How Effective Is Chemotherapy For Breast Cancer?

After mastectomy, women are sent to see the oncologists, and they are often told to go for chemotherapy. This treatment is like an "insurance" against future problems. Chemotherapy can kill all the remaining cancer cells in the body. In this way the cancer can be cured. Chemotherapy can also stop cancer from spreading to other parts of the body. Or at the very least it slows the cancer growth. To the oncologists, chemotherapy is the proven way to go, other ways are hocus pocus!

These points are often well taken by women in general. The fear of recurrence is sufficient enough to make women go through chemotherapy. To them, the sufferings of the treatment are worth enduring for the promise of cure at the end of the adventure. What some oncologists don't tell their patients is that not all the cancer cells are killed by the treatment. There is no way that a hundred percent of the cancer cells can be wiped by chemotherapy. Add to that, even the good healthy cells are killed and the immune system destroyed.

Patients, on the other hand don't ask these questions: Will there truly be a cure? If indeed the promise of cure is real, can we put it in terms of real numbers or percentage? To put it bluntly, how effective is chemotherapy for breast cancer? I wonder how many women ask their oncologists these questions, and if they do, what would the answers be like?

a) Without chemotherapy what percentage of people died or would die from breast cancer?

b) With chemotherapy what percentage of people are cured or would be cured?

c) What is meant by cure?

Try and search the answers from the internet and see if you can get anything. There is a great chance that you will go on a merry go round trip! I experienced exactly just that and was terribly disappointed. Thousands of articles are written about breast cancer but I fail to find the clear-cut answers to the above questions. Perhaps they are not important? Or something that women do not need to know before they embark on their treatment? Women just need to have full faith and trust in the experts and everything would turn out fine. Few women realize that such attitude may just be the beginning of more problems to come.

Let me try to share what I have gathered from the medical literature.

Karin Stabiner in her book (To dance with the devil) wrote: "Breast cancer takes the life of an American woman every twelve minutes. There is no sure cure for the disease, no known way to prevent it and no means of predicting." With all the advances in science and technology, may I ask, how could this be? Why such high degree of uncertainty?

Chantal Bernard-Marty, Fatima Cardoso, Martine J. Piccart of Jules Bordet Institute, Brussels, Belgium (The Oncologist 9: 617-632, Nov. 2004) wrote: "20%-85% of patients ... who are diagnosed with early breast cancer will later develop recurrent and/or metastatic disease. Despite more than 3 decades of research, metastatic breast cancer remains essentially incurable." Women are told that "catching" breast cancer early is a sure way of saving life. But how is it that even after early detection, twenty to eighty-five percent of patients still go on to develop more serious cancer that is incurable? Has the treatment protocols got anything to do with such failures?

How effective is chemotherapy?

Writing in Clinical Oncology (2004. 16: 549-560), three Australian doctors: Graeme Morgan, Robyn Ward & Michael Baton noted that in Australia, of the 10,661 people who had breast cancer only 164 people survived five years due to chemotherapy. This works out to 1.5% contribution of chemotherapy to survival. In their paper, they concluded that "overall contribution of curative and adjuvant chemotherapy to five-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA."

Professor Michael Boyer, head of Medical Oncology of the Sydney Cancer Centre, Royal Prince Alfred Hospital disputed this 2% figure. He said: "It's not correct for a number of reasons. The 2% figure is achieved by including a whole series of diseases in which chemotherapy would never be used." To the professor the more "correct" figures should be 5% or 6%. Okay, let us accept that new figures -- how do women feel about it -- going for chemotherapy to achieve a five to six percent success?

In the editorial of the Australian Prescriber (2006. 29:2-3), Eva Segelov wrote: "Chemotherapy has been oversold. Chemotherapy has improved survival by less than 3% in adults with cancer."

Veroort et al. from the Netherlands (British J. Cancer. 2004. 91: 242-247) in their study on the role of tamoxifen and chemotherapy for breast cancer concluded that "breast cancer mortality reduction caused by present-day practice of adjuvant tamoxifen and chemotherapy is 7%. Tamoxifen contributes most to the mortality reduction. The overall effect of chemotherapy on mortality is very small." Take note that the contribution of chemotherapy to breast cancer survival is very small - what is very small? To be sure it has to be much, much less than 7%.

Guy Faguet, after spending numerous years of research on cancer, came to this startling conclusion (The War on Cancer: An anatomy of failure, a blueprint for the future. Springer, 2005): "An objective analysis of cancer chemotherapy outcomes over the last three decades reveals that, despite vast human and financial expenditures, the cell-killing paradigm had failed to achieve its objective ... the conquest of cancer remains a distant and elusive goal." Chemotherapy for cancer is based on "flawed premises with an unattainable goal, cytotoxic chemotherapy in its present form will neither eradicate cancer not alleviate suffering."

Cured of Breast Cancer?

In a study of 1,547 breast cancer patients at the University of Chicago Hospital, USA, from 1945 to 1987, Theodore Karrison et al. (J. Nat. Cancer Inst. 1999. 91:80-85) observed that for patients who underwent mastectomy but without chemotherapy or radiotherapy, most recurrences occurred within the first ten years after mastectomy. Recurrences were rare after 20 to 25 years. Patients surviving to this time without evidence of recurrence are probably cured.

Women are often told that if they survive five years after their diagnosis of breast cancer, they are considered cured of breast cancer. Based on the work of Karrison et al. this assumption is presumptuous and is not true at all. Women perhaps need to be reminded of what Guy Faguet wrote: "We must recognize that "cure" is not an absolute term because minimal residual or slowly recurrent disease that causes no symptoms can persist and remain undetected for years." Take note, the cancer can remain dormant in the body for years not just five years!