Could Declining Chemo Be Evidence-Based?
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The option to decline chemotherapy can be made on scientific evidence, not just... I think I'm going to go out on a limb here and hope for the best.
Disclaimer: I know that there are many people who believe that surgery, chemotherapy, and radiation (traditional treatments) are the only scientifically validated ways to treat cancer. This blog post isn't written for you. And some people get really ANGRY when they're presented with information about alternative cancer treatments. Again, this blog post is written for people who are following their intuition and researching what might be the best treatments for them after a diagnosis of cancer. If you're somehow at peace when someone dies after using chemo but livid when someone dies after using alternative cancer treatments, then there's an invitation for you to explore that difference within yourself.
“When a patient chooses a form of therapy out of conviction, while accepting the fact that death is inevitable someday, that patient will never be a failure and never regret the decision.”
I often felt that when I told my doctors that I had decided to decline chemotherapy, they heard me say, "I'm going to do nothing to prevent cancer from coming back. Literally nothing." When quite the opposite was true... I was doing SO MUCH! I was focusing on my whole being... mental, emotional, spiritual, social, and physical... to heal after a diagnosis of cancer.
But to my doctors, chemo is the only option. It literally is chemo or nothing. However, more and more alternative cancer treatments are becoming mainstream. Chemo isn't the only option! Lots of them have been studied but they're often ignored. Or they're common practice in certain parts of the world (like full-body hyperthermia in Europe), but discounted in other countries.
Morbidity vs. Mortality
For me, I'm more interested in treatments that could give me decades of good quality life, not just 5 or 10 extra years of dealing with lots of side-effects life. I want my doctors to understand that my morbidity (my quality of life) is more important to me than my mortality (my length of life). I want to increase my life, not prolong my death. But that's just me. Me. That's what I want. Maybe you want something else and that's totally fine.
If you haven't already, read the book Radical Remission: Surviving Cancer Against All Odds by Dr. Kelly Turner. She's studied spontaneous healing... with data-collection and spreadsheets and charts. What she's found is based on actual evidence. Dr. Bernie Siegel says similar things, "I realized that medicine has been studying its failures when it should have been learning from its successes. We should be paying more attention to the exceptional patients, those who get well unexpectedly, instead of staring bleakly at all those who die in the usual pattern." (Love, Medicine and Miracles: Lessons Learned about Self-Healing from a Surgeon's Experience with Exceptional Patients)
The Scientific Evidence for Chemo
In 2004, Clinical Oncology published this article: "The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies" by Graeme Morgan, Robyn Wardy, Michael Barton (this is the link to the full study PDF, the abstract is below).
This is what I found really, really interesting from the study...
The five most common adult malignancies (colorectal, breast, prostate, melanoma and lung cancer) accounted for 56.6% of the total incidence of cancers in Australia in 1998. In this group, the 5-year survival rate due solely to cytotoxic chemotherapy was 1.6%. [In my words, chemotherapy will help 3 out of 200 people diagnosed with those cancers to still be alive 5 years after being diagnosed.]
The minimal impact on survival in the more common cancers conflicts with the perceptions of many patients who feel they are receiving a treatment that will significantly enhance their chances of cure. In part, this reflects the presentation of results as a ‘reduction in risk’ rather than as an absolute survival benefit [89,90] and by exaggerating the response rates by including ‘stable disease’.
The best example of the ‘over-selling’ of chemotherapy is in breast cancer, where chemotherapy was introduced as the example of the new cure for solid malignancies. In Australia, in 1998, only 4638 of the 10661 women with newly diagnosed breast cancer were eligible for adjuvant chemotherapy [given after surgery] (44% of total). From our calculations, only 164 women (3.5%) actually had a survival benefit from adjuvant chemotherapy. In other words, on average, 29 women had to be treated for one additional woman to survive more than 5 years.
[Or in my words, of 90 women diagnosed with breast cancer, 87 women received no benefit one-way-or-the-other from chemotherapy after surgery; they were going to live or die regardless of whether or not they used chemo. 3 women survived more than 5 years because they received chemotherapy after surgery. The issue today is that doctors don't know which 3 of those 90 women will benefit from chemotherapy, so everyone is given the message that you "must" receive chemotherapy. I looked at those odds and said I wasn't one of those 3 women out of 90 who would survive to 5 years solely from using chemo.]
