Medical Questions » Cancer Questions » Question No. 191
Question:My mother is on methotrexate for treatment of cancer. It is having terrible side effects. Is it worth continuing?
Answer:This is an extremely difficult and delicate question of ethics, medical technology and common sense. The treatment of a cancer can include surgery, irradiation and drugs. The type of treatment will vary depending on the type and site of the cancer. Methotrexate is a drug that kills cancer cells. Unfortunately it, and other cancer drugs, can have severe side effects, as they damage some normal cells while destroying the cancer. The usual problems are loss of hair and vomiting associated with constant nausea and a sense of being unwell. Ethically, all doctors are required to do everything possible to prolong human life, and cure disease. If statistics indicate that methotrexate, or any other drug, is likely to be the best treatment, a doctor is ethically obliged to prescribe it. Medical technology may also indicate that certain treatments are sometimes successful, and that a combination of several treatments may give a slightly higher chance of success, but with a dramatic increase in side effects. This is where common sense is required. If a patient is likely to be cured in 50% or even 25% of cases with the use of a course of treatment that may be most unpleasant, most doctors and patients would proceed. If the success rate was only 1%, most doctors would consult with the patient and relatives and not proceed, leaving the remainder of the patient' s life as calm, peaceful and free of side effects as possible. The problem arises between these extremes. Should the patient be given a slight chance of survival after a few months of drug-induced agony, or should nature be allowed to take its course? There is no simple answer. Frank discussions between the patient, doctor and relatives is the only way for a consensus to be reached in solving the dilemma.
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