Systemic adjuvant therapy for node-negative breast cancer: proven or premature?

Article Abstract:

Four recent studies showed that there was a significant delay in the recurrence of breast cancer in patients after adjuvant therapy. It is felt by some that a reduced relapse rate, even in the absence of any clear improvement of survival time, justifies the use of adjuvant therapy. The period of time that a patient is free of disease is an important endpoint because the quality of life is better before recurrence of the cancer than after. The assumption that delays in recurrence will be followed by improvements in survival is not necessarily true. These and earlier studies did not show any specific clear survival advantage in women with breast cancer whose lymph nodes did not contain any detectable cancer after adjuvant therapy. Without adjuvant therapy, over 70 percent of the women with node-negative breast cancer survive and are disease-free for more than 10 years. The use of adjuvant systemic therapy among women whose lymph nodes do not contain any detectable cancer is controversial. It is felt that without a significant delay in the relapse rate and without fully understanding the complications and toxicity of some of the drugs, such as tamoxifen, which is a nonsteroidal anti-estrogen compound, as well as various types of chemotherapy, adjuvant therapy is not justified. Until an increase in survival is seen to result from adjuvant therapy, or at least until long-term safety and improved quality of life can be demonstrated, adjuvant systemic therapy should not be considered standard treatment for women with node-negative breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Antineoplastic agents, Cancer, Chemotherapy, Tamoxifen, Adjuvant chemotherapy, editorial

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Prostate cancer: are we screening and treating too much?

Article Abstract:

There is not yet enough scientific evidence to determine which men with prostate cancer need to be treated. The introduction of prostate-specific antigen (PSA) testing has resulted in an increase in the number of prostate cancer cases detected each year. However, no conclusion can be reached on the possible outcome of treatment because many studies followed different patient groups. Many also discounted the complications of treatment, which include incontinence and impotence. The American Cancer Society recommends that all men over 50 have annual rectal exams and regular PSA tests.

Editorial, Standards, Medical screening, Health screening

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Update in oncology

Article Abstract:

Evaluations of treatments for the most common types of cancer that were published in 1999 are discussed. Topics include the treatment of breast cancer, prostate cancer, colorectal cancer, cervical cancer, and multiple myeloma.

Colorectal cancer, Cervical cancer, Multiple myeloma

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