Chemotherapy - Does It Work?

[fullwhenempty]

I have mentioned this topic briefly on another tread but think it merits a topic of its own, where it is likely to be read.

Although the study was conducted a few years ago, I'd never heard anything about it in the mainstream media. This is quite a feat by them, considering the startling findings.

In short, a team of Australian Oncologists (Cancer specialists) conducted a meta-study of all the existing ORTHODOX studies covering the effectiveness of Chemotherapy treatment. http://www.ncbi.nlm.nih.gov/pubmed/15630849

What they concluded was the contribution of chemotherapy to overall 5 year cancer survival rates was approximately 2%. Full report here.. http://www.burtongoldberg.com/health-artic...rate-morgan.pdf

Not sure why they use 5 years. Presumably if you drop dead of cancer after 5 years and one day, they can still say you were 'cured'. Anything that helps bolster the numbers.

So. 2%. And this was casting the results in the best possible light. That rather marginal 2% could be accounted for just by the placebo effect. In the worst case, millions of people have been killed or damaged by toxic chemicals that should more appropriately be called 'weedkiller' than 'medicine'. I wouldn't laugh... http://www.guardian.co.uk/society/2004/sep...h.lifeandhealth

So what we have here is a system that says 98 people may suffer damage, or die, in order that 2 can survive for 5 years. Bearing in mind that there is no proof they wouldn't have survived anyway or longer. Please correct me if my logic is wrong. In what way is this better than less toxic natural or alternative methods which support the bodies own efforts to heal rather than stressing it further? Somebody step up to the plate and convince me.

It's actually scandalous. How did chemotherapy get such a foothold? The cancer industry will not allow Drs to suggest alternative methods. The 'burn', 'poison' and 'mutilate' option is all that has been allowed for 60 years despite the fact that by most independent measures, it's a failure.

No wonder they don't do comparative studies between their methods and alternatives. I wouldn't either.

So if I ever get Cancer and stand in front of the Dr and he says.. 'Well. You might live another 2 months but if you take the chemotherapy there is a 'good' chance we can extend it to 5 years. And by the way you will probably have to sell all your assets to pay for it, while we destroy your immune system and leave you open to all sorts of other consequences which we will 'treat' and charge accordingly. Please sign here.

'Good chance'? Not according to their own figures.

[Chonburiram]

Maybe there is a member who was healed/found alleviation through chemo?

The people I knew who had cancer died nevertheless from the cancer or suicide .

[Xangsamhua]

Couldn't access your first link: http%3A%2F%2Fredirect.php%3Furl%3Dhttp%253A%252F%252Fwww.ncbi.nlm.nih.gov%252Fpubmed%252F15630849

"Safari can't find the server."

Thanks for the other one (burtongoldberg).

[sbk]

Hmm. Lets see. My father had chemo after being diagnosed with malignant melanoma ten years ago. And yes, he's still kicking around at the age of 75.

My mother survived two separate bouts of breast cancer thanks to chemo. She was genetically prone to cancer so the third bout finally killed her but instead of dying at the age 42 she died at the age of 68.

Friend of mine from high school is alive 15 years after receiving chemo for cancer.

Gosh, maybe you should try going to a cancer survivors website first and ask them. See how ineffective they think it is.

[Sheryl]

It is misleading to talk as if the benefits of chemo are unifrom across all cancers and all stages of cancer.

There are some cancers which can be completely cured by chemo: this include leukemias, some lymphomas, ovarian cancer if caught very yearly.

Then there are cases where chemo is used in conjunction with surgery and/or radiation to effect a complete cure, and in some of those situations (again, it varies by type of cancer and stage) the addition of chemo significantly increases the chances of total cure or very long term remission.

Lastly (and clearly what is being discussed here) is the use of chemo as a palliatuive measure in metastatic cancers. A completely different situation. In that case, indeed the gains from chemo are usually measured in months, not years.

[Xangsamhua]

Hmm. Lets see. My father had chemo after being diagnosed with malignant melanoma ten years ago. And yes, he's still kicking around at the age of 75.

My mother survived two separate bouts of breast cancer thanks to chemo. She was genetically prone to cancer so the third bout finally killed her but instead of dying at the age 42 she died at the age of 68.

Friend of mine from high school is alive 15 years after receiving chemo for cancer.

Gosh, maybe you should try going to a cancer survivors website first and ask them. See how ineffective they think it is.

