Cancer and Bone Marrow transplants…a scary past

A bone marrow harvest.

Image via Wikipedia

Cancers can be potentially treated with surgery (removal of the tumor if possible), radiation (high intensity laser source that kills the cells in the path of the laser beam), chemotherapy (drugs used to kill the tumor) or in combination of those.  Some of these work well.  Some of these don’t.  It really depends on the cancer type and the stage of the cancer and on other factors.

Surgery does not work well when a cancer is caught at later stages and when it has spread to other areas (we call that metastasis).  Radiation therapy only works on certain cancers that have cells that are sensitive to radiation (not all cells types are sensitive).  Chemotherapy works quite well for many types of cells and thus many kinds of cancers but each kind of cancer requires its own special cocktail (usually more than one) of chemotherapy and thus is often quite toxic.  None of these are curative for all cancers.  In fact, with the exception of some childhood cancers and some blood cancers, most are still not 100% cured by any means.

So, in more recent time more drastic procedures have been attempted at reaching a cure to breast cancer (and other cancers).  One of these is bone marrow transplants.  A bone marrow transplant is one in which the bone marrow (the soft liquid inside the bones) is removed and stored (usually frozen) and then added back into the same patient.  That is called autologous bone marrow transplant.  Why is this done.  Well it turns out that the chemotherapy these days being used is very toxic.  The cells that tend to be most sensitive to the drugs besides the cancer are the stem cells in the bone marrow.  As cancer doctors have tried harder and harder to kill tumors permanently they have used higher and higher doses of chemotherapy…so high that people with cancer started to lose their bone marrow.

So, they devised a way to remove the marrow and treat people with almost lethal doses of chemotherapy that would kill the tumor cells and then put the bone marrow back in.  This was a risky procedure and was still dangerous and lead to many complications.  In the 80’s it was thought that this really should work.  More and more doctors were convinced even though there was no good evidence.  Then someone from South Africa said that he had done a large trial and showed how superior this method (called STAMP) was to other treatment methods for curing breast cancer.  He claimed that he got long-term remission and that women were living longer and longer.  In reality, he cheated and made up the data (although he did try to treat many women) and when he was exposed as a fraud, it was quite late.  Oncologists, believed him and started treating more and more women this way.  Just like radical surgery that was not needed, it was discovered ten years later that STAMP was no better than standard chemotherapy and radiation for advanced stages of breast cancer.

So, in conclusion….again (seems like I have repeated this theme so often) doctors who were so sure of themselves and their procedures were so convinced that they were doing the right thing that they did not bother to collect evidence that it actually works.   Finally, it took other doctors who were passionate about learning the truth to realize that perhaps things were not as they seem.  So, doctors do want to help and they are trying.  But, often just like the rest of us, they fall into temptation.  What I am doing must be right…why challenge the status quo…why look for evidence, etc.?

Anyhow, thanks for reading…will follow up with more stories later.

For more general information on cancer please do see Cancer Made Simple!

Dr. C

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