I came accros an important paper called 'The contribution of Cytotoxic Chemotherapy to 5-year survival in adult malignancies', which was published in 2004. It concludes that the overall contribution of curative and adjuvant chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA. I am shocked, saddened and dissapointed [Sad] Is this still the case? Have things changed in the last 12 years?
Hi, Inga, when offered chemo 13 months ago I refused and decided to rely on my immune system. I had been told my cancer had a life span of 12 - 14 months. Having researched it I found it to be about right. I spent all of last year almost pain free and well. Things have gone downhill a bit now but it is what I expected. I am not saying chemo is wrong it was just my choice, I must emphasise that.
Dont just dismiss this type of chemotherapy as being not worth it. Even though the data sets in this study are out of date they do clearly show that patients with some types of cancer respond well to the treatment notably testicular and Hodgkins. Even cervical cancer in this study gave a one in eight chance of making it to five years due to chemotherapy. I frequently take 8 to 1 bets, so I'd take a chance on this and many reading this take 49 million to one bets when they buy a lottery ticket. Some cancers dont respond well, for instance some types of head and neck cancer which I have, so for a 75 to 1 chance of improvement weighed against the side effects it was not recommended and I agreed with this. Opting for surgery and radiotherapy alone.
Its best to discuss your individual circumstances with the oncologist in charge of your treatment plan, they will give you frank answers if you ask them to, and have up to date information on effectiveness. You are then better placed to make your decision on whether to proceed or not. Kim
Thank you for posting a question.
I am not sure that I can easily answer your question. This is because I have not found any recent research papers which have looked in depth at the impact of chemotherapy as a whole. But it is fair to say that chemotherapy is the treatment of choice for many hematological (blood) cancers. While there is not a one size fits all answer many people with these types of cancers can have a realistic expectation of living beyond 5 years and can be cured by chemotherapy.
Also another important use of chemotherapy is as an adjuvant (additional) treatment. This is when it is given before or after treatments like surgery to reduce the risk of a cancer coming back. While the paper you mentioned does refer to chemotherapy after surgery for breast, bowel and some other cancers, there have been some changes in the regimes that are used in recent years, making them more effective. For example the use of the drug oxaliplatin in the adjuvant treatment of bowel cancer and the drug docetaxel for some women with breast cancer. While it is fair to say that these developments are not going to make a big difference to the figures these are just two of the changes that have been made and no doubt there are others.
Also chemotherapy is now sometimes given alongside other newer treatments called biological therapies although sometimes biological treatments are given on their own. This seems to make the treatments more effective.
The authors of the Australian study that you referred to do point out that one of the main use of chemotherapy treatment is to shrink incurable cancers to relieve symptoms. While this sort of treatment often does extend life, it is not the sole aim of the chemotherapy treatment. The aim is to make people feel better. This is often called palliative treatment. Of course chemotherapy does have side effects and this can certainly have a negative impact on a person’s quality of life. But when palliative chemotherapy has been researched there has often been a quality of life element to the research. So this is certainly taken into account when looking at the use of chemotherapy when cancer cannot be cured. Therefore the contribution of chemotherapy isn’t only about extending survival it is also about helping people to feel better in the time they have left.
There is now a big investment in stratified medicine. As of yet I do not think that it has had a big impact on survival as it is early days. This is looking at ways of predicting which treatments cancers are likely to respond to. It involves looking in detail at the cancer cells and their genetic make up. Researchers want to find out if some treatments are more likely to work in cancers that have particular changes to their genes. Targeting chemotherapy in this way could make it more effective as people can be given drugs that have a high chance of working for them. At the moment sadly there are always some people who do not respond well to the common chemotherapy drugs that are used. If doctors and scientists can find out which genetic mistakes make a cancer less or more likely to respond this will give them the upper hand.
I do appreciate that I have not fully answered your question, but I hope that this is of some use. You are welcome to get back to us if you have any other questions. If you would like to telephone our freephone number is 0808 800 4040. We are here from Monday to Friday between the hours of 9am to 5pm.
chemotheraphy is one of the treatment procedures for the advanced cancer, but they do produce some side effects post treatment.
the link below clearly explains about the effect
Thanks for this Igna it's an interesting paper.
There are a few problems with some of the assumptions in it.
Firstly only 4 cancer types are considered
Secondly and very importantly they are talking about chemotherapy as the sole treatment. In many cases chemotherapy is used in conjunction with debulking surgery or radiotherapy and such combination treatments will have been completely ignored by this study.
Thirdly this only considers survivability and pays no attention to the quality of life enjoyed by patients as a result. While some people have difficulty with chemotherapy others tolerate it very well.
