Alternative Treatment Fails, a boy dies

[The Kernel]

I may not be a doctor but how does it necessarily follow that the parents are idiots if they pulled him off chemotherapy while the cancer was in remission, and put him back on when the cancer came back? I've known people who followed all the recommendations and suffered through chemo for years and died anyway. Hell, there was an unfortunate girl in my school when I was a kid, right around that same age. It's not as if there's a guarantee that the chemo's going to work, and while the cancer is in remission it only appears to be doing damage. Perhaps a cancer specialist could explain the reasoning to me, but the knee-jerk "hur hur parents are fucking idiots" reaction doesn't seem justified to me.

Some cancers (of which Leukemia is one) have to be treated EXTREMELY aggressively if you want to survive. That means chemotherapy long after the cancer goes into remission to do everything possible to make sure the fucker doesn't come back. The thing about cancer is that you need to damn near kill the patient in order to kill the cancer.

Leukemia can be patricularly nasty as variants range from extremely treatable to near-incurable. Let me say this though: anyone who does not follow the advice of their oncologist is an idiot. PERIOD.

[The Kernel]

I should also add that the first few rounds of chemo are the most important. If the cancer comes back it is much more likely to be fatal, so you want to knock it out on the first try, that's why initial chemo treatments are so aggressive.

[Justforfun000]

With advice like this, I have to wonder how much the parents were fleeced for this so-called doctor's "services".

Actually this part of the article confused me entirely. Typically a "doctor" does not give you alternative medicine advice. Especially something possibly in direct contrast with accepted protocol at this stage.

I suspect this wasn't a proper doctor at all.

[Illuminatus Primus]

I may not be a doctor but how does it necessarily follow that the parents are idiots if they pulled him off chemotherapy while the cancer was in remission, and put him back on when the cancer came back?

Are they more professionally suited to making that determination than an oncologist? Say what one wants about medical profession problems, but an oncologist typically has among his interests his patients' survival.

I've known people who followed all the recommendations and suffered through chemo for years and died anyway. Hell, there was an unfortunate girl in my school when I was a kid, right around that same age.

Its not typical procedure to indefinitely place someone on cytotoxic therapy. But oncologists do prescribe it for longer even after the cancer has gone into apparent remission because even a handful of cells can quickly reappear as cancer thanks to compound interest. The chemo may suck, but what killed this kid? The cancer.

It's not as if there's a guarantee that the chemo's going to work, and while the cancer is in remission it only appears to be doing damage.

And we are to rely on the parents' medical opinion on this one, over researchers and the boy's physician?

Perhaps a cancer specialist could explain the reasoning to me, but the knee-jerk "hur hur parents are fucking idiots" reaction doesn't seem justified to me.

Even if the cancer is not visible any remaining cancerous cells can rapidly multiply exponentially and reappear as virulent cancer. As it happened in this instance, obviously, apparent remission in the short term does not mean that the cancer is gone, which is exactly why oncologists sustain cytotoxic therapy for sometime after remission. This is exactly why it is done.

[Gerald Tarrant]

After researching alternative treatments, they found a doctor specializing in holistic medicine who recommended a healthier diet along with supplements to boost Noah’s immune system.

This is the thing which I'm most suspicious of. Perhaps I'm too credulous/gullible, but when I first read this I assumed the doctor they mentioned was an actual physician. On reflection though I don't think there would be many practicing physicians stupid enough to recommend their pet dietary theories over the expertise of a pediatric oncologist. With that in mind, my reading of the article leads me to believe that the individual in question misrepresented himsel or his qualifications. This would make him/her subject to the following:

4731.41 Practicing medicine without certificate.

No person shall practice medicine and surgery, or any of its branches, without the appropriate certificate from the state medical board to engage in the practice. No person shall advertise or claim to the public to be a practitioner of medicine and surgery, or any of its branches, without a certificate from the board. No person shall open or conduct an office or other place for such practice without a certificate from the board. No person shall conduct an office in the name of some person who has a certificate to practice medicine and surgery, or any of its branches. No person shall practice medicine and surgery, or any of its branches, after the person’s certificate has been revoked, or, if suspended, during the time of such suspension.

A certificate signed by the secretary of the board to which is affixed the official seal of the board to the effect that it appears from the records of the board that no such certificate to practice medicine and surgery, or any of its branches, in this state has been issued to the person specified therein, or that a certificate to practice, if issued, has been revoked or suspended, shall be received as prima-facie evidence of the record of the board in any court or before any officer of the state.

