Cancer Chemo Deaths Update

Up until recently, chemotherapy and radiation have been the only two approved treatment methods for treating cancer by mainstream medicine, but as more research emerges, light is being shed on just how damaging these treatment methods can be and how often they are the cause of death and not the cancer itself. Upon this discovery, many doctors are starting to see how this is not always the best treatment method.

Researchers from Public Health England and Cancer Research UK recently performed a groundbreaking study, which examined the number of cancer patients who died within 30 days of beginning chemotherapy showing how the treatment, and not the cancer itself, was the cause of death.

When looking at those death rates across hospitals in the U.K., the researchers found an alarming mortality rate that was directly associated with the chemotherapy treatment.

“England around 8.4 per cent of patients with lung cancer, and 2.4 per cent of breast cancer patients died within a month,” the Telegraph reported.

“But in some hospitals the figure was far higher. In Milton Keynes the death rate for lung cancer treatment was 50.9 per cent, although it was based on a very small number of patients.”

Results of the study showed the one-month mortality rate at Lancashire Teaching Hospitals for those undergoing palliative, rather than curative chemotherapy was 28%. One in five patients receiving palliative care for breast cancer at Cambridge University Hospitals died from treatment.

In other areas including, Blackpool, Coventry, Derby, South Tyneside, Surrey, and Sussex, saw that deaths from lung cancer patients receiving chemotherapy were much higher than the national average.

Cancer Lead for Public Health England, Dr. Jem Rashbass, requested the study and said, according to the Telegraph: “Chemotherapy is a vital part of cancer treatment and is a large reason behind the improved survival rates over the last four decades.”

“However, it is powerful medication with significant side effects and often getting the balance right on which patients to treat aggressively can be hard.”

“Those hospitals whose death rates are outside the expected range have had the findings shared with them and we have asked them to review their practice and data.”

“All women with breast cancer and all men and women with lung cancer residing in England, who were 24 years older and who started a cycle” of chemotherapy in 2014 were included in the analysis by the researchers of the study.

Could This Signify The End Of Chemo?

Finally, chemotherapy has been looked at with a skeptical eye, had this been studied sooner, it is easy to see how this method of treatment cannot distinguish between healthy cells and cancerous cells, therefore there are more ideal patients for this method of treatment and less ideal patients. The study published by the Lancet shows how the cell destroying property of chemo can eventually lead to death as there aren’t enough healthy cells to survive.

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Summary

Background

30-day mortality might be a useful indicator of avoidable harm to patients from systemic anticancer treatments, but data for this indicator are limited. The Systemic Anti-Cancer Therapy (SACT) dataset collated by Public Health England allows the assessment of factors affecting 30-day mortality in a national patient population. The aim of this first study based on the SACT dataset was to establish national 30-day mortality benchmarks for breast and lung cancer patients receiving SACT in England, and to start to identify where patient care could be improved.

Methods

In this population-based study, we included all women with breast cancer and all men and women with lung cancer residing in England, who were 24 years or older and who started a cycle of SACT in 2014 irrespective of the number of previous treatment cycles or programmes, and irrespective of their position within the disease trajectory. We calculated 30-day mortality after the most recent cycle of SACT for those patients. We did logistic regression analyses, adjusting for relevant factors, to examine whether patient, tumour, or treatment-related factors were associated with the risk of 30-day mortality. For each cancer type and intent, we calculated 30-day mortality rates and patient volume at the hospital trust level, and contrasted these in a funnel plot.

