Surgery for early breast cancer - can less be more?

Article Abstract:

Three 1995 studies strengthen the evidence suggesting that conservative breast surgery appears to be as effective as mastectomy in treating early breast cancer. One study is the audit of a previous clinical trial that involved a hospital that reported fraudulent data. Though the audit has various limitations, it found that the data was sufficiently accurate. This audit showed that many physicians were careless in following important procedures for obtaining patient consent. A second study reanalyzed the audited data with extended follow-up, and supported the original conclusion recommending lumpectomy with radiation. However, this reanalysis should have examined data from the fraudulent hospital separately. A third study involving an analysis of many trials found that adding radiotherapy to surgery decreased chances of tumor relapse but did not affect 10-year survival rates. This conclusion seems relatively reliable, but such combined analyses of many trials are often questionable.

Evaluation, Breast cancer, Lumpectomy

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Cancer undefeated

Article Abstract:

Cancer mortality rates have remained relatively stable since 1970. Researchers evaluated statistics on cancer mortality rates in the US between 1970 and 1994. Mortality rates increased from 1970 to 1990 and began to decline in 1991. However, the age-adjusted mortality rates overall were still 6% higher in 1994 than in 1970. Mortality rates have fallen fastest in black males and people under the age of 55. Much of the decline is due to changes in disease incidence, early diagnosis and smoking cessation. It seems clear that the focus of cancer research should switch to prevention rather than treatment.

Patient outcomes, Mortality, Cancer

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The powerful placebo and the wizard of Oz

Article Abstract:

A placebo should not be used therapeutically except perhaps for treating pain. A study published in 2001 showed that placebos were basically worthless for treating any other condition.

Health aspects, Pain, Pain management, Placebos

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