Chemo: Not Always the Best Option

Cancer and chemotherapy seem to go hand-in-hand in this country: You've got cancer? You need chemo. According to the Associated Press a new gene test challenges this preconception:

Claudia Lowry had a scary decision: Could she safely skip chemotherapy after surgeons removed her breast cancer?

Tens of thousands of women undergo chemo for breast cancer every year when they don't really need it, but doctors don't have an easy way to tell who can gamble on skipping the harsh drugs.

A simple gene test now promises to help women like Lowry make that nerve-wracking choice -- and a major government study is enrolling more than 10,000 patients around the country to see just how well it does the job.

Some doctors already feel many patients can do well without chemotherapy:

"Most of the patients are advised to have chemotherapy. Most of the patients are going to do very well without it," says Dr. Sheila Taube of the National Cancer Institute. "So how can we spare the patients that don't need it?"

Breast cancer is only the opening salvo. Researchers are furiously developing whom-to-treat gene tests for colorectal cancer -- particularly for early Stage 2 disease that doctors fear is being under-treated -- and other malignancies, too.

Today's guidelines for cancer treatment seem to be terribly inefficient:

More than 100,000 U.S. women a year are found to have early breast cancer that has a remarkably good prognosis: The tumors are small, haven't spread, and are hormone-sensitive. The vast majority would survive with surgery, radiation and hormone treatment. Yet guidelines today recommend chemotherapy as well for most of those women to catch the few who need more aggressive help.

In other words, 100 women get chemo, and the risk of harsh, sometimes life-threatening, side effects, to prevent two or three of them from relapsing.

Dr. Fuhrman is no stranger to this discussion, having voiced his opinions on chemotherapy in previous posts: Re-Examining Chemotherapy for Breast Cancer and Diet, Chemotherapy, and the Truth: How to Win the War on Cancer

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