Findings

Between Jan 1, and Dec, 31, 2014, we included 23 228 patients with breast cancer and 9634 patients with non-small cell lung cancer (NSCLC) in our regression and trust-level analyses. 30-day mortality increased with age for both patients with breast cancer and patients with NSCLC treated with curative intent, and decreased with age for patients receiving palliative SACT (breast curative: odds ratio [OR] 1·085, 99% CI 1·040–1·132; p<0·0001; NSCLC curative: 1·045, 1·013–1·079; p=0·00033; breast palliative: 0·987, 0·977–0·996; p=0·00034; NSCLC palliative: 0·987, 0·976–0·998; p=0·0015). 30-day mortality was also significantly higher for patients receiving their first reported curative or palliative SACT versus those who received SACT previously (breast palliative: OR 2·326 99% CI 1·634–3·312; p<0·0001; NSCLC curative: 3·371, 1·554–7·316; p<0·0001; NSCLC palliative: 2·667, 2·109–3·373; p<0·0001), and for patients with worse general wellbeing (performance status 2–4) versus those who were generally well (breast curative: 6·057, 1·333–27·513; p=0·0021; breast palliative: 6·241, 4·180–9·319; p<0·0001; NSCLC palliative: 3·384, 2·276–5·032; p<0·0001). We identified trusts with mortality rates in excess of the 95% control limits; this included seven for curative breast cancer, four for palliative breast cancer, five for curative NSCLC, and seven for palliative NSCLC.

Interpretation

Our findings show that several factors affect the risk of early mortality of breast and lung cancer patients in England and that some groups are at a substantially increased risk of 30-day mortality. The identification of hospitals with significantly higher 30-day mortality rates should promote review of clinical decision making in these hospitals. Furthermore, our results highlight the importance of collecting routine data beyond clinical trials to better understand the factors placing patients at higher risk of 30-day mortality, and ultimately improve clinical decision making. Our insights into the factors affecting risk of 30-day mortality will help treating clinicians and their patients predict the balance of harms and benefits associated with SACT.

Funding

Because of these important findings, researchers have now advised physicians to exercise more caution in the process of vetting which patients should in fact receive chemotherapy and which, ideally should not. Older, infirm patients could potentially be better off without receiving palliative care.

“The statistics don’t suggest bad practice overall but there are some outliers,” noted Professor David Dodwell of the Institute of Oncology at St. James Hospital in Leeds.

“It could be data problems, and figures skewed because of just a few deaths, but nevertheless it could also be down to problems with clinical practice,” he continued.

“I think it’s important to make patients aware that there are potentially life threatening downsides to chemotherapy. And doctors should be more careful about who they treat with chemotherapy.”

It’s important to realize that doctors aren’t intending to harm their patients by prescribing this method of treatment, this is what they have been taught during their extensive years of schooling and education, this is the curriculum, so it’s the widely accepted treatment method for cancer even though it often doesn’t help at all and can make things worse as mentioned above.

The hospitals involved maintain their stance, after reviewing the information that chemotherapy is safe, with the caveat patient selection for the treatment should be more discretionary. Chemo does seem to work for many, but there is a more ideal patient for this method and it shouldn’t be prescribed to every cancer patient that walks through the door.

Professor David Cameron of the Edinburgh Cancer Centre at West General Hospital in Edinburgh, Scotland, noted,

“The concern is that with some of the patients dying within 30 days of being given chemo probably shouldn’t have been given the chemo. But how many? There is no easy way to answer that, but perhaps looking at those places/hospitals where the death rate was higher might help. Furthermore, if we give less chemo then some patients will die because they didn’t get enough chemo. It’s a fine balance and the more data we have the better we can be t making sure we get the balance right. “

U.S. Doctors, Take Note

Unfortunately, in the United States many patients are forced to undergo chemotherapy despite what they want for themselves. This has happened with many children whose parents are opting to seek out alternative cancer treatments.

One example involves, 17-year-old Cassandra C., who has Hodgkin lymphoma, has been denied her desire to pursue alternative treatment methods when it comes to her cancer treatment. The Connecticut Supreme Court ruled, on January 8th, that Cassandra (who declined chemotherapy treatment) will be forced to undergo the treatment anyway. She cited chemotherapy’s adverse health effects as her main reason for refusing.

Cassandra expressed that being forced into surgery and chemo has traumatized her, that it should be a given human right to decide what you want and don’t want for your own body.

Alternatives?

The most frustrating part about this whole thing is that there are in fact many alternative methods to treating cancer that are not recognized, accepted or provided with enough funding for thorough studies to be considered as an option in the first place.

Successful alternative methods that have been used to treat cancer is an entirely separate topic that involves a lot of research, but success has been reported using vegan methods, fasting methods, and more. Clinical trials have been conducted in these areas, but we don’t hear much about it. The science on this that’s emerging is fascinating, and we encourage all who are interested to look into it a little deeper if interested.