Cancer and Chemo – not such a good mix

 Below is a copy of a PubMed publication abstract from Clinical Oncology that reveals a study shoeing that the efficacy of a chemotherapy regimen increases the 5-year survival rate by one 2.1%. This leads me to think of some questions and statements:
 Cancer and Chemo - not such a good mix
  • Why was this study ignored?
  • Why isn’t your oncologist addressing this?
  • If an alternative approach to ANYTHING was proven to only increase disease survival by 2.1% it would be bashed on every major network as frontline news.
  • Are the side-effects of chemo enough to overturn the chance of a 2.1% benefit?
  • When chemo destroys the immune system and INCREASES the risk for metastasis, is the 2.1% benefit negated?
  • Maybe listening only to one side of the profession (standard oncology) isn’t such a good idea.
  • I believe that a wise person once said

The study concluded that overall,

chemotherapy contributes just over 2 percent to improved survival in cancer patients.

Yet despite the mounting evidence of chemotherapy’s lack of effectiveness in prolonging survival, oncologists continue to present chemotherapy as a rational and promising approach to cancer treatment.

“Some practitioners still remain optimistic that cytotoxic chemotherapy will significantly improve cancer survival,” the authors wrote in their introduction. “However, despite the use of new and expensive single and combination drugs to improve response rates…there has been little impact from the use of newer regimens” (Morgan 2005).

Cancer and Chemo - not such a good mixThe Australian authors continued: “…in lung cancer, the median survival has increased by only 2 months [during the past 20 years, ed.] and an overall survival benefit of less than 5 percent has been achieved in the adjuvant treatment of breast, colon and head and neck cancers.”

The authors point out that the similarity of the figures for Australia and the US make it very likely that the recorded benefit of 2.5 percent or less would be mirrored in other developed countries also.

The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies.

Clin Oncol (R Coll Radiol). 2004 Dec;16(8):549-60., Morgan G1, Ward R, Barton M.

Abstract

The debate on the funding and availability of cytotoxic drugs raises questions about the contribution of curative or adjuvant cytotoxic chemotherapy to survival in adult cancer patients.

MATERIALS AND METHODS:

We undertook a literature search for randomised clinical trials reporting a 5-year survival benefit attributable solely to cytotoxic chemotherapy in adult malignancies. The total number of newly diagnosed cancer patients for 22 major adult malignancies was determined from cancer registry data in Australia and from the Surveillance Epidemiology and End Results data in the USA for 1998. For each malignancy, the absolute number to benefit was the product of (a) the total number of persons with that malignancy; (b) the proportion or subgroup(s) of that malignancy showing a benefit; and (c) the percentage increase in 5-year survival due solely to cytotoxic chemotherapy. The overall contribution was the sum total of the absolute numbers showing a 5-year survival benefit expressed as a percentage of the total number for the 22 malignancies.

RESULTS:

The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.

CONCLUSION:

As the 5-year relative survival rate for cancer in Australia is now over 60%, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival. To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.