Polypharmacy and cancer

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Published: 22 Nov 2016
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Dr Holly Holmes - University of Texas, Houston, USA

Dr Holmes speaks with ecancertv at SIOG 2016 about her thoughts on polypharmacy and the overuse of medication, supplements and vitamins, particularly in cancer therapy.

She also discusses her perspective of SIOG and why she recommends the conference to others.

This service has been kindly supported by an unrestricted grant from Merck/MSD.

There’s really a critical mass of people here in SIOG actually who are really interested in polypharmacy and it’s an issue that’s under-studied in cancer. I think it’s of particular interest in cancer with over-medication, over-use of medications and then the concern that that could expose people to additional risks, particularly when they are about to start cancer therapy and get additional supportive medications. I have always been interested in supplements and vitamins because of their overuse in the population. I’m sure that this is a global developed country phenomenon but particularly in the United States that a lot of patients divert their energy toward healthy living onto taking a supplement and it would be wonderful if there were a pill that really made us healthier instantly. There are medications that help people prevent and delay the progression of chronic disease but vitamins are not one of them. I spend a lot of time railing against the vitamins.

Could you talk a little on how repurposing drugs is affecting treatment?

Statins, aspirin, multiple drugs like that and, arguably, while they have side effects NSAIDs, anti-inflammatories, lots of medications have additional benefits that we do take advantage of but none of these have a really very, very strong, significant effect. To then look at vitamins and supplements, not only have they not panned out, they have been negative in some studies. Certainly, the effect of taking a supplement as opposed to regular exercise and healthy diet, it’s just not comparable. I would so much rather that somebody focus on diet and exercise.

Could you talk a little on your presentation at SIOG this year?

It was actually really exciting that Young SIOG invited me to talk. I haven’t really been involved in Young SIOG events, I’m not Young SIOG. One of the reasons I think that they invited me was that I have bounced around a bit in my career. I also have taken a faculty position that I’ve left after a year, so that’s an experience that I think I can share some of the pearls of wisdom that I have learned from the good and the bad. I used that session to talk about negotiation in one’s career, particularly for certain jobs and how to evaluate whether a job is meeting your career needs.

What has been your impression of the conference?

I am always recommending to geriatricians that they consider a career focusing on oncology patients. I am often recommending to oncologists they consider in their career to focus on geriatric patients. One of the many things that I tell people is there are only so many people in the world who even do this. We get together every year in late October early November and it’s the 450 people in the world who are the most expert at this, who are really generous with their time and who will promote, support, mentor, sponsor, do all of those kinds of things to help your career. You immediately have an international group of colleagues, which for people in academic medicine is critical to promotion and tenure. Just being very pragmatic about it, it’s an excellent choice if people are so inclined.

SIOG has been really helpful to me and it’s also helped me stay connected to the geriatric oncology world even though I moved over from MD Anderson over to the medical school. Now I am the only geriatrician who does oncology kind of work where I am. It’s 0.7 miles from MD Anderson and I am still very connected to them but actually I feel much more connected through SIOG than anything else. You can’t go to ASCO and find senior people who are easily available, ready to talk to you about how to do your research, how to improve your clinical work, how to get promoted, how to do the things that you want to do. SIOG is really generous in that way and unique.