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February 25, 1974

Treatment of the Advanced Cancer Patient

Author Affiliations

Rochester, NY

JAMA. 1974;227(8):941. doi:10.1001/jama.1974.03230210051022

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To the Editor.—  In the QUESTIONS AND ANSWERS in the issue of Dec 3 (226:1246, 1973), two consultants answered an inquiry about treatment of a 68-year-old woman with extensive bone and liver metastases of breast cancer.Both consultants recommended regimens of descending order of effectiveness and ascending orders of toxicity. Neither recommended assessment of the prognosis or suggested therapies. Indeed, apart from a passing brief reference to marrow tolerance, no toxicity of their proposed treatment was mentioned at all.The first duty of the expert is to know and to state the benefits of his proposed therapy. Strangely enough, present day "oncology" apparently refuses to do this, while at the same time appearing obsessed with "controlled studies." A state seems to have been reached where the only people who believe that no one dies of cancer are found among physicians specializing in the handling of cytotoxic agents!Perhaps the answers