Cancer treatment / "Non"-evidenced based medicine / What is a cure?
WHAT IS MEANT BY "SUCCESSFUL CHEMOTHERAPEUTIC TREATMENT"?
CANCER CURE RATES |
|
LOCAL TREATMENTS |
33 |
| CHEMOTHERAPY | 17 |
| TOTAL (1999) 5 year survival (2003) 5 year survival (2007) |
50 62% 67% |
- typical definition of a cure is 5 years of disease free survival
- using these standards, chemotherapy alone is only successful 10-20% of the time
- however, in combination with local treatments (radiation, surgery), chemotherapy can be synergistic, leading to a cure in an adjuvant setting
- for patients with widespread, disseminated disease, chemotherapy may be palliative (rather than curative), leading to a temporary improvement in symptoms and overall quality of life
- some newer drugs (such as signal transduction inhibitors) control --- rather than eliminate --- the cancer, meaning that turning cancer into a chronic disease may define treatment success
- this is leading to the concept that we should not use the word "cure", but, instead, refer to "no evidence of disease"