Avoid Watered-Down Chemotherapy as an
Alternative to Surveillance


There is a recent trend that should be avoided. Some doctors, especially in Europe, have been offering good risk patients a watered down form of chemotherapy as an alternative to surveillance. Instead of providing three or four cycles of chemotherapy, this option may offer just one or two. This alternative doesn't make sense. If the cancer is already cured, the patient is still subjected to the potential side effects of chemotherapy. If the cancer has already spread, undertreating it can cause it to become resistant to chemotherapy without killing it. Although the goal is to find a less toxic form of treatment, at present short cycle chemotherapy remains an unproven experimental therapy and a bad compromise. You should refuse such watered down treatment unless it is offered as part of a clinical trial and you fully appreciate the risks or after it has been clearly demonstrated (through phase II and phase III trials) to be equally effective.

In some situations an oncologist may offer single-agent chemotherapy as an alternative to combination chemotherapy. The same considerations arise.

(In some cases these alternative therapies are offered to mentally impaired patients who are less likely to comply with a more complicated treatment protocol.)

Before choosing a form of treatment, you should identify the "gold standard" treatment for your condition. There may be more than one type of treatment that has been found to be most effective. Unless there is a good reason for choosing an alternative, such as an allergy to one of the chemotherapy agents in the standard treatment, you should choose the most effective form of treatment that corresponds to your diagnosis.

Copyright © 2005-2009 by Mark Kantrowitz. All rights reserved.

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