AUSSIE ONCOLOGISTS CRITICIZE CHEMOTHERAPY

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AUSSIE ONCOLOGISTS CRITICIZE CHEMOTHERAPY - PART ONE - by Ralpy Moss Ph.D.

See full article at http://www.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 author! s, 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).

 

Thanks to , Professor of Chinese

Medicine,

Chair Department of Herbal Medicine, Institute of Acupuncture and Oriental

Medicine

Honolulu, http://www.herbsandmore.photostockplus.com

 

Best regards,