Cancer chemotherapy

Cancer chemotherapy is still in its infancy and, except for a few rare types of malignant disease, it will cure no one. Palliation may be offered a somewhat larger group, but with no implication of necessarily prolonging life. It is not yet a substitute for conventional curative or palliative procedures. The most useful summation of therapeutic methods would be a tabulation of the various types of neoplasms and the recommended drug for each. At present, an attempt to do this for most solid tumors would be an exercise in futility. Instead, Table 9 summarizes the most commonly used drugs for those solid tumors that seem to show at least occasional objective responses. The incidence and magnitude of these responses varies from a 70% 5-year survival in choriocarcinoma of women to carcinoma of the pancreas that shows a partial regression lasting 2-4 months in 5% of the cases. The lymphomas, carcinoma of the breast or ovary and, to a lesser extent, carcinoma of the colon respond to specific drug therapy frequently enough so that a definite plan for chemotherapy of these neoplasms should be followed when they become incurable. However, the general use of what might be termed a "bandwagon" approach to cancer chemotherapy is to be deplored. While the unplanned or indiscriminate use of these drugs may be opposed, the one great benefit from the intensive investigation of human cancer during the past 15 years should not be lost. The cancer chemotherapy program has resulted in much improved care for the patient with an incurable malignant tumor. No longer is he sent home with the conclusion that "nothing more can be done for you." The increased interest of the physician has given the patient increased optimism. This of itself is not a small accomplishment.