Fair enough, SBK, but anecdotal research and statistical analysis are two different things. You're right that the one should complement the other, and your experience of cancer survival post-chemo is right up there in front of you, in the flesh. However, unless the data cited by the OP is flawed then it is telling us something about the benefits or otherwise of chemo. Your sample of three people is helpful, but by itself is not a valid sample for generalizable findings.

[sbk]

I am generally quite wary of these kinds of posts, if you want the honest truth.

I would be curious if the OP can also come up with a survival rate for those who do not undergo any form of chemo.

It seems a tad disingenuous in the least to ignore the advances made in medicine in the more 7 years since the original report was made.

Perhaps something else to consider when looking at data, is exactly how old is it and what changes have occurred since they were made?

[Sheryl]

I have checked the original article.

1. It refers only to cytotoxic chemo, which is but one type of chemo (the type most often used in palliative situations)

2. It refers to the benefit obtained from chemo alone and does not pertain the to the situation where chemo is used in conjunction with surgery and/or radiation as part of an effort at complete cure.

3. It also refers solely to cancers in adults.

Cancer is not one disease, it is many, and these different diseases vary in their prognosis at various ttages and in what can be gained from chemo (which int turn, is different at different stages of the disease).

Asking "dies chemo work?" is akin to asking "does surgery work?" or "do antiobiotics work?" -- obviously the answer depends on thje situation in which it is employed.

That said, anyone considering chemo for cancer should insist ion knowing

1. Whether the cancer is potentially curable or whether the chemo is just palliative.

2. If palliative, on average how much longer does a person with cancer of this type and stage usually live as a result of chemo.

And then make an informed decision accordingly.

[fullwhenempty]

Gosh, maybe you should try going to a cancer survivors website first and ask them. See how ineffective they think it is.

Your 'Gosh' was sweet and it's of course reassuring to hear of positive stories. But your reasoning does sounds a little similar to "I know several people who smoked into their nineties". Therefore smoking is good for you. We know this to be true because..

"More Doctors Smoke Camels Than Any Other Cigarette"

Thank you for pointing out the advances that have been made since this report. Do you have any evidence of the success of these 'advances'? Considering cancer death rates show little sign of reducing, they may only be marginal. A friend's relative died recently and suddenly during chemo. Since there is no website for the % who die, they can't tell you how ineffective it is.

There are also no comparative studies done to show how conventional treatment compares to alternatives, such as the Gerson Therapy or Doctors using natural/herbal methods in Thailand such as this one.. http://www.bangkokpost.com/mail/19536/a-ch...tional-medicine He claims 40 years experience treating cancer. I have no idea with what degree of success but a Thai speaker may be able to enquire and find out.

Thank you Sheryl. Were you aware of this report or its findings and if you had not been would you have been able to make an 'informed' decision? In the real world do patients know? If the media don't publish, they have no choice but to place their trust in the Doctor. This is risky if the Doctor doesn't know and even if he does, he may, in any event, be forced to follow policy. Isn't this the case? Do Doctors actually have freedom to recommend unorthodox alternatives if a patient asks or do they face some kind of sanction/disincentive?

[hhgz]

"I have mentioned this topic briefly on another tread but think it merits a topic of its own, where it is likely to be read..."

So, what's your point? Living an extra day or month isn't worth anything to YOU?

I just read about a breakthrough prostate cancer vaccine that, on the average, extends a man's life by 4 months...and the 3 injections cost $90,000US.

Perhaps a small increase in either life span, or survival rate, isn't important to you. That's a decision you have to make personally.

[Sheryl]

Were you aware of this report or its findings and if you had not been would you have been able to make an 'informed' decision?

Not of this particular report, but of the efficacy of chemotherapy for different types of cancer and at different stages, yes. This is common knowledge and there is plenty of literature on it. One can easily find, in any medical text or online, the average survival rates for a particualr type and stage of cancer with and without specific chemo treatments.

In the real world do patients know?

In the West, they do if they ask (or look it up). Oncologists vary in how they handle the delicate business of discussing prognosis with a patient. Most allow themselves to be guided by the patient, whose responses and questions generally make clear how much information they want/can handle. In my expereince working with terminally ill people, that is the best way. If a patient asks, it is customary to tell them both approximately how much time they may have left and how much of a difference chemo is likely to make. However some patients make it clear they can't handle hearing this sort of thing. In which case beyond stressing the need to "put your affairs in order", most doctors will respect that.

Asian physicians, and Thai in particular, differ; they usually shy away from discussions of death or bad outcomes.

