False Hope: Bone Marrow Transplantation for Breast Cancer

Hardcover | February 8, 2007

byRichard A. Rettig, Peter D. Jacobson, Cynthia M. Farquhar

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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 publishedstudies 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 in the United States 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 analyzes thelimited effect of the technology assessments and randomized 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.

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From the Publisher

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 publishedstudies showed that the procedure was ineffecti...

Richard Rettig is an Adjunct Senior Social Scientist at RAND Corporation in Arlington, Virginia. Peter Jacobson is Director of the Center for Law, Ethics, and Health at the University of Michigan School of Public Health in Ann Arbor. Cynthia Farquhar is a Postgraduate Professor of Obstetrics and Gynaecology at the University of Auckl...

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Format:HardcoverDimensions:368 pages, 6.42 × 9.21 × 1.1 inPublished:February 8, 2007Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195187768

ISBN - 13:9780195187762

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Table of Contents

Part I: Initial Conditions1. Breast Cancer Patients and the Emergence of a Treatment2. Jumping the GunPart II: Drivers of Clinical Use3. Court Trials4. Litigation Strategies5. Entrepreneurial Oncology6. Government MandatesPart III: The Struggle for Evidence-Based Medicine7. Technology Assessments8. Clinical Trials9. DenoucementPart IV: The Significance of the Story10. Values in ConflictAppendix: Evidence-based Reviews of Clinical Trails.

Editorial Reviews

"This book is well written and researched. It will be of interest to all professionals and organizations involved in the trials of new treatments and drugs."--Oncology News