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Docs generally following cancer patient guidelines

Chang, who studies colorectal cancer at MD Anderson Cancer Center in Houston and was not involved in the new research, said it was noteworthy that so few patients had enough nodes removed -- 12, for colon cancer -- to meet the guidelines in this study. He said that may be in part because the surgery isn't a yes or no call, like the decision to refer a breast cancer patient for chemotherapy.

But Chang also added that in the years since this data was collected, studies have shown that doctors are getting better at following colon cancer guidelines.

Still, when it comes to cancer surgery, Greenberg said, "we don't yet know for sure what the right thing is to do in all cases." She said more data is needed to make that clearer.

Previous studies have suggested that doctors may give some people with cancer or other diseases tests and treatments beyond what guidelines suggest. One found, for example, that too many patients with low-risk thyroid cancer are treated with radioactive iodine -- only recommended for higher-risk tumors, in part because it may carry a risk of secondary cancer (see Reuters Health story of April 15, 2011.)

"We do need to improve the quality of evidence," Chang told Reuters Health. "I think the question becomes how much more evidence is necessary" for doctors to be confident about following guidelines. "That's always the challenge."

"The most important thing I think is to talk to your physicians about why they're recommending the treatment they're recommending," Greenberg concluded, "and to make the decision together."

SOURCE: http://bit.ly/iVCofL Archives of Surgery, online June 20, 2011.

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