Chemotherapy
An excerpt from an ESUN article
Today chemotherapy means to most in our society the treatment of cancer with a drug or drugs. Many people believe that chemotherapy only means the use of cytotoxic drugs given intravenously. Patients are often surprised to learn that some cytotoxic drugs have been available as pills for many years. Giving a medicine as a pill or capsule is certainly more convenient but not necessarily with less side effects or potency. Other drugs, that are used to treat cancer and often called “targeted agents” such as imatinib are really chemotherapy in every sense of the word — a systemic medication used to eradicate or control a life threatening disease.
So, now the second question, "Why does the word chemotherapy almost always evoke a negative response?" Part of the answer is easy. Most of the cytotoxic chemotherapies are associated with (ob) noxious side effects: profound nausea and vomiting; loss of hair; significant weakness; marked increase in susceptibility to infection, etc.
Even still, did Lance Armstrong think the chemotherapy was not worth it? Mr. Armstrong is a celebrity who had widespread testicular cancer with metastasis to his lungs and brain. But his cancer was eradicated; he recovered from the devastating side effects; and went on to an extraordinary career as an athlete. More than 90% of men diagnosed with testicular cancer are cured; but, not 100%. If Mr. Armstrong had died of cancer or as a consequence of the treatment would he be a celebrity or a victim?
The fact is most patients, and especially those with a sarcoma who are treated with chemotherapy, experience these same awful side effects. The fact is when I finished my fellowship training in medical oncology in 1972 only 20% of patients diagnosed with osteosarcoma survived and NO patient diagnosed with Ewing’s sarcoma survived. Today, approximately 60-70% of patients diagnosed with osteosarcoma or Ewing’s sarcoma are cured. We learned 25 years ago from several important clinical trials that if we used chemotherapy, more patients would be cured. We have gotten a little better managing the side effects of chemotherapy, but no new drug has been discovered to improve the clinical outcome in these past 25 years.
Chemotherapy significantly improves the prognosis of a newly diagnosed patient with osteosarcoma or Ewing’s sarcoma. But the success is not as great as the success in treating tuberculosis or syphilis. More progress is clearly needed. So, if I were the parent of a child who died of one of these sarcomas, I may think the problem is chemotherapy. It didn’t help my child! Sometimes we need demons to blame for ill fortune. But what we really need is progress. To make progress we must first define the problem. Chemotherapy is not the problem….it's cancer.
V3N5 ESUN Copyright © 2006 Liddy Shriver Sarcoma Initiative.