Effective Date: 03-09-1999

link

There is also this

4731.341 Injunctions.


(A) The practice of medicine in all of its branches or the treatment of human ailments without the use of drugs or medicines and without operative surgery by any person not at that time holding a valid and current certificate as provided by Chapter 4723., 4725., or 4731. of the Revised Code is hereby declared to be inimical to the public welfare and to constitute a public nuisance.

(B) The attorney general, the prosecuting attorney of any county in which the offense was committed or the offender resides, the state medical board, or any other person having knowledge of a person who either directly or by complicity is in violation of division (A) of this section, may on or after January 1, 1969, in accord with provisions of the Revised Code governing injunctions, maintain an action in the name of the state to enjoin any person from engaging either directly or by complicity in the unlawful activity by applying for an injunction in the Franklin county court of common pleas or any other court of competent jurisdiction.

Prior to application for such injunction, the secretary of the state medical board shall notify the person allegedly engaged either directly or by complicity in the unlawful activity by registered mail that the secretary has received information indicating that this person is so engaged. Said person shall answer the secretary within thirty days showing that the person is either properly licensed for the stated activity or that the person is not in violation of Chapter 4723. or 4731. of the Revised Code. If the answer is not forthcoming within thirty days after notice by the secretary, the secretary shall request that the attorney general, the prosecuting attorney of the county in which the offense was committed or the offender resides, or the state medical board proceed as authorized in this section.

Upon the filing of a verified petition in court, the court shall conduct a hearing on the petition and shall give the same preference to this proceeding as is given all proceedings under Chapter 119. of the Revised Code, irrespective of the position of the proceeding on the calendar of the court.

Such injunction proceedings shall be in addition to, and not in lieu of, all penalties and other remedies provided in Chapters 4723. and 4731. of the Revised Code.

Effective Date: 04-10-2001

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And the last one that I think is relevant if this "Dr" is a fake

4731.34 Unauthorized practice.

(A) A person shall be regarded as practicing medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, within the meaning of this chapter, who does any of the following:

(1) Uses the words or letters, “Dr.,” “Doctor,” “M.D.,” “physician,” “D.O.,” “D.P.M.,” or any other title in connection with the person’s name in any way that represents the person as engaged in the practice of medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, in any of its branches;

(2) Advertises, solicits, or represents in any way that the person is practicing medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, in any of its branches;

(3) In person or, regardless of the person’s location, through the use of any communication, including oral, written, or electronic communication, does any of the following:

(a) Examines or diagnoses for compensation of any kind, direct or indirect;

(b) Prescribes, advises, recommends, administers, or dispenses for compensation of any kind, direct or indirect, a drug or medicine, appliance, mold or cast, application, operation, or treatment, of whatever nature, for the cure or relief of a wound, fracture or bodily injury, infirmity, or disease.

(B) The treatment of human ills through prayer alone by a practitioner of the Christian Science church, in accordance with the tenets and creed of such church, shall not be regarded as the practice of medicine, provided that sanitary and public health laws shall be complied with, no practices shall be used that may be dangerous or detrimental to life or health, and no person shall be denied the benefits of accepted medical and surgical practices.

(C) The use of words, letters, or titles in any connection or under any circumstances as to induce the belief that the person who uses them is engaged in the practice of medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, in any of its branches, is prima-facie evidence of the intent of such person to represent the person as engaged in the practice of medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, in any of its branches.

Effective Date: 04-10-2001

link

From the story it seems like every one of the above was violated by the individual in question.

If the "Doctor" is actually a licensed physician then I think the following applies to him/her

4731.22 Disciplinary actions.

<snip>
(5) Making a false, fraudulent, deceptive, or misleading statement in the solicitation of or advertising for patients; in relation to the practice of medicine and surgery, osteopathic medicine and surgery, podiatric medicine and surgery, or a limited branch of medicine; or in securing or attempting to secure any certificate to practice or certificate of registration issued by the board.

As used in this division, “false, fraudulent, deceptive, or misleading statement” means a statement that includes a misrepresentation of fact, is likely to mislead or deceive because of a failure to disclose material facts, is intended or is likely to create false or unjustified expectations of favorable results, or includes representations or implications that in reasonable probability will cause an ordinarily prudent person to misunderstand or be deceived.

...



(7) Representing, with the purpose of obtaining compensation or other advantage as personal gain or for any other person, that an incurable disease or injury, or other incurable condition, can be permanently cured;

link

Not sure if 7 covers this or not, my understandig is that the Quack represented leukemia as permanently curable by alternate unsubstantiated means.

