Overtreatment

Every medical oncologist wants to cure their patients. The problem has been when to stop. The general dictum that has guided medical oncology for 50 years can be summed up as “if some is good, more is better”. This regrettably may not be true. As a rule, patients will manifest benefit from therapy within 2-3 cycles. Thereafter, treatment is continued until complete remission, failure to respond, or intolerable toxicity. We witnessed the most glaring example of over treatment during the era of bone marrow transplantation for solid tumors which proved toxic and ineffective for most cancers, the exception being leukemias, myelomas and some lymphomas. Our preference is to use the right drugs from the start to achieve the best response with the least toxicity. Depending upon the tumor type, we complete treatment with 2 additional cycles beyond complete remission or in the highest risk cases, we may suggest a form of maintenance treatment. All of these therapies are administered with a very close attention to quality of life. Every medical oncologist wants to cure their patients. The problem has been when to stop. The general dictum that has guided medical oncology for 50 years can be summed up as “if some is good, more is better”. This regrettably may not be true. As a rule, patients will manifest benefit from therapy within 2-3 cycles. Thereafter, treatment is continued until complete remission, failure to respond, or intolerable toxicity. We witnessed the most glaring example of over treatment during the era of bone marrow transplantation for solid tumors which proved toxic and ineffective for most cancers, the exception being leukemias, myelomas and some lymphomas. Our preference is to use the right drugs from the start to achieve the best response with the least toxicity. Depending upon the tumor type, we complete treatment with 2 additional cycles beyond complete remission or in the highest risk cases, we may suggest a form of maintenance treatment. All of these therapies are administered with a very close attention to quality of life.