An important paper has been published in the journal Clinical Oncology.

This meta-analysis, entitled "The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies" set out to accurately quantify and assess the actual benefit conferred by chemotherapy in the treatment of adults with the commonest types of cancer. Although the paper has attracted some attention in Australia, the native country of the paper's authors, it has been greeted with complete silence on this side of the world

All three of the paper's authors are oncologists. Lead author Associate Professor Graeme Morgan is a radiation oncologist at Royal North Shore Hospital in Sydney; Professor Robyn Ward is a medical oncologist at University of New South Wales/St. Vincent's Hospital. The third author, Dr. Michael Barton, is a radiation oncologist and a member of the Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Health Service, Sydney. Prof. Ward is also a member of the Therapeutic Goods Authority of the Australian Federal Department of Health and Aging, the official body that advises the Australian government on the suitability and efficacy of drugs to be listed on the national Pharmaceutical Benefits Schedule (PBS) – roughly the equivalent of the US Food and Drug Administration.

Their meticulous study was based on an analysis of the results of all the randomized, controlled clinical trials (RCTs) performed in Australia and the US that reported a statistically significant increase in 5-year survival due to the use of chemotherapy in adult malignancies. Survival data were drawn from the Australian cancer registries and the US National Cancer Institute's Surveillance Epidemiology and End Results (SEER) registry spanning the period January 1990 until January 2004.

Wherever data were uncertain, the authors deliberately erred on the side of over-estimating the benefit of chemotherapy. Even so, the study concluded that overall, chemotherapy contributes just over 2 percent to improved survival in cancer patients.

Yet despite the mounting evidence of chemotherapy's lack of effectiveness in prolonging survival, oncologists continue to present chemotherapy as a rational and promising approach to cancer treatment.

"Some practitioners still remain optimistic that cytotoxic chemotherapy will significantly improve cancer survival," the authors wrote in their introduction. "However, despite the use of new and expensive single and combination drugs to improve response rates...there has been little impact from the use of newer regimens" (Morgan 2005).

The Australian authors continued: "...in lung cancer, the median survival has increased by only 2 months [during the past 20 years, ed.] and an overall survival benefit of less than 5 percent has been achieved in the adjuvant treatment of breast, colon and head and neck cancers."

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