Maybe more information about this case is out there, but right now it looks to me like the "Doctor" in question misrepresented himself. This means that the parents were victims of fraud, and while their bad judgement may have been deadly, the worst act was perpetrated by that "holistic" specialist.

last second edit: MSNBC headlines the story from Canton, Ohio, which is why I spammed you all with Ohio title 47.

[Hugh]

Also one of the maintenance drugs that he was on was so hazardous that when it was administered everyone in the room had to wear a hospital gown, and mask.

Forgive my ignorance, but how can a substance that hazardous be useful as medication?

[Enforcer Talen]

It kills the disease but only hurts the user.

[Illuminatus Primus]

Quite simply the chemical agents used to treat cancer are cytotoxic (that is, lethal to cells), typically by inhibiting key aspects of mitosis (cellular division). Cancer is, by definition, tissue cells which have lost their corrective mechanisms to repair genetic damage and also their genetic countermeasures against unchecked cellular division. Healthy cells are limited in the number of reproductions - for instance - brain cells do not divide after maturity. But if these cells are damaged and begin to reproduce beyond control, invading tissues and ceasing to function in the interest of the body's health, they become cancer. As cancer is defined by unchecked aggressive cellular division, chemicals which disrupt, damage, or kill cells by interfering with mitosis will excessively impact the exponentially dividing cancer (composed of constantly dividing, and already damaged cells) as opposed to healthy tissue (which by adulthood has generally ceased cellular division). Unfortunately, there are tissues which divide regularly, such as the mucosa of the intestinal tract, blood cells, etc. And these are vulnerable to the same medications that preferentially attack the cancer. This is simply the best dedicated treatment to cancer (along with radiation, which functions on the same principle - cells are vulnerable to ionizing radiation damage during division, and cancer cells divide constantly, in contrast to healthy tissue).

Cancer IS your own cells growing beyond the built-in control mechanisms of the body. As such it is very difficult to develop treatment that selectively targets cancerous cells to the exclusion of healthy normal cells. Antibiotics, for example, are so successful at killing bacteria and so harmless to humans because they damaged bacteriologically-specific metabolic pathways that we do not use, efficiently killing bacteria but leaving cells unmolested.

Antiretrovirals suffer many of the same problems: anti-HIV drugs target the reproduction cycle of the virus, and these agents foul similar reproductive functions in normal cellular division, and other functions, causing side-effects.

[Hugh]

This is simply the best dedicated treatment to cancer (along with radiation, which functions on the same principle - cells are vulnerable to ionizing radiation damage during division, and cancer cells divide constantly, in contrast to healthy tissue).

...which is why the anti-cancer radiations are carefully targeted at narrow spots on the patient's body. But here we have a substance that's dangerous even to inhale from a certain distance. Oh wait, I get it. We're talking a leukemia patient. The substance in question is supposed to be injected somewhere specific, right?

[PainRack]

With advice like this, I have to wonder how much the parents were fleeced for this so-called doctor's "services".

Actually this part of the article confused me entirely. Typically a "doctor" does not give you alternative medicine advice. Especially something possibly in direct contrast with accepted protocol at this stage.

I suspect this wasn't a proper doctor at all.

Have you picked up a homeopathic book recently? Apparently, "doctors in holistic medicine" are suggesting homeopathic remedies recently.

Let's just say that the word "doctor" doesn't neccesarily mean M.D .

How about people who stop using antibiotics the moment the symptoms for whatever problem they have go away, and then go back on them when the symptoms return?

They made a mistake.

Its as simple as that really.

I think we're missing the pain of the parents who have to see their children suffer through chemo. After having the cancer in remission, they obviously made the choice not to inflict further pain and torture on their kid, hoping that a good diet and healthy lifestyle will prevent cancer from coming back. And its also obvious they didn't skip conventional medicine entirely, as they were able to detect its reoccurence and place him back on chemo.

They made a bad choice, they lost their boy because of it.

Forgive my ignorance, but how can a substance that hazardous be useful as medication?

You ever seen the medicine they use for treating corns and warts? That stuff burns through your skin. If you get it on your eyes or the thinner areas of your body(say your face or balls), say hello to scarring and peeling.

...which is why the anti-cancer radiations are carefully targeted at narrow spots on the patient's body. But here we have a substance that's dangerous even to inhale from a certain distance. Oh wait, I get it. We're talking a leukemia patient. The substance in question is supposed to be injected somewhere specific, right?

