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Medical Forum / Diseases and Disorders / Cancer / May 2005

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Chemo *can* help

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NoName@anon.com - 18 May 2005 14:46 GMT
   I see that many times on this newsgroup, some people
seem to suggest that multiple rounds of chemo is useless
and that further treatment should not be pursued.

   They are entitled to their opinion of course.

   Here is a recent study which seems to argue against
the extreme pessimists.  

  The final decision rests with each individual patient.

http://www.asco.org/ac/1,1003,_12-002643-00_18-0034-00_19-0032863-00_28-
002,00.asp

Meeting: 2005 ASCO Annual Meeting       Abstract No: 5136

Background: Various types of chemotherapy have been studied in patients with
refractory/relapsing ovarian carcinoma. However there is very limited
information regarding the usefulness of chemotherapy in ovarian cancer
patients who have received several lines of treatment.

[...]

Conclusions: Disease response or stabilization occurs in about a third of
patients receiving 3rd line treatment. The type of response to 2nd line
therapy (Topotecan in this study) can help predict the responsiveness and
perhaps usefulness of subsequent chemotherapy.
   This is the first study to show that median [overall survival] is
significantly improved in responders compared to non-responders in women
receiving 3rd line therapy for ovarian carcinoma.
Steph - 18 May 2005 16:18 GMT
>    I see that many times on this newsgroup, some people
> seem to suggest that multiple rounds of chemo is useless
[quoted text clipped - 6 lines]
>
>   The final decision rests with each individual patient.

The question isn't whether multiple rounds of chemo are "useless" or
"wonderful", it's whether it is the correct thing to do in the specific
circumstances of a specific patient. Nothing to do with "opinions", just the
data
Peter Moran - 18 May 2005 21:50 GMT
>    I see that many times on this newsgroup, some people
> seem to suggest that multiple rounds of chemo is useless
> and that further treatment should not be pursued.

In medicine everything is about context.

In many clinical contexts  it can be predicted that gains from additional
chemotherapy treatment will be so small and/or so rare as to be scarcely
worth pursuing.   We rarely ask what length of remission in how many
justifies impairing the lives of all those who don't respond and who may
simply have ill-effects from the treatment, and such trials as you quote
rarely ever offer that knd of information.

The thing is that medicine has one eye on the long term, and is prepared to
keep probing for small gains in the expectation that larger and more
worthwhile gains will eventually arise from all the trial and error.
That is appopriate in clinical trials,  but is of less certain  help for the
individual patient (unless small prospects of longer survival are of
paramount importance to them.)

It also needs to be emphasised that we are  referring here to palliative
chemotherapy.   Chemotherapy given with the intent to cure, or as an adjunct
to other potentially curative treatment is a separate debate.

Peter Moran>
 
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