Oncs and Chemotherapy: Would they?

[Elaine]

A friend emailed me asking me where I got information about oncologists saying they would not do chemo (of course, in the abstract--who knows what they would do if DXed.) Anyway, I did refind some information, and thought I would share a bit of it, especially since it was old info and does not pertain to newer chemos. However, the one article does focus on cistoplatin as treatment for nsclc. I also read an article that quoted the LA Times as reporting that 75 per cent of oncs said they would not do chemo. However, I could not find the date of the supposed article nor the article itself, so I have no idea what this supposed statistic is based on and therefore find it dubious.

I am only posting this, not to discourage people, but to clarify something I wrote in another post, that even I now wonder how significant this is. I would think follow up surveys have been done since the late 1980s. but I haven't found them, if so.

I will paste a section of the article and then put a link to the article below it, which has the citations etc.

The whole article is interesting as is the Site, which also has an article about radiation.

"In 1986, McGill Cancer Center scientists sent a questionnaire to 118 doctors who treated non-small-cell lung cancer. More than 3/4 of them recruited patients and carried out trials of toxic drugs for lung cancer. They were asked to imagine that they themselves had cancer, and were asked which of six current trials they themselves would choose. 64 of the 79 respondents would not consent to be in a trial containing cisplatin, a common chemotherapy drug. Fifty eight found all the trials unacceptable. Their reason? The ineffectiveness of chemotherapy and its unacceptable degree of toxicity14. "

The more familiar these doctors were with the treatment the less likely they were to accept it for themselves.

Similar findings came from two other studies published in 198715,16.

A study of how expert physicians would wish to be treated for genito-urinary cancer found a similar situation in 198817.

In relation to the treatment of 252 advanced breast cancer patients one author observed that the "risk" of being treated by cytotoxic therapy was three times as high in the terminal stage as in the remainder of the patients18. As Abel points out, this does not point to the use of a therapy that is particularly geared to patients’ wellbeing6.

In March 1989 German biostatistician Dr Ulrich Abel himself investigated physicians’ choices in cancer treatment. He received 150 replies to a questionnaire sent to oncologists and research units around the word, trying to gauge these doctors’ feelings about the use of chemotherapy in advanced carcinoma. He reported that "the personal views of many oncologists seem to be in striking contrast to communications intended for the public"1,6."

http://www.ciss.org.au/documents/chemo2.html

[kimblanchard]

You have to understand what things were like at the time of these surveys. The regimens being used were much more toxic. Most importantly, modern anti-nausea drugs (i.e. Zofran, Kytril, etc.) were not available and in widespread use. For those who have taken cisplatin, imagine that drug without effective anti-nausea medication. An older physician told me when I was in training that when they would give cisplatin, they would admit them to the hospital and keep garbage cans at the bedside for people to throw up in and that they would vomit continuously for a week. Now, many of my patients never even throw up once. I think if you did a survey in 2004, the vast majority of oncologists would take treatment. I know I would.

[Elaine]

Thanks, that's good to know. I worried about that number and then when I researched it, I found that it was old info and thus didn't know for sure what to make of it!

Thanks

[Don Wood]

Thanks for keeping us in 2004, doc. Appreciate your clarification. Don