Chemotherapy Won’t Be Remembered as “Bleeding People With Leeches”

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Earlier this month in an interview with Salon discussing his book, “But What If We’re Wrong?”, writer Chuck Klosterman was asked to name something we do today that the future will view as ridiculous.

“If we ever get to a point in medicine – and I assume that we will – where we have a better way to combat cancer, maybe with genetic engineering or something,” Klosterman says, “I would not be surprised if chemotherapy will seem like bleeding people with leeches. It will seem crazy that we poisoned people to make them better.” He goes on to say that chemotherapy isn’t “crazy,” but it will be hard to explain its usage to people centuries into the future.

During the weeks leading up to my mother starting treatment for her Glioblastoma brain tumor, some friends and neighbors voiced their opinions on chemotherapy to me. They asked, “Is your mom sure she wants to put her body through that? Does she understand what it will do to her?” They recommended that we look into natural remedies, or consider skipping treatment altogether so that she wouldn’t experience its side effects. Many paused when they said this, letting the meaning of what said sink in—that living a shorter life may be preferable to living a longer one with chemotherapy’s side effects. The treatment’s reputation of being a poison was the focus of their thoughts. Klosterman’s comparison echoes this perspective.

Bloodletting, the practice Klosterman is referring to, is the act of bleeding out a patient to remove an illness. It was done centuries ago using a special bloodletting kit or leeches. As the blood drains, the patient removes the “bad blood,” the source of the illness, and loses a healthy amount of “good” blood in the process. On the surface, this seems not unlike chemotherapy. In chemotherapy, chemicals (the poison) enter the body to target fast-replicating cells, regardless of whether they are healthy or cancerous. With side effects such as fatigue, nausea, and hair loss, the hope is that the poison will disrupt the growth of cancer cells to prolong the life of the patient. It’s the definition of a “scorched earth” method of treating a disease.

Chemotherapy will indeed seem primitive when we can compare it to the cure for cancer, whenever that is developed. But to make its comparison to bloodletting is to ignore their vastly different origins. Moreso, it disregards the work of scientists to improve chemotherapy and the lives it has prolonged since its introduction almost a century ago.

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(Above is a chart from the 15th century showing parts of the body to be bled to relieve a corresponding disease.)

First off, bloodletting began in antiquity and was founded on the idea that our health relies on the balance of four components, called “humors”: yellow bile, black bile, blood, and phlegm. An ill patient was thought to have an imbalance of these components, so draining blood in strategic places would shift them back into place. The more drained blood the better, so patients were often bled to the point of fainting. The practice lasted for centuries as a means of relieving a variety of diseases, though there was never evidence to back up its efficiency. As evidence-based medicine began to develop just before the 1900s, the supposed benefits of bloodletting gave way and its use dwindled as our knowledge of medicine progressed. It was a more painful version of snake oil.

Chemotherapy, on the other hand, has only ever been improved on thanks to science. The first patients to undergo chemotherapy in 1942 were injected with a chemotherapic agent developed by studying mustard gas and nitrogen mustards during the world wars. Scientists saw that the symptoms of their advanced lymphomas were temporarily improved—and this sparked development into what would become the current “standard of care” for cancer patients. Today, there are more than 100 different types chemotherapy drugs to treat cancer or ease its symptoms. These drugs are considered poisons and oncologists will tell you that. They will also say that advancements in chemotherapy in recent years have made it an even more potent tool in an imperfect toolbox to fight cancer. Science has improved on chemotherapy, not banished its use.

Bloodletting was based on mythology and guesswork. Using it to treat infections, headaches, and other diseases ceased once we determined that it didn’t do, well, any of what people believed it did. Bloodletting is now only used in exceptional circumstances, such as in the treatments for hemochromatosis and polycythemia (two diseases that weren’t discovered until after bloodletting had already been deemed as pseudoscience).

While chemotherapy will one day look primitive in comparison to advanced treatments, as will most modern day treatments when compared to their future replacements, chemotherapy won’t be viewed as “ridiculous” or barbaric in the eyes of future scientists. These scientists will understand that their work is part of a long chain of events built by scientists who worked within the means of their time to push their limits. These are the same scientists who recognized bloodletting as pseudoscience. 

It’s up to a patient to weigh the benefits of chemotherapy against its side effects. Chemotherapy, with all of its negatives, has prolonged lives during a time when other treatments aren’t available. My mom is still alive nine months post-diagnosis. As her doctors have said, there’s no doubt that chemotherapy is what has gotten her to this point. 

It’s not ideal, but chemotherapy is a treatment that works far more often than bloodletting did for the diseases it supposedly relieved. This isn’t the Evil Queen slipping Snow White a poisoned apple, or even draining out her blood, for that matter. Let’s not misconstrue chemotherapy’s place in the progression of cancer treatment.

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