Surgery, drugs and radiation — aka the “cut, poison, burn” strategy — are typically the only solutions offered by most conventional oncologists to treat cancer, and upon receiving a cancer diagnosis most people are willing to do just about anything to get better. Unfortunately, the standard of care for cancer is not necessarily the most effective.
Research dating back over a decade suggests many women with breast cancer can opt for gentler versions of chemotherapy, or skip it altogether, without harming their chances of recovery. One 2007 study found some breast cancer patients had better outcomes when given Taxotere, a milder chemotherapy drug than Adriamycin, which had been the standard for decades.1
Another suggested the Oncotype DX test2,3 may be able to help determine whether a breast cancer patient might benefit from chemo by measuring the activity of 21 genes involved in cancer recurrence. At the time, Dr. Eric Winer of the Dana-Farber Cancer Institute in Boston said,4 “We are backing off on chemotherapy and using chemotherapy more selectively.” Now, a number of additional studies have come to the same conclusion: Many breast cancer patients do not need chemotherapy, and have better outcomes without it.
Many Cancer Patients Fare Better Without Chemo
According to the American Society of Clinical Oncology (ASCO), many cancer patients are being overtreated to their detriment; an estimated 70 percent of women with early stage breast cancer probably do not need chemotherapy, and fare just as well without it.5 As reported by NPR:6
“One dramatic example revealed at the [2018 ASCO] meeting relates to the most common form of breast cancer, known as hormone-positive, HER-2 negative disease. For many women who have this diagnosis, but for whom the disease has not spread to lymph nodes, a new study7,8 finds that anti-hormone treatment after surgery is enough, and women won’t benefit from rounds of toxic and uncomfortable chemotherapy.
Treatment of breast cancer for this large group of women will become easier. And for the many women who already choose not to undertake chemotherapy, they can be reassured that it’s the right call. Likewise, researchers from France presented evidence that people with severe colon cancer don’t benefit from a common treatment, which involves heated chemotherapy administered at the time of surgery.
This treatment has been in use for 15 years, without good evidence that it actually works … The study9 of 265 patients found that it didn’t work … The study is ‘an excellent example of how less is more,’ when it comes to certain cancer treatments, says Dr. Andrew Epstein, an oncologist from Memorial Sloan Kettering Cancer Center who spoke on behalf of ASCO.”
Genetic Testing Allows for Safer Treatment Protocols
In the case of breast cancer, ASCO confirms that the 21-gene test, which assesses your risk of cancer recurrence, is a valuable tool that helps spare women from unnecessary treatment. It’s been estimated that about half of all women diagnosed with breast cancer worldwide have HER2-negative cancer, meaning it is a node-negative, hormone-receptor positive type of cancer, which is typically treated with a combination of estrogen-blocking drugs and chemo.
According to ASCO’s findings, women with estrogen-sensitive breast cancer that test negative for HER2, and whose tumors are smaller than 5 centimeters, have not spread to the lymph nodes, and have an Oncotype DX score between 11 and 25 (out of a max score of 100), can forgo the chemo.
For this study, more than 10,000 breast cancer patients were followed for an average of nine years. Just over 6,700 of them had Oncotype DX scores between 11 and 25, which is considered an intermediate risk. Half of this group received hormone therapy alone, while the other half received hormone therapy in conjunction with chemo.
At the end of the study, 83.3 percent of those who received hormone therapy alone had not developed a recurrence. Among the dual-treatment group, that percentage was 84.3 percent — a not statistically significant difference.
The survival rate was also near identical — 93.9 percent among those receiving hormone therapy alone versus 93.8 percent for those receiving both hormone therapy and chemo. According to Dr. Jeffrey Abrams, associate director of the National Cancer Institute’s Cancer Therapy Evaluation Program:10
“These findings, showing no benefit from receiving chemotherapy plus hormone therapy for most patients in this intermediate-risk group, will go a long way to support oncologists and patients in decisions about the best course of treatment.”