Sunday, October 21, 2007

What is the success rate of Chemotherapy?

The other day when I was in the grocery store I was asked to contribute to the Cancer Society. In all good conscience I could not contribute to such a useless cause when there are so many effective alternatives available.

It's probably time to examine the success rate of chemotherapy that has been used for so many decades. What is the success rate of chemotherapy as used by oncologists?
An important paper has been published in the journal Clinical Oncology addresses exactly this question. This meta-analysis, entitled "The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies" set out to accurately quantify and assess the actual benefit conferred by chemotherapy in the treatment of adults with the commonest types of cancer.
All three of the paper's authors are oncologists. Lead author Associate Professor Graeme Morgan is a radiation oncologist at Royal North Shore Hospital in Sydney; Professor Robyn Ward is a medical oncologist at University of New South Wales/St. Vincent's Hospital. The third author, Dr. Michael Barton, is a radiation oncologist and a member of the Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Health Service, Sydney. Prof. Ward is also a member of the Therapeutic Goods Authority of the Australian Federal Department of Health and Aging, the official body that advises the Australian government on the suitability and efficacy of drugs to be listed on the national Pharmaceutical Benefits Schedule (PBS) – roughly the equivalent of the US Food and Drug Administration (FDA).

Their meticulous study was based on an analysis of the results of all the randomized, controlled clinical trials (RCTs) performed in Australia and the US that reported a statistically significant increase in 5-year survival due to the use of chemotherapy in adult malignancies. Survival data were drawn from the Australian cancer registries and the US National Cancer Institute's Surveillance Epidemiology and End Results (SEER) registry spanning the period January 1990 until January 2004. Wherever data were uncertain, the authors deliberately erred on the side of over-estimating the benefit of chemotherapy.

Even so, 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. Give me a break!!

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