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Surgery

  • Chapter
The Science of Cancer Treatment

Part of the book series: Cancer Biology and Medicine ((CABM,volume 2))

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Abstract

The objectives of cancer treatment can be defined according to population requirements or according to the needs of the individual. As far as the population is concerned, Government authorities are entitled to expect that cancer treatment will lead to mortality reductions and cost containment. Furthermore, it is reasonable to expect that these mortality reductions will be concentrated amongst the most productive sections of society, so that the work force and the family are protected. As far as the individual is concerned, he or she is entitled to expect that the cancer treatment will either improve the length or quality of life. Regarding the objectives for the population at large, there is no good evidence that cancer treatment has achieved these goals. Viewed as a whole, there is no evidence of a reduction in mortality from the common solid tumours in Western cultures in spite of an enormous investment in high technology1. For example, we are familiar with the appalling increase in deaths from lung cancer, amongst men and women, almost entirely related to the adoption of smoking as a socially acceptable practice in the 1940s and the 1950s. At the same time, we have seen significant reductions in mortality from gastric cancer which are totally unrelated to therapy but are simply due to reduction in the incidence of the disease, perhaps as a result of improvements in social circumstances, or the removal of an as yet unidentified carcinogen from the environment.

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References

  1. Breslow, L. and Cumberland, W. G. (1988). Progress and objectives in cancer control. J. Am. Med. Assoc., 259/11, 1690–1694

    Article  Google Scholar 

  2. Timmins, N. (1988). Controversy grows over cancer machine scheme. Article in The Independent Newspaper, 6 October, page 2

    Google Scholar 

  3. Committee for Evaluating Medical Technologies (1985). Assessing Medical Technologies. (Washington DC: National Academy Press)

    Google Scholar 

  4. Early Breast Cancer Trialists Collaboratives Group (1988). The effects of adjuvant tamoxifen and of cytotoxic therapy on mortality in early breast cancer: an overview of 61 randomized trials among 28,896 women. N. Engl. J. Med., 319, 1681–1692

    Article  Google Scholar 

  5. Popper, K. R. (1959). The Logic of Scientific Discovery. (London: Hutchinson)

    Google Scholar 

  6. Baum, M. (1983). Quack cancer cures or scientific remedies? Clin. Oncol., 9, 275–280

    PubMed  CAS  Google Scholar 

  7. Bunker, J. P., Hinkley, D. and McDermott, W. V. (1978). Surgical innovation and its evaluation. Science, 200, 937–941

    Article  PubMed  CAS  Google Scholar 

  8. Barnes, B. (1977). Discarded operations: surgical innovation by trial and error. In Bunker, J. P., Barnes, B. A., Mosteller, F. (eds.) Costs, Risks and Benefits of Surgery, pp. 109–123. (New York: Oxford University Press)

    Google Scholar 

  9. De Moulin, D. (1983). A Short History of Cancer. (Lancaster: Martinus Nyhoff Publishers)

    Google Scholar 

  10. Halsted, W. S. (1898). The radical operation for the cure of carcinoma of the breast. Johns Hopkins Hosp. Rep., 28, 557

    CAS  Google Scholar 

  11. Gross, S. W. (1880). A Practical Treatise of Tumours of the Mammary Gland. (New York: Appleton)

    Google Scholar 

  12. Keynes, G. (1937). Conservative treatment of cancer of the breast. Br. Med. J., 2, 643–647

    Article  PubMed  CAS  Google Scholar 

  13. Cade, Sir S. (1948). Discussion: the treatment of cancer of the breast. Proc. R. Soc. Med., 41, 129

    Google Scholar 

  14. Paterson, R. P. and Russell, M. H. (1959). Clinical trials in disease. J. Fac. Radiol., 10, 130

    Article  Google Scholar 

  15. Berstock, D. A., Houghton, J., Haybittle, J. and Baum, M. (1985). The role of radiotherapy following total mastectomy for patients with early breast cancer. World J. Surg., 9, 667–670

    Article  PubMed  CAS  Google Scholar 

  16. Cuzick, J., Stewart, H., Peto, R., Baum, M., Lythgoe, J. P., Ribeiro, G., Scheurlen, H. and Wallgren, A. (1987). Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer. Cancer Treat. Rep., 71, 15–29

    PubMed  CAS  Google Scholar 

  17. Haybittle, J. L., Brinkley, D., Houghton, J., A’Hern, R. P. and Baum, M. (1989). Postoperative radiotherapy and late mortality: evidence from the CRC (King’s/Cambridge) trial for early breast cancer. Br. Med. J., 298, 1611–1614

    Article  CAS  Google Scholar 

  18. Fisher, B. (1970). In Current Dilemmas in the Primary Therapy of Invasive Breast Cancer. A Critical Appraisal. Current Problems in Surgery. (Chicago: Year Book Publishers)

    Google Scholar 

  19. Maguire, P. (1982). Psychiatric morbidity associated with mastectomy. In Baum, M., Kay, R. and Scheurlen, H. (eds.) Birkhauser Clinical Trial in Early Breast Cancer (2nd. Heidelberg symposium), pp. 373–380

    Google Scholar 

  20. Fallowfield, L., Baum, M. and Maguire, G. P. (1988). The effects of breast conservation on the psychological morbidity associated with the diagnosis and treatment of early breast cancer. Br. Med. J., 293, 1331–1334

    Article  Google Scholar 

  21. Goldhirsch, A., Gelber, R. D. and Davis, B. W. (1986). Adjuvant chemotherapy trials in breast cancer: an appraisal and lessons for patient care outside the trials. In Breast Disease, Chap. 10, pp. 123–138. (Edinburgh: Churchill Livingstone)

