The remarks of Drs Jamieson and Ludbrook revive recent controversy in major scientific journals and in the public press. However, adjuvant chemotherapy has been widely accepted by the public and the profession; there is a case for presenting the alternative view.
The cited adjuvant programs in breast cancer are designed for high-risk patients, not patients with stage I breast carcinoma.1,2 Adjuvant chemotherapy has been given to patients with stage II breast cancer whose expectancy of death approximates 75% by ten years.3 Treatment failure is proof of residual disease.
There is no fate worse than death. Drs Jamieson and Ludbrook rightly express apprehension about the unknown long-term effects of chemotherapy. With a 75% likelihood of death from cancer, some risk of chemotherapy has to be acceptable.
Life without cancer has to be of better quality than life with recurrent cancer. The studies of Fisher et al1,3 and Bonadonna
DeCosse JJ. Adjuvant ChemotherapyThe Alternative View. Arch Surg. 1977;112(2):120-121. doi:10.1001/archsurg.1977.01370020014002