tiistai 12. huhtikuuta 2016

Is It True That Only 2 Or 3 % Of Cancer Patients Survive Chemotherapy?

Anaximperator blog

Blogging against alternative cancer treatments

Is It True That Only 2 Or 3 % Of Cancer Patients Survive Chemotherapy?

Luella May
No, it’s not true: currently, the average "non-chemo" cancer cure rate is close to 60%.
Some time ago I happened to read a discussion on Tony Isaacs’s Curezone, on the best treatment for breast cancer. The thread was started by a woman who had just been diagnosed with breast cancer.
Tony Isaacs’ partner Luella May suggested the forum member paint her breasts with iodine to combat the cancer and advised strongly against surgery and all other forms of conventional cancer treatments:
Chemotherapy 2 percent curezone
What does this mean? I can only mean that 98% were not cured – which means they died; look at this website, where it says: Chemo has a 97% fatality rate!
Some time later I read the same kind of unsettling statement concerning chemotherapy, this time posted on a discussion board of Breastcancer.org:
Breastcancer.org - Only 3 percent survive chemo

Where do these numbers come from??

The “2% chemo efficacy” comes from an Australian study into the contribution of chemotherapy to 5-year cancer survival, and the researchers claimed to have found that the average benefit of chemotherapy was about 2%. So: the study is about the contribution of chemotherapy to survival and not about survival of patients having chemotherapy.
For obvious reasons, this study has become immensely popular with alternative therapists and is quoted by them ad nauseam.
A rather strange  phenomenon took place after the publication of this study: over time, the 2-3% contribution to survival had somehow become 2-3% plain survival – period. Some of these altmeds now actually claim the outcome of the study was that of all cancer patients receiving chemo, only 2-3% survive for more than 5 years.
In other words: chemotherapy kills an average 97% of cancer patients within 5 years.
Now, as these numbers sound totally weird – to say the least – we decided to find out if there was any truth in them.

What the study was about

The researchers stated as the aim of their study:
a literature search for randomised clinical trials reporting a 5-year survival benefit attributable solely to cytotoxic chemotherapy in adult malignancies.
So they wanted to know what the contribution was of chemotherapy to 5-year survival. There are many therapies to treat cancer: surgery, radiotherapy, hormonal therapy, immune therapy – and chemotherapy. The researchers wanted to know to what extent  chemotherapy contributed to five-year-survival of cancer patients.
Of all 154,971 patients whose files were examined, in 3306 of these, 5-year survival could be attributed solely to chemotherapy.
In 98% of the patients, 5-year survival was due to a combination of factors, of which chemotherapy sometimes also was a factor and sometimes was not.
The researchers then extrapolated the outcomes to all cancers. The average 5-year cancer survival in Australia at the time of the study was 60%. On the basis of the extrapolation of the outcome of their study, the researchers estimated that the average contribution of chemotherapy to 5-year survival would be 2.3% in Australia and 2.1% in the USA.
Nowhere in the study does it say that only 3306 patients survived their chemotherapy and that consequently 151,665 patients died because of chemotherapy.
Leave out a few words and you get a completely different message.

The study design

The study was carried out in 2004, using data from 1998. A number of things can be said about the design of the study.
  • The researchers looked at a lot of cancers, but they didn’t look at all of them.
  • They did not differentiate between cancers for which chemotherapy is the primary treatment and cancers for which chemotherapy is only given as an adjuvant. This is the case in most solid cancers, for which surgery is the primary – and by far the most effective – treatment.
  • They did not include cancers for which chemotherapy is very effective, such as leukemia.
  • They did not include children’s cancers, some of which are highly responsive to treatment, e.g. Wilms’ tumour, with about 90% of patients surviving at least five years.
  • They did not differentiate between early stage cancers (tumour <1cm, no mets in lymph nodes), for which chemotherapy often is not even indicated, and late stage, incurable cancers which had already metastasized at the time of diagnosis, some even quite extensively.
  • They did not look at the effect of chemotherapy on life extension (median survival), which in my opinion they should have, since they included already incurable cancers in their study.
Correction for these factors would result in an average contribution of chemotherapy to 5-year survival of about 8%, based on the data from 1998.

Statistics: average and specific

It is important to keep in mind that a statistical average is always about middling, about the ‘mean.’ Statistics are never about the many deviations from the mean, such as your or anyone else’s specific situation.
A few examples:
1. Suppose the effect of chemotherapy on 5-year survival in leukemia is 60% and the effect of chemotherapy on 5-year survival of very early stage breastcancer is 0% (because: not indicated, therefore not administered). The average effect of chemotherapy on both cancers combined is 30% (60+0 : 2 = 30). But what does this overall average tell the individual patient regarding their prognosis? Well… nothing actually.
2. In a number of situations, depending on stage, grade and type of cancer, women with breast cancer are advised to take adjuvant chemotherapy, in order to destroy any (clinically invisible) micrometastases in their blood.
This kind of chemo improves the 10-year survival prognosis with an average 5 – 7%. The percentage is based on allwomen receiving adjavant chemo. If you don’t have micrometastases, the chemo will do nothing for your prognosis. However, for the women who do have them, the chemo may enhance their personal prognosis much more, sometimes as high as 20%.
3. Cancer with unknown primary tumour (CUP) has a very bad prognosis: average 5-year overall survival rate is about 10%. Yet there are cases known of patients who have been surviving for 14 years or more without any evidence of disease.
The big differences in the overall effects of chemotherapy on 5-year survival become obvious if we look at the tables in which the specific numbers are given for each particular cancer that was included in the study. In the 4th and 3rd column on the right you can see to what extent chemotherapy contributed to cancer survival. When chemotherapy was no factor in survival, the column shows a dash.
Chemotherapy Australia
Chemotherapy USA

So… now what?

The data from the study are from 1998. We are now in 2009 and progress has been made in those years. There is better medication to diminish side effects of chemotherapy. There is new, sophisticated technology to assess which breast cancers are prone to metastasize and which are not, resulting in less women having to undergo chemotherapy. Scientists are working hard on similar tests for other cancers.
There are over 80 different kinds of chemotherapy. Some are sheer hell, but many are quite doable, including the one I had. Nevertheless: chemotherapy still is the ultimate cancer scare factor and the sooner we can do without it, the better. But it is not true that only 2-3% survive chemotherapy. It is not true that the average benefit of chemotherapy to 5-year survival is as low as 2%. And it is also not true that all chemotherapy is by definition completely and totally unbearable.
If we really want to get anywhere at all, then honesty about the facts, not manipulation, self-aggrandizing and scare mongering, should be the basis for discussion and decision making.



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