Let me give you a personal example.
My wife was diagnosed with Peritoneal cancer in 2012 she had a bad case of ascites - fluid build up in the abdomen. It seemed that it filled faster than they could drain it, this got to the point where the fluid got to her lungs - a pleural effusion. Her life was only saved with an emergency drain in the lung.
The ascites was only stopped when she was able to start chemotherapy, that stablised her and controlled the fluid. Over the following 3 years she received various chemotherapy agents on a monthly basis - she suffered some flu like symptoms for a day or so after her monthly chemo but otherwise was pretty fit - we travelled to Mauritius for a holiday, I've posted an infamous picture of her balancing on a chair in the garden to build a greenhouse and barring walking brazenly about town with a head as bald as a snooker ball and outrageous earrings you'd have never known that she had cancer we never applied for a disabled parking badge as she just didn't need it. In fact it was only when the chemotherapy agents stopped working that she suffered a brief decline before succumbing. two weeks before she died we went for a walk in the country of a bit over a mile I'd guess
Did she live longer due to chemotherapy? without a doubt - the ascites would have killed her on the 24th of September 2012 - I remember that because it was the day after my birthday - I'd visited her on the 23rd and thought I might never see her again - she could hardly move from the fluid in her lungs - she'd still managed somehow to buy me a bar of white chocolate from the trolly as a birthday present - probably the most touching present I've ever received
Did she live longer than someone without ascites and no chemo - I couldn't say - Sadly her mother had the same cancer 30 years earlier and lasted an extra year but with a much lower quality of life
Did she live better? definitely!
Now different people have different experiences and it seems to me that a great deal depends on the type of cancer all I can tell you is if I'm ever in that situation I won't be able to get that platinum into me fast enough
This study is of very limited relevance and would be easy to take out of context. These guys put the case for a balanced view of chemo far better than I ever could saying "promoters of alternative cancer cures can deny it all they like, but chemotherapy is indeed a major part of the reason for better outcomes and more hope in cancer. “Cut, poison, burn”? Well, yes. Unfortunately, that’s what works, including the “poison” part. Until we find something that works without as much morbidity, “cut, poison, burn” will have to do."
I get hacked off by the number of people put off having chemo and dying unnecessarily by irresponsible journalists and well-meaning exponents of alternative medicine. Chemo isn't a panacea, but I know too many people (including me) who have had good results and had their lives extended by chemo.
Enjoy the article!
Dave, four months ago when one of my medications had stopped working I told the oncologist that I wouldnt have chemo. He shocked my son and I by saying he would follow the same course as me and so would most of his colleagues. I know my cancer has a short span (my friend had the same cancers as me but had chemo abd radio to the end and lasted a year.)
We are all different and we must live our lives the way we choose. If I were 20 years younger I may have made different choices.
Thanks so much for sharing your stories! It's not me who's sick but my dad In September 2015 he was diagnosed with stage 4 duodenal cancer and had chemo for 2 months. The side effects were pretty awful,he started losing weight, was really nauseous, had no energy. It's been 2 months since he last had chemotherapy and he is feeling and looking great! He even started working again! We don't know what to do though. Is he feeling better because of chemo or because he stopped doing chemo? :/
Hi, Inga, has your dad had a scan to see if the chemo has reduced the tumour? from what I have heard, once the chemo is over many peoole do feel very well. I do hope that it has worked and that you have good news.
I was given a year, which according to statistics is about right. I didnt want to spend half that having chemo that would not have given me anymore time. But you see, all cancers are different and far be it for me to give opinions. It is always a choice, and I made mine, for which I am not sorry.
With best wishes to your dad, I do hope he carries on feeling well. Do let us know how things are going.
Sorry for the belated response, I've been offline for a few days.In your circumstances I would probably have made the same informed choice.
It's the "informed" part that is important to me, especially when newly diagnosed when people are vulnerable and often feel overwhelmed. There are so many quacks peddling miracle cures out there, plus dangerously misinformed comment in the mass media, which can easily result in people making uninformed or misguided choices.
After several years of fighting cancer using every therapy made available to her, my Mum decided that she would stop chemo as she believed it was doing more harm than good. That was her informed choice and I fully supported her in that decision, as I hope my own son will support me if/when I reach that stage.
We ARE all different and we all need to make choices that best suit both ourselves and our circumstances.
I guess if your Dad felt better after finishing chemo than he did before starting it, you could conclude that the chemo made him better in the long term. His follow up scans should tell you whether there was a real improvement.
That said, like so many medications, chemo is a poison and once you stop taking it you should start feeling better than you did when you were being poisoned!
I hope things go well for your Dad.