You ever seen what radiation therapy does? It has the same problems of immuno-suppressive effects, has the added benefit of giving you leathery skin and of course, radiation burns along vast swathes of the body. In fact, I think the only advantage it has is that it doesn't inflict hair loss:D

Oh wait, unless its to the head. Then, hair loss is PERMAMENT. As opposed to chemotherapy.

[PainRack]

I should also note that RT is currently not effective against leukemia. Its being prescribed for lung cancer and liver along with some other organs, and they ingest radioactive stuff to treat thyroid cancer.

[wolveraptor]

After researching alternative treatments, they found a doctor specializing in holistic medicine who recommended a healthier diet along with supplements to boost Noah’s immune system.

What the fuck does one's immune system strength have to do with cancer? Doesn't the immune system ignore cance because it is not technically composed of foreign bodies?

[Hugh]

You ever seen the medicine they use for treating corns and warts? That stuff burns through your skin. If you get it on your eyes or the thinner areas of your body(say your face or balls), say hello to scarring and peeling.

It's basically an acid IIRC? Of course it requires caution (like a lot of other substances), but definitely not wearing a surgical mask when opening the bottle.

You ever seen what radiation therapy does?

My grandmother did some. Not enough to show visible ill effects. But I think it may have affected her immune system. She came out very weak (though cancer-free) and died soon after anyway.

[Geodd]

Hugh, the drugs used in chemotherapy are amazingly nasty yes, but the safety precautions are mainly there for the nurses and doctors who administer it. They have do handle the stuff pretty much daily and long-term exposure to even small amounts the stuff has nasty consequence's.

[Gerald Tarrant]

It's basically an acid IIRC? Of course it requires caution (like a lot of other substances), but definitely not wearing a surgical mask when opening the bottle.

Perhaps I should have been more clear, when administering this chemical the doctors were very concerned that it not come in contact with the skin of healthy people, everyone wore surgical masks, safety goggles, etc. The also took great pains to avoid having it splash anyone, including my little brother. I always got the impression that it was splashing that they were protecting against, not inhalation per se (although I don't think inhaling the stuff would have been pleasant for our lungs). I never was curious enough to check information about molarity or strength or any of that. I always just trusted that the hospital people knew what they were doing when they made us gown up. I just took seriously the precautions they had, I never questioned the particulars about it.

You ever seen what radiation therapy does?

My grandmother did some. Not enough to show visible ill effects. But I think it may have affected her immune system. She came out very weak (though cancer-free) and died soon after anyway.

As an aside, the treatment that they had for my little brother didn't use radiation. Although if he'd gone with the Bone Marrow Transplant they would have used intensive radiation (the Bone Marrow guy said one of the concerns when performing chemo is how much damage is done to the bone marrow-normal chemo treatment apparently tries to allow time for it to recover. When the transplant route is used that becomes a non-issue and the chemo can be much more agressive.). One of the side effects of the radiation was potential sterility.

They made a mistake.

Its as simple as that really.

I think we're missing the pain of the parents who have to see their children suffer through chemo. After having the cancer in remission, they obviously made the choice not to inflict further pain and torture on their kid, hoping that a good diet and healthy lifestyle will prevent cancer from coming back. And its also obvious they didn't skip conventional medicine entirely, as they were able to detect its reoccurence and place him back on chemo.

They made a bad choice, they lost their boy because of it.

Completely agree with the above.

Chemo sucks, it was horrible to watch my little brother going through that. It was only worth doing because his survival chances without it were essentially zero. I remember listening to my mom once wondering about whether it was worth it to put him through this. So I have plenty of sympathy for the parents in the OP.

I still think the "holistic doctor" that's mentioned in the OP perpetrated a fraud.

[Hillary]

Also one of the maintenance drugs that he was on was so hazardous that when it was administered everyone in the room had to wear a hospital gown, and mask.

Forgive my ignorance, but how can a substance that hazardous be useful as medication?

Someone I know who recently underwent chemo had it described to him that the process is roughly one where you poison the patient just enough for him to survive and the cancer to die. It's not pretty.

[SylasGaunt]

Even if the cancer is not visible any remaining cancerous cells can rapidly multiply exponentially and reappear as virulent cancer. As it happened in this instance, obviously, apparent remission in the short term does not mean that the cancer is gone, which is exactly why oncologists sustain cytotoxic therapy for sometime after remission. This is exactly why it is done.

IIRC (considering this was for a report a long ways back and may be out of date or have been incorrect to begin with) doesn't it have to be gone for something like a full year before they'll even consider saying you're cured?

