Two recent studies from the University of Rochester suggest that women receiving adjuvant chemotherapy for breast cancer can tolerate full doses of treatment based on body weight or surface area. They also found that such women had better outcomes based on the full weight adjusted dose rather than the reduced dose often prescribed.
Interestingly, overweight or obese women were also less likely to be hospitalised with febrile neutropenia (fever) than women of normal weight.
These findings have important implications for treatment because of the number of overweight and obese individuals in the US.
There is a wide individual variability in metabolising drugs so these studies go some way towards better optimisation of therapy for larger women. There are some circumstances where dose reduction is, however, appropriate such as when the drug causes excessive toxicity.
Patients should certainly be partners with their doctors and actively participate in the treatment decisions. It is also a good idea to ask whether a doctor is adjusting doses, especially when talking about curable diseases, and if they are…. why or why not?