Posted: Jun 02, 2012 6:46 pm
by epepke
Rachel Bronwyn wrote:Every cancer is different as is every chemotherapy regimen so blanket statements just don't apply to the discussion of chemotherapy cost/benefit analysis.

We've all seen someone suffer through chemo and die. It's not a valid argument against.

Nor, however, does it make a good argument for the contrary. That is, just because an argument is not a good argument against does not make arguments for any better. This should be a "that's obvious," but I see a lot of bald statements, such as the idea that it is in general a choice between 6 months of crap and 5 years of great life. It may not be. Where is the evidence?

I do not get the impression here, from the literature, or from people I've known with cancer that chemotherapy really is a calculated risk, targeted to understanding of specific cancers where it is known to be particularly effective. Rather, it seems like a stock treatment that generally seems to get applied.

There are some disturbing factors in cancer reporting and research. Lots of professionals seem to think that early detection is important for effective treatment. It certainly seems plausible that catching something quickly should require less severe intervention which is more likely to work. Is this true, however? There's a confounding purely numerical problem, though. Cancer survival rates are counters and reported for statistics by the amount of time after detection. So, if someone gets a cancer detected two years earlier, that person will be reported to have lived two years longer with the cancer, completely regardless of the effectiveness of the actual treatment. I've seen two meta-studies on this. One concluded that all of the supposed more life with cancer was because of this, and the other concluded that most of it was.

When there are costs to treatment, then a rational approach would involve weighing and judging based on information. Nobody seems to have information that is of very high quality (other than surgeons, who generally do seem to know approximately what they are doing).