[PainRack]

It's basically an acid IIRC? Of course it requires caution (like a lot of other substances), but definitely not wearing a surgical mask when opening the bottle.

You ever seen what radiation therapy does?

My grandmother did some. Not enough to show visible ill effects. But I think it may have affected her immune system. She came out very weak (though cancer-free) and died soon after anyway.

So, your sole contention is that the medicine involved is cyotoxic and required the wearing of gloves and mask? If that's so, what about RT? You need to be physically absent from the room and standing behind a lead shield. The patient gametes require protection too IIRC.

Anyway, as I already stated, RT is currently unsuitable for Leukemia.

[PainRack]

Perhaps I should have been more clear, when administering this chemical the doctors were very concerned that it not come in contact with the skin of healthy people, everyone wore surgical masks, safety goggles, etc. The also took great pains to avoid having it splash anyone, including my little brother. I always got the impression that it was splashing that they were protecting against, not inhalation per se (although I don't think inhaling the stuff would have been pleasant for our lungs). I never was curious enough to check information about molarity or strength or any of that. I always just trusted that the hospital people knew what they were doing when they made us gown up. I just took seriously the precautions they had, I never questioned the particulars about it.

Errr, depending on the drug in question, inhalation IS a problem. That's why chemo drugs are prepared and diluted outside the wards.

[Gerald Tarrant]

Errr, depending on the drug in question, inhalation IS a problem. That's why chemo drugs are prepared and diluted outside the wards.

I'll defer to your expertise, but either those drugs were never administered to my little brother, or a surgical mask was sufficient for the fumes from what was administered.

[PainRack]

Errr, depending on the drug in question, inhalation IS a problem. That's why chemo drugs are prepared and diluted outside the wards.

I'll defer to your expertise, but either those drugs were never administered to my little brother, or a surgical mask was sufficient for the fumes from what was administered.

http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html

hepatocellular damage has been reported in nurses working in an oncology ward; the injury appeared to be related to intensity and duration of work exposure to CD's.96 Symptoms such as lightheadedness, dizziness, nausea, headache, and allergic reactions have also been described in employees after the preparation and administration of antineoplastic drugs in unventilated areas.22,86 In occupational settings, these agents are known to be toxic to the skin and mucous membranes, including the cornea.69,82

WORK AREAS.

Risks to personnel working with HD's are a function of the drugs' inherent toxicity and the extent of exposure. The main routes of exposure are: inhalation of dusts or aerosols, dermal absorption, and ingestion. Contact with contaminated food or cigarettes represents the primary means of ingestion. Opportunity for exposure to HD's may occur at many points in the handling of these drugs.

1. PHARMACY OR OTHER PREPARATION AREAS.

1. In large oncology centers, HD's are usually prepared in the pharmacy. However, in small hospitals, outpatient treatment areas, and physicians' offices they have been prepared by physicians or nurses without appropriate engineering controls and protective apparel.16,20 Many HD's must be reconstituted, transferred from one container to another, or manipulated before administration to patients. Even if care is taken, opportunity for absorption through inhalation or direct skin contact can occur.35,36,73,116

2. Examples of manipulations that can cause splattering, spraying, and aerosolization include:

* withdrawal of needles from drug vials;
* drug transfer using syringes and needles or filter straws;
* breaking open of ampules; and
* expulsion of air from a drug-filled syringe.

Evaluation of these preparation techniques, using fluorescent dye solutions, has shown contamination of gloves and the sleeves and chest of gowns.97

3. Horizontal airflow work benches provide an aseptic environment for the preparation of injectable drugs. However, these units provide a flow of filtered air originating at the back of the work space and exiting toward the employee using the unit. Thus, they increase the likelihood of drug exposure to both the preparer and other personnel in the room. As a result, the use of horizontal BSC's is contra-indicated in the preparation of HD's. Smoking, drinking, applying cosmetics, and eating where these drugs are prepared, stored, or used also increase the chance of exposure.


2. ADMINISTRATION OF DRUGS TO PATIENTS.

1. Administration of drugs to patients is generally performed by nurses or physicians. Drug injection into the IV line, clearing of air from the syringe or infusion line, and leakage at the tubing, syringe, or stopcock connection present opportunities for skin contact and aerosol generation. Clipping used needles and crushing used syringes can produce considerable aerosolization as well.

2. Such techniques where needles and syringes are contaminated with blood or other potentially infectious material are prohibited by the Bloodborne Pathogens Standard.109 Prohibition of clipping or crushing of any needle or syringe is sound practice.

