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Breast cancer treatment controversy: radiologists versus chemotherapists.

Breast Cancer Treatment Controversy: Radiologists Versus Chemotherapists

Seldom is the gentleman's agreement breached: medical doctors are too polite to criticize each other in public. However, the growing rancor between two forms of cancer treatment, chemotherapy and radiation, is unprecedented. Arguments have erupted in stately medical journals.

In a recent issue of the International Journal of Radiation Oncology (11:4:87), Seymour Levitt, M.D., a leading authority on the staff of University of Minnesota School of Medicine, argues the case for use of radiation after surgery for breast cancer and refutes advocates of chemotherapy, who say that it controls local disease and improves survival better than radiation and therefore there is no need for the latter.

Further, Dr. Levitt refutes claims by chemotherapists who insist "radiation therapy interferes with `lifesaving chemotherapy.'" He is particularly resentful that adjuvant radiation is alleged to be harmful and decreases survival.

The scientific article, written in retort to a Gilbert H. Fletcher Lecture, summarizes: "We have looked at a number of original, beautiful hypotheses and found some ugly truths. Chemotherapy does not prevent local recurrences, that local recurrences, once they develop, are difficult to control. Radiation therapy does not interfere with chemotherapy if both are given properly. The reason that radiation therapy has not shown improved survival is probably because of the quality of the trials that have been completed..."

Taking up the lancet for chemotherapy, two physicians associated with the Medical Breast Cancer Section, National Cancer Institute, contributed a paper extolling the virtues of chemotherapy and hormonal therapy, noting that the death rate for breast cancer has remained unchanged in the past 25 years. (Sandra M. Swain, M.D., and Marc E. Lippmann, M.D., Annual Review of Medicine, 86:38:287:94.)
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Author:Swain, Sandra M.; Lippmann, Marc E.
Publication:Nutrition Health Review
Date:Mar 22, 1989
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