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The breast cancer treatment dilemma.

The Breast Cancer Treatment Dilemma

Negative effects common to both chemotherapy and radiation include nausea, fatigue and diarrhea. In addition, chemotherapy may also result in amenorrhea (cessation of menstruation, usually permanently), alopecia (hair loss, usually not permanently), heart damage and suppressed immune systems (seriously lowering resistance to infections). Radiation may cause skin burns, extreme sun sensitivity, weakened bones and sudden bone fractures, as well as "ulcers" (body sores that do not heal). Some drugs lessen these symptoms, but they may have their own negative effects.

Chemotherapy and radiation were formerly used only when cancer recurred in the same organ or metastasized elsewhere. Increasingly, doctors favoring the systemic theory of cancer recommend radiation and/or chemotherapy immediately after surgery even when there is no evidence of spread (e.g., breast lumpectomy with radiation). A few physicians try chemotherapy and radiation without surgery (if the cancer is too advanced for surgery).

We feel some concern that physicians are overusing chemotherapy and radiation in instances where there's no proven benefit -- almost as though they were "miracle" cures. This is understandable. Most doctors genuinely want to help their cancer patients and are frustrated by the lack of a reliable cure. Most people with cancer feel more reassured when they and the doctor are doing something. Overtreatment is psychologically appealing on both sides; both want to hope that "this time" treatment will make the difference.

Popular articles about cancer often give the impression that chemotherapy is working wonders with all types of cancer. This image makes people more likely to accept treatment under the false notion that it will increase their survival time also. Actually it has shown significant results only in a few of the less common types. Doctors often urge the therapy by quoting the statistics on these rare types of cancer without making it clear to the person that this treatment cannot be expected to be of benefit. This lack of informed consent raises false hopes. It is important to check that chemotherapy has been proven effective for your type of cancer.

It is also important to find out exactly how much increased survival time can be gained. Sometimes the percentages doctors or researchers give are misleading: what is called 50 or 100 percent increased survival time may mean only two or three more months, or it may mean two or three years more.

Many people question whether the possibility of longer survival times is worth the negative effects of these therapies. Others feel that even one more day of life is worth any price.
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Publication:Nutrition Health Review
Date:Mar 22, 1989
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