If the media don't publish, they have no choice but to place their trust in the Doctor. This is risky if the Doctor doesn't know and even if he does, he may, in any event, be forced to follow policy. Isn't this the case?

No.

Do Doctors actually have freedom to recommend unorthodox alternatives if a patient asks or do they face some kind of sanction/disincentive?

There is no "policy" or set of sanctions against recommending alternative treatments, but good medical practice requires that one not recommend things that have no scientific basis and have never been shown to be effective, which pretty much covers what you seem to have in mind.

There is also no sanction/rule against the more obvious alternative (and one which, unlike many of the "unorthodox alternative" treatments, does not raise false hopes or bilk terminally ill people out of whatever funds thay have left) and that is to recommend foregoing further treatment when it is apparent that there is no hope of cure and to suggest instead hospice-type care.

The final decision rests with the patient, though. Some people simply can't accept a terminal diagnosis and insist on doing "everything" even if it is not going to change the outcome. Others simply feel that even a few weeks or months more of life, is worth struggling for.

[gougouluxembourg]

I had Lymph System Cancer in June 2007, chemo 8 times, every 2 weeks, so far nothing came back.

In 2008 had stomach cancer (no connection to first Cancer), as i was scanned regulary after the first cancer, it was found early, operation and chemo afterwards.

I think without the first Chemo, would not be alive and could not enjoy rest of Life in LOS.

Have to go back for scanning every 6 Month and sure, if anything, will be found early.

Edited May 1, 2010 by gougouluxembourg

[PhilHarries]

I haven't read all the replies but if I were to be diagnosed with the big C I'd want every dang weapon in the medical amoury brought to bear on it, no holds barred.

One thing I would not be doing is surfing the internet reading all the kooky websites.

If you are diagnosed with anything from an ingrowing toenail upwards go with the advice of your medic. Yeah, sure there are differences of opinion but we mere laymen (and women ) aren't qualified to make that call.

[phetaroi]

I had friends and associates who were dying of various cancers. Some died despite the chemo...although they were extremely advanced cases of cancer. Others died after refusing the chemo...although their doctors admitted it was only to extend a very sick life by a few months. Others recovered fully (a.k.a., years or decades) after having chemo.

As Sheryl pointed out, it depended on the type of cancer and the progression of the cancer up to that point.

[up-country_sinclair]

Chemo didn't cure my father's lung cancer; in fact, it probably killed him quicker. But he was already stage 3 when diagnosed.

However, chemo seems to have conquered my FIL's lymphoma. It was caught relatively early.

So, as mentioned above, it depends on many variables: type of cancer, when it is detected, etc...

[billzant]

I wanted to raise the question of lifestyle and healthy eating as a possible contribution to cancer. I do have a couple of case studies on video where patients with a combination of healthy eating, beneficial exercise, Chi gung and acupuncture have recovered from cancer. I do not recall the type of cancer nor is there much statistical evidence to be able to be too definitive and make strong recommendations. But it is worth considering. If someone is diagnosed with a form of cancer, why not try a healthy diet, good exercise, and energetic medicine to begin with?

When considering modern advances in science it is also worth considering the nature of the scientific establishment. Research projects are often funded by business interests, and for researchers to get grants their research has to be geared towards those interests. Medical equipment, including chemotherapy, is big business and there are profits to be made from a medical establishment who continually recommend the use of chemo. But whilst there is little scientific proof out there about the benefits on cancer to be gained from a healthy lifestyle, what choice for treatment does a doctor have without fear of litigation?

A patient can of course choose a healthy lifestyle for themselves. There is plenty of evidence that bad lifestyle contributes to bad health. Therefore if someone were to be diagnosed with cancer, making a recommendation that they eat healthily and do exercise can only be beneficial even if it does not cure.

I saw a video that Farrah Fawcett made of her death through cancer, and how her health and lifestyle deteriorated with chemo treatments. After seeing this, if there were other approaches to take before taking chemo that video would be enough to convince me.

[sbk]

If I read Sheryls analysis of the 6 year old study cited by the OP, it was of the efficacy of chemo as a palliative treatment. My reading of that is that it means chemo for terminal patients. If that is not correct then please feel free to correct me.

**edit** definition of Palliative chemo:

Palliative chemotherapy - Palliative is a type of chemotherapy that is given specifically to address symptom management without expecting to significantly reduce the cancer

But it seems to me that a 2% success rate for patients deemed terminal would not be too bad. I would hope most doctors would allow the patient the right to choose their course of treatment knowing they have been diagnosed with terminal cancer and if that person feels the extra time that might be gained by chemo is worth it (or not) then it is completely their choice to make.

