Too Much, Too Little, Too Late
by Jo Ann Mueller
Today’s session on “High-Dose chemotherapy in Breast Cancer” was the most well attended breast cancer session so far.
Over 12,000 women with breast cancer have undergone bone marrow transplantation (BMT) since the mid-80s. It is about time women got some answers that up to now have been unavailable to positively show that BMT is an effective treatment in increasing survival. What we are getting instead are major public health decisions based on womens' hopes for longer life expectancies.
In the preponderance of evidence presented in five recently released trials, an actual increase in survival has not been shown for patients taking BMT over those patients on standard, lower dose chemotherapies. It must be noted that this treatment is not just used for metastatic cancer, cancer that has spread to other parts of the body, but other breast cancer.
More recently it has also been used to treat primary cancer when 7-10 lymph nodes are involved with other high-risk criteria. In fact it is alarming to note that although in this group only 7% were treated with HDC in 1989 it has climbed to 50% in 1995.
And now we hear the data doesn’t support using this technique in any way other than a clinical trial setting. Hello, excuse me, but might not our human and monetary resources be better spent on less debilitating treatment more likely to yield a benefit measured in years, not months at best, and not necessarily even that?
Let's move on people.
