AN OPINION
Intention: provoke a desire in global citizenry to acquire the science literacy & critical appraisal
skills necessary to scrutinize the aims, methods and results of clinical trials supported
by BIG PHARMA and to take responsibility for their personal health & treatment
decisions;
Additionally, to demand that appropriate resources be directed to PREVENTION,
improved patient selection for efficacious Rx, and post-treatment health care.
Personal COUNSELS, 2003:
Surgeon: "if it were my wife, I would advise her to take chemo."
Oncologist: "Nobody refuses chemo;" "Be careful with any herbal antioxidants - it may inhibit action.."
"If it comes back, it's harder to treat." "The aches & pains will go away."
"....Like insurance."
skills necessary to scrutinize the aims, methods and results of clinical trials supported
by BIG PHARMA and to take responsibility for their personal health & treatment
decisions;
Additionally, to demand that appropriate resources be directed to PREVENTION,
improved patient selection for efficacious Rx, and post-treatment health care.
Personal COUNSELS, 2003:
Surgeon: "if it were my wife, I would advise her to take chemo."
Oncologist: "Nobody refuses chemo;" "Be careful with any herbal antioxidants - it may inhibit action.."
"If it comes back, it's harder to treat." "The aches & pains will go away."
"....Like insurance."
NCIC CTG MA.21
Clinical Trial: to compare standard Canadian and American protocols and a combination. Patient Population
A total of 2,104 patients were recruited from Canadian and US centers, between December 2000 and May 2005. (I was one of the "participants," recruited Oct 2004) * WHY recommend and subject the "potentially cured" to chemotherapy? For alleged 10% improved statistical risk in 10-yr SURVIVAL with 100% risk of morbidity?? Since "nobody refuses chemo," 10% compared to what?? Background: In 2000, cyclophosphamide(C), epirubicin(E) and fluorouracil (F) (CEF) and doxorubicin (A) and C followed by paclitaxel (T) (AC/T) given every three weeks were commonly used regimens in Canada and the USA to treat women with node positive or high risk node negative operable breast cancer. In a previous trial in women with locally advanced breast cancer, 3 months of dose-dense EC was equivalent to six months of CEF. We hypothesized that the addition of 3 months of a taxane following dose-dense EC would be superior to CEF alone or AC/T. In a randomized trial in women with early breast cancer we compared CEF, dose dense EC/T and AC/T. An interim analysis (JCO, 2010) conducted when 50% of the events for the relapse-free-survival (RFS) analysis were observed, demonstrated that AC/T administered every 3 weeks was ?significantly inferior to CEF or EC/T. The results of the final RFS including CEF versus EC/T will be presented.
Methods: Women, 60 years or younger, with operable axillary node positive or high risk node negative breast cancer were randomized to adjuvant CEF, EC/T or AC/T. ........ |
Results: ...The required 453 events for the RFS analysis were observed by the clinical cut-off date of March 30, 2012. At this point 369 deaths had been observed. The median follow-up is 87.5 months........
Conclusions: Although the two regimens considered a standard of care at the time the study was initiated are *no longer widely used, the trial results will enhance our understanding of the magnitude of benefit of taxane following an anthracycline, the significance of cumulative anthracycline dose, and the role of dose density/ intensity as backbone of conventional chemo regimens. SAY WHAT????
? * due to acute toxicity/poor efficacy ? long-term sequelae RFS - Relapse free survival
Recipient selection REGIMENS PROTOCOLS TOXICITY - narrow definition; later life-altering chronic conditions remain undefined |
In this "trial" the cost of all drugs, other than the chemotherapeutic drugs, including drugs to "treat" consequences of "toxicity" was borne by the participants. The protocol in Group 1 means: 12 chemo doses, given on day 1 & day 8, in my case, all IV; plus 6 months of continuous oral antibiotic - in my case mainly CIPRO, a fluoroquinolone, adverse effects of which not considered nor acknowledged to date by a plethora of "specialists"; plus Decadron 2X/day (a potent steroid) plus Ondansetron (antinauseant), for 3 days after each chemo dose. Cost of odansetron alone = ~$20/pill.
I suspect I am alive because I missed 2 doses: the first because I had quit after the first dose! The second due to high fever. My usual weight is between 84-90lbs.
See "Tapestry" for a glimpse of my friend who was not in the study, had SAME CHEMO drugs but on a simpler protocol= "standard," and died from an aggressive acute leukaemia.
I suspect I am alive because I missed 2 doses: the first because I had quit after the first dose! The second due to high fever. My usual weight is between 84-90lbs.
See "Tapestry" for a glimpse of my friend who was not in the study, had SAME CHEMO drugs but on a simpler protocol= "standard," and died from an aggressive acute leukaemia.
First Nations girl chooses traditional medicine over chemo Makayla Sault faces possible apprehension by Children's Aid, which family and First Nation vow to fight By Connie Walker, CBC News
May 16, 2014 5:00 AM ET Last Updated: May 16, 2014 10:16 PM ET
http://www.cbc.ca/news/aboriginal/first-nations-girl-chooses-traditional-medicine-over-chemo-1.2644637
Excerpt - MODERN
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. |
http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html
|
Excerpt - CLASSICAL
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. |