Study Says 2% Improvement in Survival with Chemotherapy

Posted on Wednesday, March 15, 2006
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Cancer Monthly's summary:

A recent study published in the journal Clinical Oncology (Great Britain) states that chemotherapy contributes to a cancer cure about 2% of the time. "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."

In respect to a cure, there are obvious problems with chemotherapy as a cancer treatment, including: 1) the drugs can seriously compromise a patient's immune system and the immune system is now known to play an important role in controlling cancer; 2) many chemotherapy drugs are carcinogenic - they can actually cause cancer; 3) for many patients, their cancer cells are resistant to chemotherapy; 4) typically when a person is diagnosed with cancer, they already have millions of cancer cell in their body and the chemotherapy would have to kill every single cell to effect a long-term cure.

The "one size fits all" approach to chemotherapy is also problematic. In some cases, a minority of patients actually do obtain a survival benefit, but at a cost to the majority.  A rational approach to chemotherapy would be to test drugs outside a patient's body to determine which drug or drug combinations would be the most effective. There are actually tests to do this, but many oncologists have resisted the idea.

To read the study's abstract click here.

To read an interview with one of the study's author's click here.

To lean more about tests you can have to determine what drugs would be effective before you start chemotherapy click here. 

Below are excerpts from an Australian interview with one of the study’s authors – Dr. Graeme Morgan, Associate Professor, Royal North Shore Hospital, Sydney, Australia. The interviewer is Dr. Norman Swan.

Graeme Morgan: The reason for my doing the paper was to really show that there hasn’t been any improvement in survival, or the improvement has been very, very modest despite all these new drugs and new combinations and bone marrow transplants…We did for 85% of the cancers, we didn’t do it for leukaemias and the reason we didn’t do it for leukaemia is that in acute leukaemia it’s very difficult to differentiate between adults and children and the numbers are fairly small. And in chronic leukaemias, particularly in chronic lymphatic leukaemia which is basically a disease of the elderly, it’s an indolent disease and the median survival is way over ten years. And we also excluded smaller cancers.

Norman Swan: So there might be a slight bias against chemotherapy because you’ve eliminated the leukaemias which can be quite chemo sensitive.

Graeme Morgan: Well yes, but the other reason that I eliminated those because they are mostly looked after by haematologists rather than medical oncologists. So this was really looking at the impact of medical oncology.

Norman Swan: And medical oncologists are basically physicians who specialise in cancer and use drugs.

Graeme Morgan: Yes, correct.

Norman Swan: Whereas you as a radiation oncologist do it through radiotherapy?

Graeme Morgan: Correct, yes.

Norman Swan: What were your findings?

Graeme Morgan: Well the findings were that in Australia that the five year survival due to chemotherapy was 2.1% of the total cancers.

Norman Swan: You mean the additional survival benefit?

Graeme Morgan: Yeah, from the chemotherapy. So in other words if there was no chemotherapy in Australia, the survival of all patients with cancer would drop from 62% to 60%.

Norman Swan: How is the consumer to respond to this message?

Graeme Morgan: Well I think the consumer has to really evaluate the information they’re given.