False Hope
Bone Marrow Transplantation for Breast Cancer
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Product details:
- Publisher OUP USA
- Date of Publication 1 March 2007
- ISBN 9780195187762
- Binding Hardback
- No. of pages368 pages
- Size 166x240x24 mm
- Weight 685 g
- Language English
- Illustrations 5 line illustrations 0
Categories
Short description:
In the late 1980s, a promising new treatment for breast cancer emerged: high-dose chemotherapy with autologous bone marrow transplantation or HDC/ABMT. By the 1990s, it had burst upon the oncology scene and disseminated rapidly before having been carefully evaluated. By the time published studies showed that the procedure was ineffective, more than 30,000 women had received the treatment, shortening their lives and adding to their suffering. This book tells of the rise and demise of HDC/ABMT for metastatic and early stage breast cancer, and fully explores the story's implications, which go well beyond the immediate procedure, and beyond breast cancer, to how we evaluate other medical procedures, especially life-saving ones.
MoreLong description:
In the late 1980s, a promising new treatment for breast cancer emerged: high-dose chemotherapy with autologous bone marrow transplantation or HDC/ABMT. By the 1990s, it had burst upon the oncology scene and disseminated rapidly before having been carefully evaluated. By the time published studies showed that the procedure was ineffective, more than 30,000 women had received the treatment, shortening their lives and adding to their suffering. This book tells of the rise and demise of HDC/ABMT for metastatic and early stage breast cancer, and fully explores the story's implications, which go well beyond the immediate procedure, and beyond breast cancer, to how we evaluate other medical procedures, especially life-saving ones.
It details how the factors that drove clinical use - patient demand, physician enthusiasm, media reporting, litigation, economic exploitation, and legislative and administrative mandates - converged to propel the procedure forward despite a lack of proven clinical effectiveness. It also analyses the failure of the technology assessments and randomised clinical trials that evaluated the procedure and the ramifications of this flawed system on healthcare today.
Sections of the book consider the initial conditions surrounding the emergence of the new breast cancer treatment, the drivers of clinical use, and the struggle for evidence-based medicine. A concluding section considers the significance of the story for our healthcare system.
Table of Contents:
Part I: Initial Conditions
Breast Cancer Patients and the Emergence of a Treatment
Jumping the Gun
Part II: Drivers of Clinical Use
Court Trials
Litigation Strategies
Entrepreneurial Oncology
Government Mandates
Part III: The Struggle of Evidence-Based Medicine
Technology Assessments
Clinical Trials
Dénoument
Part IV: The Significance of the Story
Values in Conflict