What answer would you give to someone who asked you the following question:
Someone sent me a video of an interview of a doctor in the USA who was criticising the extent of use of chemotherapy despite its poor outcome, especially in adults with cancer. Having heard the clip and the doctor talking about the ability of Selenium supplementation to prevent cancer, I filed it under the ‘not too sure this sounds right’ folder in my brain. Later I found out that he was a ND (Naturopathic Doctor and not a Medical Doctor). I dismissed the issue from my mind because my MD gut answer to the above question was at the higher end and surely the ND had to be wrong! But then I heard a BMJ podcast on the very same issue and it was quite an eye opener.
The interview was with Dr Peter White a former consultant and senior lecturer at the Imperial School of Medicine. He recently authored an article for the BMJ called Cancer drugs, survival and ethics.
He points to a meta-analysis done in 2004 looking at the 5 year survival of patients with metastatic cancer in randomised trials published in Australia and the US. How much do you think chemotherapy increased survival by in 90% of cancers including lung, prostate, colorectal and breast cancer? The answer was 2.5% or in terms of months 3 months. But what about newer drugs? Surely biotech and pharma industry have improved leaps and bounds since 2004? He says (the emphasis is mine):
Similarly, 14 consecutive new drug regimens for adult solid cancers approved by the European Medicines Agency provided a median 1.2 months overall survival benefit against comparator regimens.4 Newer drugs did no better: 48 new regimens approved by the US Food and Drug Administration between 2002 and 2014 conferred a median 2.1 month overall survival benefit.5
There have been exceptions to this poor outcome of the fight against cancer and these include cancers such as: testicular cancer (40%), Hodgkin’s disease (37%), cancer of the cervix (12%), lymphoma (10.5%), and ovarian cancer (8.8%). The improved 5 year survival is given in brackets. Sadly these cancers account for less than 10% of cancers.
He goes on to argue that the financial motivation for such drugs is very high and the regulatory process for their approval needs tightening.
Have a read or a listen:
Article: Cancer drugs, survival and ethics