False Hope

False Hope : Bone Marrow Transplantation for Breast Cancer

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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 published studies 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 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 analyses the failure of the technology assessments and randomised 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.show more

Product details

  • Hardback | 368 pages
  • 160 x 238.8 x 25.4mm | 635.04g
  • Oxford University Press Inc
  • New York, United States
  • English
  • 5 line illustrations
  • 0195187768
  • 9780195187762

Review quote

"False Hope is a must-read- a cautionary tale of what happens when our hopes for a medical breakthrough lead us to press for access to it too soon. This book is a rare treat. It is chock full of detail yet a real page turner. Whether you are someone in a position to help prevent similar mistakes in the future, a student seeking to understand the complexities of advances in health sciences, or simply an interested observer of human nature, False Hope is a great story."--Kay Dickersin, Director, Center for Clinical Trials at Johns Hopkins Bloomberg School of Public Health"This fascinating and important book should be a must-read for all who are professionally associated with health care. The story reaffirms the importance of randomized controlled trials, and the dangers of relying on patient panic, physician enthusiasm, the media, litigation, and money."--Alain Enthoven, Marriner S. Eccles Professor of Public and Private Management(Emeritus), Graduate School of Business, Stanford University"False Hope is an in-depth study of one of the many new cancer therapies that have offered early promise and eventually failed. An emotionally wrenching process, it can be very confusing for cancer patients who pin their hopes on these promising therapies. This book provides invaluable insight into the many factors at play when a new therapy comes on the scene."--I. Craig Henderson, Adjunct Professor of Medicine, University of California, San Francisco"The story is not only fascinating, like a complex mystery novel, but many of the players in academia, industry and private practice are well known to most of us...I highly recommend the book in the hope that through its lessons we can postpone a recurrence for a long time."--Oncology Times"False Hope shows how painfully obvious, in retrospect, is the case for high standards of evidence when it comes to medical decisionmaking."--Lancet"The old proverb says that 'history is written by the winners, ' and this book is no exception...This piece of medical history is a sobering reminder that although some new therapies pan out, many do not, and caveat emptor is not a satisfactory approach to choosing health care."--New England Journal of Medicine"False Hope is a meticulously researched case study of clinical medicine 'jumping the gun' by introducing an expensive and toxic procedure in response to the desperation of women (and their families and physicians) with metastatic and high risk early breast cancer...I recommend this book to all Oncology health professionals and anyone with an interest in health technology assessment of new medical procedures. It is a surprisingly 'good read.'"--New Zealand Medical Journal"The authors push beyond what is widely known about the use of the procedure in an organized and effective fashion. Chapters focus on the emergence of HDC/ABMT as a treatment for cancer, the various litigation strategies used by those representing patients seeking coverage of HDC/ABMT from insurers, and the role of entrepreneurial oncology (that is, those who profited from the procedure) in rapidly expanding its use."--Health Affairs"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"This story of the convergence of medical innovation, social and economical pressures in health care, the women's movement, and media forces is mesmerizing...Members of all healthcare professions, administrators who offer or anticipate offering a program of clinical cancer research, and the general public will benefit from reading this book."--Oncology Nursing Forumshow more

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