Chemotherapy--Is It Worth It?

Look at this research and see for yourself. My answer? Not really. It is interesting. Many docs who get cancer might choose surgery, but rarely choose radiation and chemo.

Look at this:

Olaussen and colleagues analyzed data from a very large clinical trial looking at whether post-surgery chemo improved survival for non-small-cell lung cancer patients. It did -- but only by about 4%.

As part of the study, the researchers collected 761 tumor samples. Less than half -- 44% -- carried a protein called ERCC1; the other 56% did not. ERCC1 has been a suspect in chemotherapy resistance because it repairs DNA. Platinum-based chemotherapy works by disrupting the cancer's DNA.

Sure enough, the researchers found that patients whose tumors did not carry ERCC1 had better odds for survival -- about 14 months longer -- if they underwent chemo. Five years after treatment, 47% of those who got chemo were still alive. The five-year survival rate was 39% among those who did not undergo chemo.

Chemo did not affect the survival of patients whose tumors carried ERCC1. However, in an interesting note, among patients who did not get chemo, ERCC1-positive patients survived longer than ERCC1-negative patients.

While the study was conducted in lung cancer patients, Olaussen and colleagues note that ERCC1 has been linked to chemo resistance in patients with other kinds of cancer, including stomach, ovarian, colon, and esophageal cancers.

Read that again. Of those who chose not to have chemo, the ones with the DNA fixing ERCC1 gene (meaning the Cancer could continue multiplying because the DNA could be fixed by itself) lived longer. You would think that unfixable cancer DNA would fizzle out faster, but it doesn't. So ERCC1 patients live longer.

Makes me wonder if chemo is worth it for anyone. Would you go through it for a 4% chance improvement? (This is for non-small cell lung cancer only.) I wouldn't.