Do Chemotherapy’s Risks Outweigh Its Benefits?


Chemotherapy has, for a long time, been used as a cancer treatment method along with radiation and surgery. Most oncologists are shunning chemo as ineffective and risky at fighting breast tumors at their early stages. Conventionally, most women with breast cancer were treated with a combination of chemotherapy, surgery and radiation.

A chemo alternative

Some doctors see chemo as a method that uses years of treatment with drugs, and it may more harmful rather than helpful. They are shifting to less chemotherapy or no chemotherapy at all, known as “de-escalation”. The proponents of de-escalation suggest that chemotherapy should only be used when it can reduce the possibility of cancer spreading.

A rift among oncologists

De-escalation has caused a rift among various oncologists, with some of them expressing worry that women may not find the treatment needed to survive. Since late 1980s, cancer mortality rates have gone down, and some researchers attribute this improvement to chemotherapy.

Chemotherapy has been in use since 1940s, and it’s generally been less harmful and more effective since the days of nitrogen mustard. Although chemo has side effects such as nausea, it’s possible for doctors to help control these side effects.

Overtreatment concerns

Chemotherapy’s fault lines are emerging amid a huge debate regarding overtreatment. There are concerns regarding the prescription of too many antibiotics for diseases that don’t warrant them. Other concerns are whether surgery has been forced on patients with prostate cancer despite tumors that didn’t pose a major risk.

More options

In the past chemo was regarded as a crucial treatment, but the evolving tumor biology has revolutionized how doctors approach chemo. Using genomic testing, which focuses on genes that affect cancer, doctors give a tumor a score. A higher score shows a higher risk of recurrence and the need for conservative chemotherapy. On the other hand, a low score shows that the patient has good prognosis and may not need chemo. The middle scores are in the gray zone on whether or not to prescribe chemo.

Those who choose not to opt for chemo may go for radiation or surgery. Women whose tumors seem receptive to tumor estrogen can get hormone therapy. They may take pills like Tamoxifen that lower the risk of occurrence.

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