Notwithstanding, several studies have justified adjuvant chemotherapy in early breast cancer by showing that women are willing to undertake treatment for a very small benefit [91].
"A Very Small Benefit"
This "very small benefit" they discovered in their research is why I declined chemotherapy after my mastectomy. Seriously. When I looked at that very small benefit in comparison to the loooooong list of short-term and long-term side-effects, it didn't make sense to me.
Even though I was getting the message from my doctors that declining chemo was against scientific data, it was actually evidence-based... for me, there wasn't strong enough evidence of its benefit to me to risk the negative consequences of chemo.
However, I didn't find this study until 4 months after I had already made my decision! If I had seen this article shortly after I was given the diagnosis, it would have given my research-oriented mind the information it was looking for. But who knows... maybe it was one of the first steps towards learning what my intuition sounds like and feels like. (*hint*hint*nudge*nudge)
If you have peace and feel like chemotherapy is the best choice for you... DO IT! I'm sharing my journey but it's finding the steps of your journey that are most important. If you love your doctor and what he/she is telling you, then you're making the best choice for you.
If you have peace and feel like declining chemotherapy is the best choice for you... DO IT! I'm here to say that I declined and know many other people that have refused it; you're not alone. Again, this doesn't mean that you sit back and do nothing, but instead you're maximizing all of your resources to keep your whole being in balance.
Integrative & Complementary Cancer Treatment
Pssst... this decision also doesn't have to be "either/or." There's a "both/and" answer as well... a third way :)
Many alternative cancer treatments can be used in conjunction with chemo (like high-dose IV Vitamin C). And some cancer treatment plans can use a much smaller does of chemo (like Insulin Potentiation Therapy). I often say that there are over 1,000 natural treatments for cancer and you can read about a lot of them at www.CancerTutor.com. And if you'd rather talk with me about all of this, that's what I'm here for!
And don't forget about the incredible healing power that the body, mind, and soul have! Good nutrition, good thoughts, good relationships... these are extremely important! Here's a TedTalk by Dr. Lissa Rankin, MD about what she found out when she studied spontaneous remission case studies and placebo and nocebo effect data.
“Neglect of the mind-body link by technological medicine is actually a brief aberration when viewed against the whole history of the healing art.”
The Abstract and Conflict of Interest
Aims: The debate on the funding and availability of cytotoxic drugs raises questions about the contribution of curative or adjuvant cytotoxic chemotherapy to survival in adult cancer patients.
Materials and methods: We undertook a literature search for randomised clinical trials reporting a 5-year survival benefit attributable solely to cytotoxic chemotherapy in adult malignancies. The total number of newly diagnosed cancer patients for 22 major adult malignancies was determined from cancer registry data in Australia and from the Surveillance Epidemiology and End Results data in the USA for 1998. For each malignancy, the absolute number to benefit was the product of (a) the total number of persons with that malignancy; (b) the proportion or subgroup(s) of that malignancy showing a benefit; and (c) the percentage increase in 5-year survival due solely to cytotoxic chemotherapy. The overall contribution was the sum total of the absolute numbers showing a 5-year survival benefit expressed as a percentage of the total number for the 22 malignancies.
Results: The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.
Conclusion: As the 5-year relative survival rate for cancer in Australia is now over 60%, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival. To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.
Conflict of Interest. GM has received educational grants from Varian Medical Systems and AstraZeneca Pharmaceuticals. RW is a member of the Pharmaceutical Benefits Advisory Committee (PBAC), Commonwealth Department of Health and Ageing, Canberra, ACT, Australia. The views presented here are those of the authors and should not be understood or quoted as being made on behalf of the PBAC or its Scientific Committees. MB has no conflict of interest.
Colleen Flowers was given the diagnosis of aggressive Stage 2 breast cancer on June 1, 2015 at the age of 35. She's trained as a Holistic Reproductive Health Practitioner and does her best to walk the talk. Please explore this site for resources, information, and ideas you may not have been presented with before now. If you like what you see, then subscribe to her newsletter and consider talking with her. Want to stop making decisions based on running away from fear and death, and base them on walking toward love and life? Book a Consult and Buy a Package for individualized coaching support.
