By a definition propoed by many doctors, chemotherapy is a generic term that describes the use of pharmacweutical prodiucts to fight disease; i.e. the term is not limited to oncology.
"Chemotherapy (also called chemo)," proposes the National Cancer Institute of the United States in their 2014 publication Chemotherapy and You: Support for People With Cancer, is:
"... is a type of cancer treatment that uses drugs to destroy cancer cells.".
In one medical textbook chemotherapy is described simply as "anticancer drugs".1
In another hemisphere, Australia to be precise, the national cancer agency, known as Cancer Australia, presumes a knowledge of the term cytotoxic (which it does not otherise defne), as it defines chemotherapy, as of July 7, 2014 as "the use of drugs, which kill or slow cell growth, to treat cancer. These are called cytotoxic drugs.
Judges, though, in writing legal decision that afect the rights of people not only befor it but with issues similar, do not have the luxury of proposing circuar definitions. Nor do they venture into the realm of medicine without a "walker", always in the form of expert opinion which, by being shared within an opinion then published, allows for the endering of an understandable, medico-legal defunition.
To wit, in Superintendent of Belchertown State Sch. v. Saikewicz, the Supreme Judicial Court of Massachusetts issued this opinion signed by Justice Liacos. The distinguishing features of this decision is the date, 1977, thus in the earlier years of chemotherapy, and that it dealt with chemotherapy in the context of leukemia, though much of what is extracted from the expert opinion of the Supreme Judicial Court of Massachusetts Court is applicable to the medico-legal term at large:
“Chemotherapy, as was testified to at the hearing in the Probate Court, involves the administration of drugs over several weeks, the purpose of which is to kill the leukemia cells. This treatment unfortunately affects normal cells as well. One expert testified that the end result, in effect, is to destroy the living vitality of the bone marrow. Because of this effect, the patient becomes very anemic and may bleed or suffer infections — a condition which requires a number of blood transfusions. In this sense, the patient immediately becomes much "sicker" with the commencement of chemotherapy, and there is a possibility that infections during the initial period of severe anemia will prove fatal. Moreover, while most patients survive chemotherapy, remission of the leukemia is achieved in only thirty to fifty per cent of the cases. Remission is meant here as a temporary return to normal as measured by clinical and laboratory means. If remission does occur, it typically lasts for between two and thirteen months although longer periods of remission are possible. Estimates of the effectiveness of chemotherapy are complicated in cases, such as the one presented here, in which the patient's age becomes a factor. According to the medical testimony before the court below, persons over age sixty have more difficulty tolerating chemotherapy and the treatment is likely to be less successful than in younger patients. This prognosis may be compared with the doctors' estimates that, left untreated, a patient in Saikewicz's condition would live for a matter of weeks or, perhaps, several months. According to the testimony, a decision to allow the disease to run its natural course would not result in pain for the patient, and death would probably come without discomfort.
“An important facet of the chemotherapy process, to which the judge below directed careful attention, is the problem of serious adverse side effects caused by the treating drugs. Among these side effects are severe nausea, bladder irritation, numbness and tingling of the extremities, and loss of hair. The bladder irritation can be avoided, however, if the patient drinks fluids, and the nausea can be treated by drugs. It was the opinion of the guardian ad litem, as well as the doctors who testified before the probate judge, that most people elect to suffer the side effects of chemotherapy rather than to allow their leukemia to run its natural course….
”(The) toxic side effects of chemotherapy include pain and discomfort, depressed bone marrow, pronounced anemia, increased chance of infection, possible bladder irritation, and possible loss of hair.
In Bailey v. Blue Cross & Blue Shield of Virginia, an insurance policy was before the Court tat suggested that chemotherapy consisted of "the treatment of malignant disease by chemical or biological neoplastic agents".
- Bailey v. Blue Cross & Blue Shield of Virginia, 67 F. 3d 53 (1995) US Department of Health and Human Services, National Cancer Institute, Chemotherapy and You: Support for People With Cancer
- NOTE 1: Younger-Lewis, Catherine, medical editors, The Canadian Medial Association Complete Home Meical Guide, (Toronto: page 274.