Chemotherapy and Bloodletting

The goal of chemotherapy is to kill part of a cancer patient’s body without killing the patient. It involves lethal drugs that do serious damage, hence the side effects. The drugs work by damaging the RNA or DNA that controls cell division. If cells are unable to divide, they die. Healthy cells grow back; hopefully the cancer cells won’t.

Pharmaceuticals are risky business. Having them prescribed and monitored by a doctor is a safeguard, but it doesn’t make them safe. In her book, Another Day in the Frontal Lobe, neurosurgeon Katrina Firkin notes that,

Anything strong enough to help you is strong enough to hurt you. No treatment, at least no worthwhile treatment, comes without risk. Even natural supplements, if you take unnaturally large amounts, can have untoward effects… There are plenty of medications that work wonders without us having a clear idea as to how or why they work. To me, that means there are probably other things those drugs are doing that we may not expect. It would be unlikely for a drug to have one and only one effect on the body. That’s not how the body works. One physiological mechanism can mediate numerous different functions. One natural chemical, blocked or enhanced by a certain drug, may have dozens of different targets. Those targets are probably not all figured out yet.

It’s a Faustian bargain, but I’ve adopted Dr. Firkin’s approach, “I’ll take a medication when I need it, when the time comes, if the benefits clearly outweigh the risks. But I won’t expect to get something for nothing.”


A hundred years from now chemotherapy may be looked back upon with the same aversion we have to bloodletting today as a barbarous rite of pre-enlightened medicine. For almost 2,000 years sincere physicians drained copious amounts of the vital fluid to relieve their patients of “bad blood.”

The practice was supported by the best scientific minds of the time and based on observation of the body itself, specifically menstruation. None other than the father of medicine, Hippocrates-who gave us the word “cancer”-believed menstruation purged women of bad humors. His most famous student, Galen, began physician-initiated bloodletting in the second century.

Bloodletting was once used to treat cancer, along with everything else from cholera to diabetes, herpes to leprosy, plague to pneumonia, and scurvy to smallpox. The earliest recorded cancer treatment comes from the Egyptians, who used a “fire drill” to cauterize tumors. Medical science lurches forward by trial and error.

Even great advances sometimes have unforeseen consequences. A popular theory regarding how AIDS entered the human population posits that it came from chimps whose organs and fluids were used in culturing a strand of oral polio vaccine used in the Congo, the epicenter of the pandemic.

Never mind inadvertent danger, modern chemo causes lots of collateral damage. It is a shotgun that indiscriminately kills both terrorists and hostages. But for many forms of cancer, it’s the best weapon we have right now.

Chemo is one of those things in life for which a stunt double would be absolutely great. Other experiences where a stand-in would be wonderful are:

  • childbirth
  • IRS audits
  • root canals
  • prostate exams
  • (add your least favorite activity here)
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