Cancer Victim’s Care Followed Protocols

Re “A Son Crusades for Mom,” Feb. 11: Physicians at Kaiser Permanente acted responsibly by referring Zevart Yedalian to the City of Hope, a National Cancer Institute Comprehensive Cancer Center, to be considered for an autologous stem cell transplant. Kaiser Permanente had no role in establishing or applying the criteria for the City of Hope’s clinical trials involving autologous stem cell transplantation. The City of Hope clinical investigators decided upon the specific criteria that needed to be met in order to ensure patient safety while attempting to determine whether in fact this unproven treatment had clinical benefit. This patient was turned down because her heart function did not meet the standards established by the City of Hope for any of its autologous stem cell transplantation protocols.

Unfortunately, autologous stem cell transplantation has not proved to be the breast cancer cure that its advocates once claimed. Since this patient’s death, the results of randomized clinical trials have failed to reveal any benefit for autologous stem cell transplantation over standard treatment for breast cancer. Far from being a lifesaving treatment, it is now considered by most oncologists to be an excessively toxic treatment that needlessly exposes patients to increased chances of injury or death from transplant complications. We can understand Chant Yedalian’s anguish, but we respectfully deny the premise of his lawsuit.

Joanne Schottinger MD

Medical Oncology

Southern California

Permanente Medical Group

Pasadena