3. Excreta from patients who have received certain antineoplastic drugs may contain high concentrations of the drug or its hazardous metabolites. For example, patients receiving cyclophosphamide excrete large amounts of the drug and its mutagenic metabolites.46,92 Patients treated with cisplatin have been shown to excrete potentially hazardous amounts of the drug.112 Unprotected handling of urine or urine-soaked sheets by nursing or housekeeping personnel poses a source of exposure.

[Hugh]

So, your sole contention is that the medicine involved is cyotoxic and required the wearing of gloves and mask? If that's so, what about RT? You need to be physically absent from the room and standing behind a lead shield. The patient gametes require protection too IIRC.

Anyway, as I already stated, RT is currently unsuitable for Leukemia.

http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html

Gah. It's all clear now. This is one of those cases where the cure is worse than the disease. Well, at least these are real cures. I've seen educated people falling for pseudo-scientific bullshit, and it's ugly, even though I know why it happens,

At least the boys' parents woke up pretty fast. Gave him a fighting chance, I think.

[Illuminatus Primus]

This is simply the best dedicated treatment to cancer (along with radiation, which functions on the same principle - cells are vulnerable to ionizing radiation damage during division, and cancer cells divide constantly, in contrast to healthy tissue).

...which is why the anti-cancer radiations are carefully targeted at narrow spots on the patient's body. But here we have a substance that's dangerous even to inhale from a certain distance. Oh wait, I get it. We're talking a leukemia patient. The substance in question is supposed to be injected somewhere specific, right?

Leukemia is a blood cancer; and not well-isolated like pre-metastasis lung, colon, or skin cancers. No well-defined loci to target. Quite simply cytotoxics that potent may be this kid's best bet for survival (over the virulent cancer), but an unnecessary risk for health care personnel.

Routine medical treatments and procedures are extremely life-threatening. And besides, perhaps aerosolized agents have peculiarly bad effects in this case. Who knows? Its really very difficult to discern without them citing what it was.

[Broomstick]

In fairness to the parents, they did put him back on chemo only four months later when the cancer returned.... [snip].... His parents were certainly criminally idiotic, but saying that the four month gap in the chemo treatment plan that lasted three and a half years was the proximate cause of his dying may be a bit much.

No, his parents were not criminally idiotic. After all, when the cancer returned they put him back on chemo immediately, and given the time frame he must have been observed by competant medical personnel.

The problem here is that parents do not like to see their children suffer. I think the parents here understand that easily, but many of us here are not parents. Chemo is painful. It's awful. You watch your kid puke and get weak and get thinner and thinner... Chemo can also have mental effects, including a "chemo brain" effect interferring with memory and abstract thinking. Sometimes this is permanent. In other words, it can cause permanent brain damage, particularly in the young. In fact, there is a high rate of learning disabilities among survivors of childhood cancer. Other long-term effects include damage to the heart, lungs, kidneys, liver, nerveous system ("chemo brain" as well as peripheral systems, causing numbness and tingling in the extremities), endocrine systems (thyroid disfunctions and diabetes are also much more common among childhood cancer survivors than other people), and reproductive problems ranging from delayed puberty to failure to enter puberty to sterility.

As for the toxicity - my dad, as a hospital pharmacist, used to mix chemo drugs. He often used isolation compartments (those boxes with the gloves attached to the sides), chemical ventilation hoods, elaborate filtering systems, and extensive skin and eye protection. After working with these drugs he'd clean up at the hospital, then come home and shower before he'd let us kids touch him or even get too close to us, he was that concerned about inadvertant contamination of his family. The chemicals used can be corrosive, toxic, and mutagenic. Some of them, ironically, also have carcinogenic properties.

This is seriously nasty stuff. It's poison. Cancer treatment is frequently a race to see who dies first - the cancer or the patient. And people DO sometimes die from chemo, radiation, or surgery instead of the cancer, all of those treatment carry real risks of death.

It is NOT puzzling that parents, being told their child's cancer is in remission, to want to spare their child the pain of this treatment and further risk of side effects, some of them permanent. Only knowledge and allowing reason to override very strong emotions will allow parents to subject a child that (finally!) appears healthy to be treated with chemicals that will make that child terribly, terribly ill in a very visible manner. If the parents are not particularly knowledgable about medicine they can easily make a poor decision despite the best of intentions.

[The Duchess of Zeon]

The point's conceded entirely, and gladly done at that.