[Hopeful]

Rich,

I came to a similar conclusion as you about metronomic chemo two years ago, for many of the same reasons. In addition to all of the points in your post, let's not also forget the inflammatory/fatty acid issues R.B. spent a long time trying to educate us about, which have been shown to be ameliorated by statins. Another drum that Alaska Angel bangs loud and hard (and accurately, I believe) about the risk of using steroid pre-meds is that the associated weight gain and loss of muscle mass, leading to difficulties keeping weight off post treatment, causes survivors to struggle with unwanted weight that has been shown to increase the risk of bc recurrence. Finally, maximum tolerated doses of highly toxic chemos often require supplementation with growth colony stimulating factors, which have been shown in some instances to enhance recurrence and in others to shorten life spans. There absolutely has to be a better way.

My personal belief is that greater toxicity does not confer greater benefit, just greater side effects and permanent damage to the body. We focus too strongly on the "shock and awe" mentality of blasting every last cancer cell to smithereens (as if we knew that to be actually possible), rather than focus on fine tuning whatever is out of balance in the body, to reduce carcinogenicity. It is my belief that the changes which cause or stimulate cancer are largely epigenetic, and could be corrected through a better appreciation of the endocrine system, and all of the related signalling pathways between the various hormonal systems in the body, not just sex hormones, as all of the hormones seem capable of utilizing all of the available hormonal pathways in the body, if push comes to shove.

As to whether anyone is asking for your thoughts, assume we are, and please put them out there as they come to you.

Hopeful