As for healthy lifestyle, certainly it helps. But, my mother (step mother in fact) was vegan. Ate all organic foods, did not smoke, did not drink and was not overweight. But she was genetically inclined to cancer. Sadly, it killed her in the end but without chemo and radiation, I doubt she would have lived past the first bout of breast cancer at the age of 41.

[Robby nz]

I havent read all the long winded bits of this thread but I have had chemo.

I was diagnosed with rectal cancer over a year ago now that was getting close to a stage where it was uncurable. I was given chemo and radiation to shrink the tumor before surgery and it was very obvious to me that the tumor did shrink with this treatment. whether that can be credited to the chemo or the radiation I cant say.

After an OP I had more chemo to try to flush out anything that remained. It was recomended that I have intravenous chemo but that was far too expensive for my budget so I had oral (dont know the drugs) instead.

Now I have a problem with something in the bladder I have had a cystoscope exam and biopsy and will have a CT scan and a colonostopy soon to look for anything else.

I feel fine no pain and am fit enough to walk a fair bit and do a short run each morning. I am very aware of alternatives and will make my own decisions when I get the results.

[PattayaParent]

<snip>

Thank you Sheryl. Were you aware of this report or its findings and if you had not been would you have been able to make an 'informed' decision? In the real world do patients know? If the media don't publish, they have no choice but to place their trust in the Doctor. This is risky if the Doctor doesn't know and even if he does, he may, in any event, be forced to follow policy. Isn't this the case? Do Doctors actually have freedom to recommend unorthodox alternatives if a patient asks or do they face some kind of sanction/disincentive?

I think it would be more pertinent to ask do patients insurance policies cover them for unorthodox alternative treatments or are they only covered for chemo?

Edit: I know people who have received chemo and survived, received chemo and died, not received chemo and died and tried unorthodox alternatives and died.

Edited May 3, 2010 by PattayaParent

[Sheryl]

If I read Sheryls analysis of the 6 year old study cited by the OP, it was of the efficacy of chemo as a palliative treatment. My reading of that is that it means chemo for terminal patients. If that is not correct then please feel free to correct me.

**edit** definition of Palliative chemo:

Palliative chemotherapy - Palliative is a type of chemotherapy that is given specifically to address symptom management without expecting to significantly reduce the cancer

But it seems to me that a 2% success rate for patients deemed terminal would not be too bad. I would hope most doctors would allow the patient the right to choose their course of treatment knowing they have been diagnosed with terminal cancer and if that person feels the extra time that might be gained by chemo is worth it (or not) then it is completely their choice to make.

The 2% is the contribution to 5 year survival. It is not the percentage who live longer as a result of chemo, that would be much higher. Chemo is not approved for treatment of a cancer unless it is shown to result in an increase in average length of survival.

How much of an increase varies greatly by both type of cancer and its stage. There are some cancers and stages wherein all that chemo is going to offer is a few more months. There are other situations in which it offers years. And, in some specific types of cancer and stages, chemo can be curative.

which is why a generic discussion of "chemo" is pretty meaningless. One needs to specify the type and stage of cancer. And certainly anyone seeking to make a decision about whether or not to have chemo should refer top studies specific to their type and stage of cancer as they may otherwise be very much misled.

Should also note that average is just that..average. The specifics of a person's condition and the side effects of the particular type of chemo being contemplated need to be taken into account. if it is cytotoxic chemo (which is not the only kind) and if the patient is very elderly or debilitated then it might indeed do more harm thtn good in terms of survival. But this has to be assessed on a case by case basis.

[fullwhenempty]

There is a big difference between discussing these issues in an abstract way. It's a totally different matter when it comes to the cold reality of cancer eating up the body and all the suffering that accompanies it.

This article called "Does Palliative Chemotherapy Palliate?" supports Sheryl's comment that a general discussion on whether chemo works or not is almost impossible. Individual circumstances play such a huge role. http://www.supportiveoncology.net/journal/...les/0101065.pdf

As to the original report, there's no smoke without fire. It would not have been written unless there were valid concerns.

I don't personally believe that alternatives are not a viable option but that's just one opinion. My experiences with orthodox medicine have not been positive ones and on reflection I can see I'm still angry and grieving over the deaths of close family members who might have been saved by less toxic methods. There has never been any acknowledgment by the profession, only 'ad hominem' attacks and abuse if I dare to criticize.

