest study, researchers looked at data on nearly 10,000 breast cancer patients who underwent radiation therapy after lumpectomy. The patients were treated at 29 practices throughout the state of Michigan.

Of those patients, more than 5,500 reported suffering at least one significant side effect of radiation therapy, and 53% reported doctors were unable to recognize either pain, itchy skin, swelling or fatigue.

The researchers found doctors underestimated symptoms in Black patients at a rate 92% higher than in white patients. They underestimated side effects in other minorities, except Black or Asian, at a rate 82% higher than they did white patients.

There have been numerous studies over the years about how bias, historic mischaracterizations of Blacks and racism consistently result in doctors unconsciously believing Black patients have a higher pain tolerance or do not feel pain the same way as white patients.

In 2016, researchers from the University of Virginia found African Americans were routinely under-prescribed pain medications, and white patients were often over-prescribed those same drugs. Their findings showed that Black patients in the U.S. received pain treatment that fell below guidelines established by the World Health Organization.

The researchers also found age was a factor, with patients younger than 50 35% more likely to have their radiation side effects go unrecognized.

“Physicians sometimes miscalculate the severity of patients’ symptoms, which can lead to reduced quality of life, Dr. Reshma Jagsi, the Newman Family Professor and deputy chair of the Department of Radiation Oncology and director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan, said in the press release. “In our study, we found that physicians are more likely to miscalculate symptom severity when patients have certain characteristics, including patients who are younger and patients who are Black.”