Doctors often give obese patients less chemotherapy by not adjusting the dose to the person’s size, but instead use an ideal weight or cap the dose from fear of over-treating such patients, though research shows bigger people handle chemo better than smaller people, according to a report by the Associated Press.
 
Studies show that up to 40% of obese cancer patients have been getting less than 85% of the right dose for their size, the report says. Under treatment can result in higher mortality for such patients with all types of cancer, including breast, colon, lung, ovarian and leukemia. An August paper published in Nature said a 20% reduction in doses lowered remission and cure rates by half in animals, while increasing tumor resistance to the drugs.
 
Sometimes physicians give lower doses for good reasons, the report notes. Chemo treatments are complicated for obese patients with other diseases like diabetes or heart problems, for example. Typically, however, doctors are afraid that following the weight-based formula can make some doses so high they may harm the heart and blood system.
 
The American Society of Clinical Oncology has adopted guidelines advocating for full, weight-based doses for the obese.
 
For more on physician best practices, turn to Part B News.