Kelly, Susan E. and Koenig, Barbara A.
"Rescue" technologies following high-dose chemotherapy for breast cancer: how social context shapes the assessment of innovative, aggressive, and lifesaving medical technologies
Boyle, Philip J. (eds.)
Getting Doctors to Listen: Ethics and Outcomes Data in Context.
Georgetown University Press
(Hastings Center Studies in Ethics).
Full text not available from this repository.
In 1995, two women at Dana-Farber Cancer Institute were given accidental
overdoses of chemotherapy as they underwent experimental high-dose treat
ment for metastatic breast cancer. One woman died, the other was seriously
injured. The goal of high-dose chemotherapy is to kill the maximum number
of cancer cells; the drugs used are so potent they destroy not only the
malignant cells but the patient's own blood-producing system as well. Even
at conventional levels, the drugs given are highly toxic. Experimental high?
dose chemotherapy requires doses so large the patient must subsequently be
"rescued" by infusion of new bone marrow or blood-producing stem cells.
Breast cancer patients risk death in order to buy a chance at cure. The mistaken
doses of chemotherapy at Dana-Farber tragically highlight the tension between
hope for cure and the destructive potential of aggressive, potentially lifesaving
therapies. If desperate women—and their physicians—are willing to take such
risks, how can new therapies such as bone marrow transplant for breast cancer
be evaluated? Innovative, dramatic, and lifesaving technologies hold special
cultural appeal in the United States. What features of this unique social context
shape the technology assessment process?
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