End Size Discrimination in Cancer Treatment

Target: American Society of Clinical Oncology

Goal: Commend ASCO for working to ensure that patients receive an accurate, weight-based dosage of chemotherapy drugs

Statistics show that obese people are less likely to survive cancer, but it has little to do with their actual weight. When it comes to chemotherapy for treating cancer, applying the correct dose is essential. But studies over the last few years have found that as many as 40 percent of obese cancer patients receive less than 85 percent of their correct dose. Oncologists agree that under-treatment of obese patients is contributing to higher mortality rates from cancer. Luckily, the American Society of Clinical Oncology has recently set new guidelines to ensure accurate, weight-based doses for all patients.  Commend this organization for working to end size-bias among the medical community and reduce cancer mortality rates.

While doctors generally have the patient’s best care in mind, they are often hesitant to administer appropriate doses to obese patients. The dose may seem unusually high, making them afraid of potential harm to the heart and circulation. However, heavier individuals actually suffer fewer negative side effects from chemotherapy than do the thin. They are less likely to develop low-blood levels because the drugs exit their system more rapidly.

Reducing a patients’ chemotherapy dose by even a little can greatly reduce his or her odds for survival. Research suggests that under identical forms of treatment, normal weight and obese people have a similar likelihood of recovery. But inadequately low doses of chemotherapy will decrease rates of remission and may even cause tumors to develop resistance to the drugs.

Past studies have established that the medical community as a whole discriminates against overweight patients. Heavier individuals are more likely to be denied insurance, turned away from surgeries, misdiagnosed, or rejected by fertility doctors. This is a problem in itself. That oncologists are not following a weight-based formula to determine patient’s doses is a separate issue, and one more easily fixed. Applaud the American Society of Clinical Oncology for establishing new guidelines to ensure that all cancer patients receive equal treatment.


Dear American Society of Clinical Oncology,

I am writing to thank you for establishing new guidelines to ensure that all cancer patients receive an appropriate dosage of chemotherapy drugs. As obesity continues to be one of America’s greatest health problems, size discrimination is on the rise. It is pervasive even among healthcare providers, who should ideally remain unbiased and objective. A University of Pennsylvania study found that more than half of primary-care doctors attributed negative characteristics to their obese patients. Sexism plays a role too. Size discrimination affects women disproportionately. Prejudice from doctors is often present when a woman is as little as 13 pounds above her “ideal” weight range. Male patients aren’t discriminated against until they are at least 75 pounds overweight.

Unfortunately, doctors are approaching the problem of obesity in a poor fashion. Rather than work to understand patients’ struggles and unique problems, many doctors slam the door on obese individuals, signaling to the patient that he or she is a lost cause. Doctors, who make it their life’s work to preserve people’s health, can’t hope to solve the problems of obesity by ignoring them altogether. Much of the harmful bias is cultural and individual, but some comes from flaws built into the institution. Luckily, these are easier to fix.

Inadequate dosing of chemotherapy drugs for obese patients is one such example. While it’s unfortunate that obese individuals are more likely to develop certain forms of cancer, it’s extremely unfair that these people are also more likely to die from them simply because of a small medical mistake. Doctors have their patients’ best care in mind, but ultimately administer too little a dose because of inadequate information. Setting accurate, weight-based guidelines for the administration of chemotherapy drugs will correct this problem and save many lives. Thank you.


[Your Name Here]

Photo credit: Bill Branson via Wikimedia Commons

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