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Chemotherapy: hit or myth?

MagazineSeptember 2002 (Vol. 13 Issue 6)Chemotherapy: hit or myth?

What is it that persuades some people to succumb to the use of extremely toxic petrochemical drugs in the hope of killing a deadly disease? After all, if chemotherapy were classed as a criminal punishment, it would be deemed inhumane, immoral and downright wicked

What is it that persuades some people to succumb to the use of extremely toxic petrochemical drugs in the hope of killing a deadly disease? After all, if chemotherapy were classed as a criminal punishment, it would be deemed inhumane, immoral and downright wicked. Yet, in the name of 'curing' cancer, it is classified as a treatment, the best type of medical care.


The problem lies with the power of the medical model itself and its so-called scientific supremacy, which has become such a trusted part of our culture. There is also the uneven balance of power inherent in the doctor-patient relationship.


A patient or his/her family are not working on a level playing field when it comes to a discussion of treatment and prognosis with a physician. Doctors frequently employ language like 'response rates' and 'clinical trials' to inspire hope and confidence that the treatment being offered will conquer the cancer that lives in your body. It's difficult to trust your own feelings and subjective judgements about your own illness and treatment in the face of so many supposed facts.


In 1990 at Chelmsford Crown Court, a 42-year-old woman was awarded lb155,000 of damages after suffering seven years of cancer treatment that she didn't need. Her hair fell out and she suffered continual nausea during six courses of radiotherapy and drug treatment. Following more surgery, the woman was then told that it had all been a dreadful mistake. Apart from all the pain and suffering she had endured, during the course of her treatment, she also lost both her career and her husband (The Times, 9 June 1990).


The saddest part of the story is that she herself had never believed her diagnosis. She had failed to trust herself and her own intuition, and had allowed herself instead to be convinced by the supposed objectivity of science and her doctors.


When I myself was diagnosed with breast cancer last year, I desperately wanted to be told by a doctor that '. . . this is what we'll do and everything will be all right'. But I wasn't going to just hand my life over. I have a good academic grounding in health and I wanted to be as informed as I possibly could be.


At first, I was convinced that the answer lay with conventional medicine. I scoured the Internet and ordered books intended only for the medical profession. But in my reading, I came to believe that a number of alternative therapies could work for me. During consultations with eminent cancer experts, my change of diet was disparaged, and I was told that if I didn't have the recommended treatment and turned instead to alternative therapy, I would be a 'very silly girl'.


In the end, I decided to turn my back on conventional treatment and to use alternative treatment. This was not without a struggle against the medical profession, and many friends and family, who viewed my decision with pity and disbelief.


Our society is so immersed in the primacy of the medical model that to do anything else is considered certain death, at least when it comes to cancer. However, if you look beneath the medical jargon, you realise there is very little success with medical treatments for cancer. Indeed, after reviewing 10 randomised trials, breast cancer experts concluded that adjuvant therapy had no effect on improving overall survival time (JAMA, 1991; 265: 391-5).


Cancer studies often conclude with phrases such as: 'We are on the verge of achieving high enough response rates on a consistent basis to affect positively the survival outcome of patients . . .' (Semin Oncol, 1983; 10: 111-22). What the disempowered patient hears is 'response rates' and 'survival outcome'.


The truth is, response rates don't predict survival outcome for advanced cancers. In fact, the US Food and Drug Administration defines a 'response' in cancer as a reduction by 50 per cent or more in all measurable tumours for as little as 28 days.


In addition, studies from the 1980s failed to show any improvement in survival statistics with the introduction of combination chemotherapy (Cancer, 1981; 47: 2398-403; Lancet, 1980; i; 580-2; J Clin Oncol, 1983; 1: 406-8).


Clinical trials are also often mentioned as if they are the last word in scientific veracity. Many trials, especially those involving cancer patients, suffer from selection bias - where healthier or stronger patients are chosen to test the drugs on. In a study of colorectal cancer patients, those who appeared to respond well to chemotherapy in fact had a better natural prognosis (a slow-growing tumour), but their longer survival time was claimed to be thanks to chemotherapy (Cancer, 1980; 46: 1536-43).


Another 'trick of the trade' is lead-time bias. The lead-time is the difference between the time cancer is identified by tests and when it is clinically detectable. Researchers often choose to use one set of data over the other to boost their survival statistics (N Engl J Med, 1985; 312: 1604-8).


In 1986, the McGill Cancer Centre in Montreal, Canada, sent a questionnaire to 118 doctors treating non-small cell lung cancer; 64 of 79 respondents said they would not consent to be in a drug trial using cisplatin, and 58 of those 64 said no to all drugs. Why? They believed that chemotherapy is ineffective and has unacceptable degrees of toxicity (Br J Cancer, 1986; 54: 661-7).


Chemotherapy's main success seems to be in maintaining doctors' supremacy over patients and in conventional medicine's fight against alternatives. Maybe it's time for a revolution.


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