European Stars and Stripes (Newspaper) - September 07, 1985, Darmstadt, Hesse Saturday september 1985 the stars and stripes Page 17 is modern Medicine going overboard toxic cocktails to Battle cancer by Philip m. Boffey new York times a adjuvant chemotherapy the use Olto Xic drugs to wipe out microscopic cancer cells presumed to remain hidden in the body after visible tutors have Bee removed was hailed As one of the major achievements of the past 10 years by scientists at the National cancer Institute in late 19b3. But when president Reagan was sent Home from the Hospital in july the White House announced that he would almost certainly not be getting any adjuvant drug treatments to Ward off a possible recurrence of his cancer of the Colon. The announcement gave wide Public recognition to a sobering medical fact the drugs tested in adjuvant treatments Over the past decade have had varying degrees of Success and allure in preventing the recurrence of cancer in patients who like Reagan have no detectable signs of its remaining in their bodies after surgery or radiation have eliminated the primary tumor. Adjuvant chemotherapy has proved highly effective in treating certain rare childhood tutors moderately effective in treating breast cancer and variously effective against rectal cancer Bone cancer soft tissue cancers of the arms or legs one form of lung cancer and possibly head and neck cancer. But the adjuvant drugs have thus far failed to demonstrate a Clear effect in preventing the spread of cancers of the Colon stomach kidney or pancreas most lung cancers or malignant Melanoma a skin cancer according to a Range of experts. Even where the adjuvant drugs have proved effective a Sharp controversy is emerging Over whether the gains Are great enough to outweigh the Side effects. The drugs can sometimes kill patients by causing additional cancers or heart problems and they almost always cause such morale sapping ailments As vomiting sore Mouth and baldness. We have gone on a Bimpe of giving every cancer patient every possible chemotherapy usually toxic cocktails made by mixing three or four different drugs complains or. Michael b. Sham Ken emeritus professor at the University of California at san Diego who spent 25 years As an administrator at the National cancer Institute. I m All for that kind of treatment in studies designed to find a More useful therapy Sham Ken said. But it should not become routine. Many of the effects Are very transient and very partial and Many of the drugs produce cancers . Chemotherapy is one of the Many area where Modem Medicine has gone overboard Rose Kushner a breast cancer victim who sits on the National cancer advisory Board As a patient advocate charged in an article published in an american cancer rom Reck have several Good friends who have never succumbed to a Job outside the Home. Despite the pressure from their friends who Are Busy climbing Trees in the corporate Jungle they have never considered themselves chairman of the bored. I paid a visit to one of them the other Day and she was visibly depressed. When i asked Why she said Haven t you heard Barbie s gone corporate. Society journal in november that doctors Are literally making healthy people sick by administering toxic drugs that Are of Only marginal Benefit to Trie vast majority of women who develop breast toxic chemotherapy drastically reduces your Quality of life she said in an interview. When doctors say that the Side effects Are tolerable or acceptable they Are talking about life threatening things like a drop in your White blood cells or vomiting to the Point where you have to go into the Hospital for intravenous nutrition. But if you just vomit so hard that you break the blood vessels in your eyes or you have a sore Mouth that can be treated by putting a paste of baking soda in your Mouth at night they Don t consider that even Mentio Nable. And they certainly Don t care if you re for her own breast cancer Kushner elected adjuvant treatment with a hormone that is effective in some Post menopausal women she ignored advice to take the cell killing adjuvant drugs. She cites studies that show she believes that the hormone is just As effective As the drugs in women Over 50 and far less toxic. I Don t believe that every woman Over 50 should get zapped with chemotherapy just because one sixth of them May be helped she said. But other doctors and scientists who appear to represent the mainstream of current medical thinking contend that drugs used in adjuvant chemotherapy have demonstrated their value against some cancers and have generally been considered tolerable by patients desperate to save their lives and less worried about Side effects. Two officials of the National cancer Institute or. Marc e. Lippman head of the medical breast cancer Section and or. Bruce e. Chabner director of the division of cancer treatment published a reply to Kushner. They argued that adjuvant chemotherapy with one particular combination of drugs has reduced mortality from breast cancer by 34 percent in women under 50 