Questioning Chemotherapy:
Is it safe? Is it effective? Is it necessary?
by Ralph W. Moss, Ph.D.
reviewed by Ed Hill

It is reported that cancer is now the leading cause of death for people under the age 85. Every year, more and more people with cancer are being given chemotherapy. Is chemotherapy safe? Is it effective? Is it necessary? In Questioning Chemotherapy, author and researcher Ralph Moss offers information and advice to help the reader make wise decisions for themselves and those they love.

Moss says that people who agree to receive chemotherapy have accepted the idea that even if a notoriously toxic and expensive treatment cannot cure, it must at least have some beneficially effect on the patient. The reason this idea is accepted is that the public has been subjected to a media barrage reporting the supposed success of new treatments. According to Moss, there are several ways people are led to believe they will be helped, even when there is not trust-worthy evidence.

One of the most misleading assumptions people make when they read reports about idea that shrinkages or "response rates" have anything to do with increased survival time or improved quality of life. For example, when a patient asks, "What are my chances?", the doctor may give an impressive-sounding "response rate" like 60%. No explanation is given of exactly what "success" or a "response" is or whether it actually correlates with increased survival. In fact, says Moss, such a correlation has not been proven for most kinds of cancer and cancer treatments. The doctor talks "response rate" but the patient hears "cure"! These patients and their family members may be disappointed, or even furious, when they later realize that increased "response rates" often do not mean increased survival or improved quality of life. Application of chemotherapy drugs may indeed result in a temporary shrinkage of measurable tumors for some patients. But what are the long term results of some shrinkages? Does the patient survive any longer?
 

This most basic question is almost never asked, let alone answered.

Deceptive Reporting

Moss describes 4 major problems with reporting of cancer research that can deceive patients, and even doctors, into believing that a treatment offers more promise than it actually does.

Lead-time bias: Lead time bias accounts for much of the illusory "improvement" seen in the last few decades in treating many kinds of cancer. We are told, "The earlier the cancer is found, the longer the patient survives."

Because we are getting better at detecting cancer, we can detect it sooner. Even if the patient dies at the same time as if the cancer had not been detected or treated, if the cancer is detected earlier, he will live longer after detection. Actually no time has been added to the patient's survival, but the statistics look much better.

Stage migration: With better diagnostic equipment, patients' metastases are being found in an earlier "silent" condition. Thus, they are being staged differently, and placed into more advanced categories. The net result is that patients appear to have considerably improved survival rates for their stage. But this is merely another statistical artifact.

Publication Bias: Positive results of drugs are more quickly and frequently published than negative ones.

Selection bias: This bias arises if responders to therapy happen to be those patients who would have lived longer anyway, whether or not they had received the treatment. When they live longer, the credit is given to therapy.

Chemotherapy's "Rubber ruler"

Another way patients can be misled is by the use of the term "cure".

According to Webster's Dictionary, a cure is "something that corrects, heals, or permanently alleviates a harmful or troublesome situation". To the cancer establishment, the word "cure" has a different meaning. For them a cure can be a 5-year, a 3-year, or even a 1-year interval of survival, free from cancer. The definition of "cure" varies depending on the type of cancer and on the individual patient. Moss calls this using a "rubber ruler" to construct definitions of "cure" to fit the chemotherapy establishment's purposes.

Suppose a patient has cancer that goes into remission after treatment. Several months or years later there is a recurrence, and the cancer returns, more aggressive than it was before. Moss asks, "Is that a cure? Not by any common meaning of the word, yet that very thing can happen with a cancer "cure"."

Hypocrisy

According to studies cited in the book, the vast majority of oncologists refuse to participate in clinical drug trials. Many or most reject chemotherapy for themselves or their own families. Yet the same doctors continue to prescribe it for their patients. Moss asks, "What should we call this?"

Not an effective weapon

The author notes that chemotherapy is very good-for the balance sheets of drug companies. It builds careers. It may even offer patients and their families a sense of hope (albeit false) in hopeless times. But he argues that chemotherapy is not an effective weapon against the vast majority of cancers in adults.

It rarely extends overall survival, and the little advantage that may be gained is generally offset by the damage that is done. Chemotherapy should not be regarded as a "proven" or conventional treatment for most cancers. Less toxic alternative treatments are still desperately needed.

What should you do?

Moss emphasizes that patients and their families need to question their doctors before consenting to any treatment (a good practice with any medical diagnosis or treatment). The key question to ask is, "What proof is there that the treatment being offered will cure, extend actual survival, or increase the quality of life?" Ask to see scientific papers and reports on the treatment. If necessary, seek professional help in interpreting this information.

You have a moral and legal right to ask for, and be given, that information. Be on your guard against evasive maneuver of all kinds. Be especially wary of doctors who say, "Our treatment is so new that we haven't had a chance to evaluate it yet."

Moss passes on hard won advice from a cancer patient's widow who wrote, "Question your doctor. Question him every step of the way. The more serious the condition, and the more drastic the treatment, the more stringent the questioning must be. If you don't have the energy, enlist the help of someone who does… Don't be afraid to fight. Question your doctor the same way you would a politician, for the 2 are not dissimilar. If your doctor won't answer the questions, find one who will… There is a party line within the medical system. Question your doctor, always."

If a drug or regimen has not been proven to cure, significantly prolong actual survival, or improve the quality of life-if it only temporarily shrinks tumors, with a probable loss in well being-then it is, at best, experimental and unproven, and should not be represented as anything else. At worst, it could be not only ineffective, but painful, destructive, or even fatal.

It may be time to look into other alternative, nutritional, or nontoxic treatments. It is Moss' personal opinion that the best of these treatments are based on more plausible theories and offer more compelling evidence than most chemotherapy. They certainly do far less harm.

Patients and their loved ones are often understandably devastated when they learn that they have cancer. It is an additional blow to learn that chemotherapy is not likely to help, much less cure. But cancer is not a death sentence. It can be a turning point. The end of illusions can be the beginning of wisdom.

Ralph W. Moss is an internationally known writer whose other books include Antioxidants against Cancer, Cancer Therapy, and The Cancer Industry. His scientific articles have appeared in such peer-reviewed journals such as The Lancet, The Journal of the American Medical Association, and Integrative Cancer Therapies, of which he is a corresponding editor. Visit his website at www.cancerdecisions.com

Ed Hill and his wife, Kathy, are Samaritan Ministries members from Franklin, North Carolina.