Sheryl, you set a good example of how to manage genuinely expressed concerns. You've clearly had a lot of practice. My apologies for playing fast and loose with my own prejudices.

[gburns57au]

As a recently diagnosed stage 4 lung cancer patient....that is inoperable and incurable...means I willl have palliative treatment...I am still hopeful that when I start Chemo that it does shrink the tumour to a manageable size. I had a bleeding attack over a month ago and had a big hit of radiation after 6 days in hospital....Glad to say the tumour has shrunk by around 10%...

Edited June 14, 2010 by gburns57au

[souvenirdeparis]

I have been under chemo since the beginning of January for a stage III lung cancer, which means one original tumor + secondary ones or 'nods' in both lungs. (stage IV means + outside the lungs, like brain or liver )

I was diagnosed in October - just at the time when I found I had advanced colo rectal cancer as well, the two being unrelated .So the doctors talked and decided I had to be operated of the colo rectal first ; it went remarkably well. That was November ; I had to have scans & coloscopies &fibroscopy+ biopsy of the lungs & be fitted with a veinous contraption for chemos & they had to hold meetings and it was one week every time.

I have chemos in what is from all accounts a good place to be if you're under chemos.I am lucky to enjoy 100 % coverage (this is France) ; the cost is staggering , easily from 500 to 1500 euros for one round depending , 3 rounds a month.

So all the nods went off the radar, but the original tumor is more resilient ; I have become less resistant to the chemos and can take less now; they are doing a genetic testing on the cells to see whether some molecule would work better, but few cases are concerned .They don't give me X rays nor surgery for technical reasons too long to explain . I weekly share a room with another patient, I now know a lot on different types of cancer (+ my mother had a last-chance kamikaze chemo 30 years ago for leukemia), like stage IV lung cancer , palliative chemos, you name it . Sherryl obviously knows the subject pretty well. I have been told chemo would notfinish this tumor , that I might have X rays later , and will have pills to take to keep it stabilised . Of course I am dubious of the result .

I don't mind dying , I had plenty good times in my life (in LOS). I want to stay around as much as possible to take care of my young son . Yes, a few more months (or years ) would matter to him I think .

My regards to my chemo fellows on this thread.

Edited June 14, 2010 by souvenirdeparis

[Sheryl]

gburns and souvenirdp, thank you for sharing and please know our best wishes are with you both.

I did oncology nursing in the past, and while I often felt that if I had terminal cancer I would not opt to undergo what many of my patients did, I also recognized that (1)unlike them, I did not have terminal cancer, so that's easy enough to say/think but (2) no one really knows what they would choose to do in such a circumstance untile they are truly faced with it.

[souvenirdeparis]

http://www.lungcancerfoundation.org/

you speak right Sheryl .

Jill Costello's pages on the link are worth a look.

*

[gburns57au]

I am stage IV because although I dont have any secondary tumours, I do have fluid in the Pleura which they have said is probably full of cells....that increases the risk of spreading. my tumour is in the Hilar region around the bronchial tubes and affecting the lymph nodes that sit under the junction of the two branches...I also have a partial collapse of the middle lung lobe but that improved from a total collapse of the lobe after radiation.

Still early days for me at this stage and will know more after Thursday this week.

[souvenirdeparis]

@Gburns

chemo can clean the cells in this pleura fluid ; fluid can be drained if necessary.

my tumor is about at the same brunchial spot

all the best, keep in touch .

[gburns57au]

@Gburns

chemo can clean the cells in this pleura fluid ; fluid can be drained if necessary.

my tumor is about at the same brunchial spot

all the best, keep in touch .

My chemo doctor told me that it is possible for the chemo to clear the fluid but said that it doesnt always work...see what happens.

At the moment I have a persistant cough and some shortness of breath after minimal exercise...a little bit of chest pain and tightness but not severe. It is definately letting me know it is there.

I have also put in for a trial of nitro glycerine patch treatment which is being done in conjunction with the chemo...60% of patients had a good reaction to this in Japan on a study of about 100 people, it increases the effectiveness of the chemo in lung cancer and they believe that it may increase life expectancy. It is a random trial of 500 people with 250 getting the patch.

Edited June 15, 2010 by gburns57au

[sbk]

Best wishes to you both guys, fingers and toes crossed for you.

[souvenirdeparis]

Best wishes to you both guys, fingers and toes crossed for you.

(can't seem to leave you a comment)

Thanks sbk

I love Ban Kai