Re: For those of you with Medline access........

From: Steph (steph_at_vancouver.island)
Date: 02/23/05

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    Date: Wed, 23 Feb 2005 02:25:21 GMT

    "J" <virtual@privacy.net> wrote in message
    news:421B5F73.1E7E16A8@execulink.com...
    > Steph wrote:
    >
    >> "J" <virtual@privacy.net> wrote in message
    >>
    >> > Peter Moran wrote:
    >> >
    >> >> "Steph" <steph@vancouver.island> wrote in message
    >>
    >> >> > I'd be interested in everyone's views on this article.
    >> >> > I think it is one of the most important articles in the medical
    >> >> > literature
    >> >> > in the past 10 years.
    >> >> There seems to be no reason not to post the abstract and here it is.
    >> >> I
    >> >> agree with the conclusions, from the point of view of ensuring
    >> >> accurate
    >> >> informed consent whenever chemotherapy is offered to patients. But
    >> >> think
    >> >> the value of chemotherapy varies too greatly over many different
    >> >> clinical
    >> >> contexts for such *overall* calculations to be meaningful.
    >> >
    >> > Same point made here.
    >> >
    >> > Questioning methodology - accusing them of statistical gymnastics.
    >> > This seems to be making 3 points:
    >> > Some cancers/stages do respond (maybe I saw that elsewhere - mentioned
    >> > testicular)
    >> > The authors did not include people with mets and/or see Colon Duke C ?
    >> > The authors ignore the positives of partial responses at year 1, 2, 3,
    >> > 4
    >> >
    >>
    >> The paper is very careful to state that it only includes people being
    >> treated with curative or adjuvant intent, not patients with metastatic
    >> disease.
    >> It also points out that the survival improvements from chemotherapy for
    >> patients with metastatic disease would certainly be even less.
    >> What positives of partial responses are you referring to?
    >
    > Well, if a tumor shrinks or lesions disappear at year one or two (on
    > chemo),
    > that's viewed as a positive by the patient.
    >

    Yes. Viewed as positive by the patient, and often the oncologist. But does
    it mean anything? Just like does a reduced tumor marker mean anything?. It
    might, it might not.

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