    Google Scholar 

  22. Bonadonna, G. and Valagusa, P. (1981). Dose-response effect on adjuvant chemotherapy in breast cancer. N. Engl. J. Med., 30, 10–15

    Article  Google Scholar 

  23. Rose, D. P. and Davis, T. E. (1977). Ovarian function in patients receiving adjuvant chemotherapy for breast cancer. Lancet, 1, 1174

    Article  PubMed  CAS  Google Scholar 

  24. Cole, M. P. (1970). Prophylactic compared with therapeutic X-ray artifical menopause. 2nd Tenovus Workshop on Breast Cancer, pp. 2–11. (Cardiff: Alpha-Omega)

    Google Scholar 

  25. Nolvadex Adjuvant Trial Organisation (NATO) (1983). Controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer. (1983). Interim analysis at 4 years by NATO. Lancet, 1, 257–261

    Google Scholar 

  26. Nolvadex Adjuvant Trial Organisation (NATO) (1985). Controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer. (1985). Analysis at 6 years by NATO. Lancet, 1, 836–840

    Google Scholar 

  27. Early Breast Cancer Trialists Collaborative Group (1988). The effects of adjuvant tamoxifen and of cytotoxic therapy on mortality in early breast cancer: an overview of 61 randomized trials among 28,896 women. N. Engl. J. Med., 319, 1681–1692

    Article  Google Scholar 

  28. Nolvadex Adjuvant Trial Organisation (NATO) (1985). Six year results of a controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer. World J. Surg., 9, 756–764

    Article  Google Scholar 

  29. Overview of adjuvant trials — JNCI Supplement: 1989 in press.

    Google Scholar 

  30. Nolvadex Adjuvant Trial Organisation (1988). Analysis at eight years of a controlled trial of tamoxifen as a single adjuvant agent in the management of early breast cancer. Br. J. Cancer, 57, 608–611

    Article  Google Scholar 

  31. Kon, O. L. (1983). An antiestrogen-binding protein in human tissues. J. Biol. Chem., 258, 3173

    PubMed  CAS  Google Scholar 

  32. Lippman, M. E. (1975). Oestrogen responsive human breast cancer in long term tissue culture. Nature (London), 256, 592–593

    Article  CAS  Google Scholar 

  33. Dunn, A. R. (1986). Viral and Cellular oncogenes: a molecular basis for breast and other cancers. In Forbes, J. F. (ed.) Breast Disease, Chap. 5, pp. 59–68. (Edinburgh: Churchill Livingstone)

    Google Scholar 

  34. Fisher, B., Redmond, C. and Fisher, E. R. (1980). The contribution of recent NSABP trials of primary breast cancer therapy to an understanding of tumour biology. Cancer, 46, 1009

    Article  PubMed  CAS  Google Scholar 

  35. Meyer, J. S., Rao, B. R., Stevens, S. C. and White, W. L. (1977). Low incidence of oestrogen receptor in breast carcinoma with rapid rates of cellular replication. Cancer, 40, 2290

    Article  PubMed  CAS  Google Scholar 

  36. Waterfield, M. D., Scrace, G. T., Whittle, N. et al. (1983). Platelet derived growth factor is structurally related to the putative transforming protein p28 of simian sarcoma virus. Nature (London), 304, 34

    Article  Google Scholar 

  37. Steele, R. J. C. (1983). Clinical, histological and immunological studies in human breast cancer. MD Thesis, University of Edinburgh

    Google Scholar 

  38. Sainsbury, J. R. C., Farndon, J. R., Sherbet, G. V. and Harris, A. L. (1985). Epidermal-growth factor receptors and oestrogen receptors in human breast cancer. Lancet, 1, 364–366

    Article  PubMed  CAS  Google Scholar 

  39. Trivedi, D. (1986). Antigenic profile of human breast tumours. PhD Thesis, University of London

    Google Scholar 

  40. Knabbe, C., Lippman, M. E. and Wakefield, L. (1987). Evidence that factor beta is a hormonally regulated negative growth factor in human breast cancer cells. Cell, 48, 417–428

    Article  PubMed  CAS  Google Scholar 

  41. Coletta, A. A., Wakefield, L. M., Howell, F. V., Ebbs, S. R., Sporn, M. and Baum, M. (1989). Oestrogen receptor independent synthesis of transforming growth factor beta 1 induced by triphenylethylenes. J. Molec. Endocrinol. (in press)

    Google Scholar 

  42. Gelber, R. D. and Goldhirsch, A. (1988). Can a clinical trial be the treatment of choice for patients with cancer? J. Natl. Cancer Inst., 80, 886–887

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. M. Baum
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Editors and Affiliations

  1. CRC Human Cancer Genetics Research Group, Department of Pathology, University of Cambridge, UK

    B. A. J. Ponder (Director) (Director)

  2. University of Cambridge, UK

    M. J. Waring (Lecturer in Pharmacology) (Lecturer in Pharmacology)

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© 1990 Kluwer Academic Publishers

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Baum, M. (1990). Surgery. In: Ponder, B.A.J., Waring, M.J. (eds) The Science of Cancer Treatment. Cancer Biology and Medicine, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0709-6_1

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  • DOI: https://doi.org/10.1007/978-94-009-0709-6_1

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6804-8

  • Online ISBN: 978-94-009-0709-6

  • eBook Packages: Springer Book Archive

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