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When Breast Cancer Treatment is worse than the disease

April 7, 2011

Australian Oncologists Research Paper on effectiveness of chemo
How is it possible that patients are routinely offered chemotherapy when the benefits to be gained by such an approach are generally so small? In their discussion, the authors address this crucial question and cite the tendency on the part of the medical profession to present the benefits of chemotherapy in statistical terms that, while technically accurate, are seldom clearly understood by patients.

For example, oncologists frequently express the benefits of chemotherapy in terms of what is called “relative risk” rather than giving a straight assessment of the likely impact on overall survival. Relative risk is a statistical means of expressing the benefit of receiving a medical intervention in a way that, while technically accurate, has the effect of making the intervention look considerably more beneficial than it truly is. If receiving a treatment causes a patient’s risk to drop from 4 percent to 2 percent, this can be expressed as a decrease in relative risk of 50 percent. On face value that sounds good. But another, equally valid way of expressing this is to say that it offers a 2 percent reduction in absolute risk, which is less likely to convince patients to take the treatment.

It is not only patients who are misled by the overuse of relative risk in reporting the results of medical interventions. Several studies have shown that physicians are also frequently beguiled by this kind of statistical sleight of hand. According to one such study, published in the British Medical Journal, physicians’ views of the effectiveness of drugs, and their decision to prescribe such drugs, was significantly influenced by the way in which clinical trials of these drugs were reported. When results were expressed as a relative risk reduction, physicians believed the drugs were more effective and were strongly more inclined to prescribe than they were when the identical results were expressed as an absolute risk reduction (Bucher 1994).

Read more here:
http://www.icnr.com/articles/ischemotherapyeffective.html

Reported deaths from Herceptin
http://www.druglib.com/adverse-reactions_side-effects/herceptin/seriousness_death/
Reported deaths from Avastin
http://www.druglib.com/adverse-reactions_side-effects/avastin/seriousness_any/reaction_death/<
Adverse warnings: Other Chemo
http://www.druglib.com/druginfo/adriamycin/warnings_precautions/

Unreported death by overtreatment using conventional medicine
http://shinscancerblog.blogspot.com/

A classic example of a woman who refused chemo and radiation, and was criticized for her choice
http://www.youdidwhatbook.com/blog/2010/10/7/criticism-surgery-alone-cured-hollie.html?lastPage=true&postSubmitted=true

Very nice article, just a few excerpts:

http://www.healthcentral.com/breast-cancer/c/78/135697/treatment-cure?ic=4046
by: PJ Hamel ,Health Central Community Member

How do you decide whether to skip chemo, or stop taking Arimidex? And how do you talk to your oncologist about your decision, without leaving the office feeling like you’ve been beat up emotionally – or simply dismissed as weak?

Or “suicidal”?
First, understand where your oncologist is coming from. Of course s/he wants you to follow “doctor’s orders.” After all, your oncologist is a highly trained professional, someone who’s studied cancer for years; someone with access to information on the latest, cutting-edge treatments.

First, get your hands on all the information you can. Ask your oncologist for a complete rundown of your suggested treatments, including the following information:

•What does the treatment entail, including duration, procedures, and drugs?
•What are its side effects, and what percentage of women experience each?
•Statistically speaking, how much will this treatment reduce your risk of recurrence, and/or increase your survival rate?

Speaking of statistics, make sure you understand the doctor when s/he gives you these figures. There’s relative risk, and absolute risk; and they’re very different. For an easy to understand explanation, please read Risks and Benefits: Understanding the Statistics that Affect You.

Next, make sure you understand completely the possible benefit of each treatment. For instance, a mastectomy reduces your risk of cancer in the affected breast by 90%; but in many cases it doesn’t increase your survival rate, compared to lumpectomy/radiation.

And chemotherapy may be the treatment of choice for many women with your diagnosis: say, stage 2 IDC. But how well will it work for YOU? Oncotype-DX is a personalized assessment test for chemo; if your doctor hasn’t offered it, ask if you’re a candidate.

Then, look into your own heart, and judge your personality. Be truthful, now; this is important. Are you a worrier and a second-guesser, someone who has trouble feeling comfortable with important decisions? Or are you comfortable with making a choice and, if it doesn’t work out, going forward without guilt or self-recrimination?

If the former, you’ll probably want to take your doctor’s advice, and go with the recommended treatment. If the latter, it’s probably worth “going with your gut” – bypassing a particular treatment, thus avoiding any chance of its side effects; but potentially raising your risk of recurrence.

Finally, how do you tell your oncologist you’ve decided to skip chemo?

Bravely. It’s not easy to speak your mind to an authority figure, and that’s surely the way we all feel about our oncologists. But if you believe you’re doing what’s right for YOU, look the doctor in the eye, and speak your piece:

“I understand the treatment you recommend may reduce my risk of recurrence. I’ve researched this, thought hard and long about it, discussed it with my family and friends, and have come to the conclusion that for me, the benefits of this treatment aren’t worth its risks. I’m willing to accept the consequences of my decision.”

Then listen quietly while the doctor responds. If you hear new information that may change your mind, tell the doctor you’ll think about it. If not, simply say thanks, and move on.

Hey, no one ever said cancer is easy; the emotional torment is often as great (or greater) than the physical pain. But taking the time to research your treatment options, and all that they entail – both good, and bad – is worth the effort

Disclaimer: I am not a medical practitioner, so take my opinions as OPINIONS and not facts. I copied and pasted the above article from PJ Hamel because I respect her views and definitely can relate to her. You have to make your own research and make your own treatment decisions. If you are taking chemo therapy yourself, this is not a personal attack to you (I do not know you- so I do not have any motive to hurt you or offend you)- but in the process of stating and reflecting my opinions and treatment decisions there may be statements that can potentially cause you stress and anxiety– so take it with a grain of salt and move on. Each of us has to make our treatment decisions and have the maturity to stand by it without hurting each other in the process.

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