and by 22 percent in women Over 50. The achievements of adjuvant chemotherapy Are Clear they wrote. Tho therapies Are toxic risky and do not Benefit everyone. But in agreeing with these causes for concern we see no reason to Overlook the important improvements in or. Sydney e. Salmon director of the Arizona cancer Center in Tuscon and editor of a highly regarded series of books on adjuvant therapy of cancer disputed the notion that doctors Are indiscriminately pumping toxic drugs into patients. I feel that doctors who Are oncologists try to identify which patients will Benefit from the treatments and which wont he said. Some physicians May be Over enthusiastic or not sufficiently knowledgeable but they Are he noted that most Broast cancer patients appeared to Barbe s n in two Inch bust who never has to worry about hair color. She just removes her head. Ott Ess isso has been a role Mode to All of us who have chosen to stay at Home. The first woman to Ever admit she shops for a has been a trend setter said a Lent she Wear her sunglasses on top of her head two years before Mario Thomas willing to put up with such unpleasant Side effects As nausea vomiting and loss of hair which Are not generally severe enough to disrupt their Normal activities. The disputes highlight a dilemma of adjuvant chemotherapy individual patients can never be sure they need the drugs. They Are taking them to wipe out hidden cancer cells that May or May not be there. This dilemma is not present when toxic drugs Are used As a primary treatment to shrink and destroy cancer cells that Are definitely known to exist in the body. Indeed such drugs Are often the Only weapon available against cancers that have spread from the initial site to Distant Points in the body beyond the effective reach of surgery or radiation. In such cases doctors and patients can see a Clear reason for using the drugs and they often have no alternative. But starting in the 1960s the anti cancer drugs came to be used in a new role As Given to patients whose visible tutors had been removed and who had no detectable cancer left in their bodies but who were considered at High risk Tor developing now tutors based on statistical analyses of similar cases. The Assumption was that some but not All. Of these patients had microscopic cancer cells in their bodies ready to Start new tutors unless eradicated. But the whole group of patients at risk would have to be treated and suffer the Side effects when Only an unidentifiable portion of the group still harboured cancer cells. That is part of the dilemma of adjuvant said Samuel Hellman. Phys Cla a in chief at the memorial Sloan Kettering cancer Center in new York City. You have to treat everybody to Benefit Only a Many experts say that decisions have to be made on an individual basis with each patient and doctor weighing How much they fear a recurrence versus How much they Are willing to suffer in the Way of Side effects. Or. Mary e. Costanza head of the oncology unit at the University of Massachusetts medical Center in Worcester said that if adjuvant chemotherapy reduced mortality in 25 to 34 percent of breast cancer patients of different Ages As a recent worldwide review suggests that could add us to a significant number of lives saved by the adjuvant drugs. But from the individual patient s Point of View it s not Clear that taking the adjuvant is Worth the Side effects she said. Is the reduction big enough and important enough each woman has to think about the adjuvant approach has proved most effective in patients who can tolerate High drug doses and whose tutors Are sensitive to drugs. It is often less effective in the elderly who Are too weak to withstand heavy dosing and against cancers such As Reagan s Colon cancer that Are not susceptible to currently used drugs. And Don t forget the first to have a hair dryer that was half the size of her body. And now she s sold what kind of a Job does she have i asked. I Don t know. Something on an executive level that requires an attache Case to match every it figures. What kind of training does she have As an executive what Are you getting at asked my Friend. I m not getting at anything. I m Onty suggesting that i have to wonder when a doll who does t talk walk eat or shed tears suddenly has her own word you Don t grow up. What do you think she and Ken did in that cardboard car under the bed. Play John Denver records i never suspected she said. And we All know Why a 46-year-old woman still wears a Ponytail Don t we if she took the rubber band off her face would fall to her Barbie is 46" has to be. She was 20 or so when she came out in 1959." my Friend thought a minute and what has she got to show for it a Lousy Hall million Dollar How meaningless she said. At least i have my four children meals to Cook House to run shopping to do Bills to pay and toilets to you Are blessed i said. Well get another role How about Mother Teresa i suggested. She does t stay i stay at Home i said. Her eyes lit up. Miss bile on Dallas shops for a c los a Noelck Ternei Send Scalt
