BMJ  2004;328:1430-1432 (12 June), doi:10.1136/bmj.328.7453.1430

Education and debate

Chemotherapy for cancer patients who present late

Stella J Bowcock, consultant haematologist1, Charles D Shee, consultant physician in respiratory and palliative medicine1, Saad M B Rassam, consultant haematologist1, Peter G Harper, consultant medical oncologist2

1 Queen Mary's Sidcup NHS Trust, Sidcup, Kent DA14 6LT, 2 Department of Medical Oncology, Guy's and St Thomas's Hospital NHS Trust, London SE1 9RT

Correspondence to: S J Bowcock stella.bowcock@qms.nhs.uk

Doctors should not overlook the potential benefits of chemotherapy in patients with incurable cancer

The first 150 words of the full text of this article appear below.

A patient presenting with an advanced curable cancer is usually regarded as a medical emergency and treated with chemotherapy and full medical support. However, a patient presenting with a chemosensitive but incurable cancer at an advanced stage may be offered only palliative care. We argue that giving reduced dose chemotherapy to very ill patients with incurable cancer can be beneficial. The benefits can include symptom control and buying a short window of time to allow the patient and family to come to terms with the diagnosis. The cancer patients we are discussing are those who are newly diagnosed with chemosensitive tumours and who have not had previous chemotherapy. They must be distinguished from previously treated cancer patients, who may be resistant to chemotherapy and in whom supportive palliative measures may be more appropriate.

Trials in most malignancies show that poor performance status correlates closely with reduced survival1 2 and in some . . . [Full text of this article]

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