cancer, chemotherapy, a critical look

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AUSSIE ONCOLOGISTS CRITICIZE CHEMOTHERAPY - PART ONE - by Ralpy Moss

Ph.D.

 

full article at cancerdecisions.com

 

An important paper has been published in the journal Clinical

Oncology. 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. Although the paper has attracted some attention in Australia,

the native country of the paper's authors, it has been greeted with

complete silence on this side of the world.

 

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.

 

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.

 

" 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).

 

The 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 results of the study are summarized in two tables, reproduced

below. Table 1 shows the results for Australian patients; Table 2

shows the results for US patients. 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. (NB: We apologize for the poor image

quality of these tables.)

 

To view Table 1 click or go to:

http://www.cancerdecisions.com/images/Table1.jpg

 

To view Table 2 click or go to:

http://www.cancerdecisions.com/images/Table2.jpg

 

Basically, the authors found that the contribution of chemotherapy to

5-year survival in adults was 2.3 percent in Australia, and 2.1

percent in the USA. They emphasize that, for reasons explained in

detail in the study, these figures " should be regarded as the upper

limit of effectiveness " (i.e., they are an optimistic rather than a

pessimistic estimate).

 

 

 

Professor of

Chair Department of Herbal Medicine

Institute of Acupuncture and Oriental Medicine

Honolulu, HI

 

www.herbsandmore.photostockplus.com