[dropcap]A[/dropcap] Washington Post article about the growing trend to de-escalate the severity of some cancer treatment regimens features University of Pennsylvania Associate Professor of Radiation Oncology Justin Bekelman.

Bekelman, MD, is Director of the Penn Center for Cancer Care Innovation at the Abramson Cancer Center, a Senior Fellow at the Leonard Davis Institute of Health Economics (LDI), and a recent recipient of the 2018 American Cancer Society Cancer Control Award.

[content_elements:element:0]New therapeutic insights
Authored by Health & Medicine reporter Laurie McGinley, the Washington Post story explores how new biological insights, improved therapies and rapidly advancing genetic tools are revolutionizing how some cancers are being diagnosed and treated in “softer,” less toxic and physically traumatic ways. 

It’s a sea change in thinking from the medical traditions that have long viewed any cancer as an enemy against which the most intense kinds of chemical and radiological battles must always be waged.

“Our focus historically on the ‘war on cancer’ implied that more is better and decimation is desired,” Bekelman told the Post. 

‘De-escalating’ some treatments
At the root of this changed thinking, the newspaper reports, “is the recognition that not all cancers are the same: Some need to be bludgeoned, but others can be treated with more tailored therapies or simply watched. Equipped with new tools and evidence, oncologists are ‘de-escalating’ — cutting back on toxic and costly approaches likely to do more harm than good. “

“Knowing when not to treat is great medicine,” Bekelman told McGinley.

Some of the cancer types that are now recognized at potential candidates for these milder therapeutic approaches are early stage prostate cancers, throat cancers, certain varieties of lung and kidney cancers. But other forms of the disease, like pancreatic cancer, are so lethal and fast moving that oncologists are using even more aggressive therapies in their treatment plans.

The article emphasizes that identifying patients for less-intensive therapies is critically important and that many kinds of cancer still do require aggressive forms of chemotherapy and/or surgery.