The efficacy of surgical treatment of cancer.
This paper is the result of a study to provide a scientific basis for the claim that surgery is effective in extending the life of cancer patients. The study failed to locate any scientifically valid evidence for the claim. The paper includes an outline of some of the factors which led to surgery becoming an 'accepted' treatment for cancer and a discussion of how the problem of ethics continues to prevent proper trials being carried out to prove the efficacy of surgery. Alternative ways of obtaining evidence for the efficacy of surgery are discussed including the Graphical Method, Comparative Studies, Survival Rates, Comparison of Incidence and Mortality, Epidemiological studies and Comparison of Survival after treatments based on two different hypotheses about what cancer is. Each analysis showed no reliable evidence of surgery's efficacy or, where evidence for efficacy could be inferred from the evidence, an alternative conclusion was also possible. Poor methodology, invalid assumptions and definitions, and poor logic are some of the characteristics of this field of medicine. This paper brings together results from scientific papers published over the past 35 years which, taken together, suggest that the reason for the lack of evidence for surgery's efficacy might be that it is not effective because cancer is a systemic rather than a localised disease when first diagnosed.
Benjamin
D J
DJ
D000367:Age Factors; D001675:Bioethics; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis