Some time back in the dark days of February I had to make a decision about whether or not to have chemotherapy. It was a tough decision, and not even something I realised was even a decision for about three weeks. It took me that long to wake up and realise I had a choice, and I did not have to do something that felt so very wrong to me.

One of the hardest things about making that decision was that I didn’t feel I could trust the statistics I was provided with. I was slightly cynical as the computer tool used by health care professionals to decide whether to offer their patients chemotherapy is called Adjuvant Online and adjuvant therapy basically means the treatment offered after surgery to make sure nothing is left behind to start growing again. I was concerned that there is no way of knowing whether the cancer has spread elsewhere, but with no lymph nodes showing signs of cancer cells, it was unlikely. I felt that if the cancer was so aggressive that it had jumped my lymph nodes and gone rogue, the chemotherapy might not even help, and I’d be putting myself through months of hell, many more months to recover from the side effects, and an early menopause based on figures I instinctively didn’t trust. Those figures, calculated using my age, tumour size, grade and hormone results, gave me a 39% chance of a recurrence within 5-10 year either in my breast or elsewhere. At the time I was concerned that statistics calculated using research conducted by the very companies who want to keep marketing their cytotoxic drugs for a large profit could perhaps be biased. 

I’d been teaching Critical Thinking just before I went and got stupid bloody cancer, and when I was researching Adjuvant Online at the time, I found the possibility – or probability, when you consider that drug companies don’t have to release all their trial findings if they don’t want to – of bias being involved in what amounts to a massive decision like that just too much to stomach. I opted not to do chemo as we know, after finally deciding that as it couldn’t offer a definite cancer free outcome, and would ravage my entire body, possibly for no reason, it wasn’t the right thing for me to do. 

Of course, I could be germinating little cancer growths right now, in my breast, my lungs, my bones, my brain or my liver (this is where breast cancer generally moves it’s funky reproducing business to from the initial tumour site). If that was the case, once I discovered it, I could never know if chemotherapy would have prevented the new cancer parties, or just delayed them. I could have gone through all that for nothing. I decided I could live with that, only slightly more than I could live with the thought of not throwing every available drug on the market into my body and at my errant cancer cells, but it ultimately triumphed as the lesser of the two evils, so I went and gave my consultant’s registrar a bit of a shock when he started telling me what date he’d booked for the start of my chemo.

If only I’d Googled ‘NHS breast  cancer predictor’ at the time. Then I might have found this:

http://www.predict.nhs.uk/predict.shtml

or this, a US counterpart;

http://www.lifemath.net/cancer/breastcancer/therapy/index.php

Both of these give me a much lower chance of 18-23% of a recurrence within 5-10 years. That is quite a disparity!

Adjuvant Online is used globally by medical oncologists to decide whether a patient needs chemotherapy. Aren’t doctors who specialise in chemotherapy going to be inclined to use a tool that is biased towards the use of chemotherapy? It must be in their interest, career-wise. 

Incidentally, I have never regretted that decision, now I just feel a little bit less worried than I did, and even more positive that if the cancer is still having a latent rave in my liver or lungs, it wouldn’t have had an off-switch, and would’ve ignored the cytotoxic medication in favour of carrying on the party. It is, after all, my own cells being rebellious.