Question: My mother is on methotrexate for treatment of cancer. It is having terrible side effects. Is it worth continuing?
This is an extremely difficult and delicate question of ethics, medical technology and common sense. The treatment of a cancer can include surgery, irradiation and drugs. The type of treatment will vary depending on the type and site of the cancer. Methotrexate is a drug that kills cancer cells. Unfortunately it, and other cancer drugs, can have severe side effects, as they damage some normal cells while destroying the cancer. The usual problems are loss ot hair and vomiting associated with constant nausea and a sense of being unwell.
Ethically, all doctors ate required to do everything possible to prolong human life, and cure disease. If statistics indicate that methotrexate, or any other drug, is likely to be the best treatment, a doctor is ethically obliged to prescribe it. Medical technology may also indicate that certain treatments are sometimes successful, and that a combination of several treatments may give a slightly higher chance of success, but with a dramatic increase in side effects.
This is where common sense is required. If a patient is likely to be cured in 50% or even 25% of cases with the use of a course of Treatment that may be most unpleasant, most doctors and patients would proceed. If the success rate was only 1%, most doctors would consult with the patient and relatives and not proceed, leaving the remainder of the patient’s life as calm, peaceful and free of side effects as possible.
The problem arises between these extremes. Should the patient be given a slight chance of survival after a few months ot drug-induced agony, or should nature be allowed to take its course? There is no simple answer. Frank discussions between the patient, doctor and relatives is the only way for a consensus to be reached in solving the dilemma.

Question: Where does cancer spread to when you have a secondary cancer? I have had cancer in the breast, and I have been told that surgery has been successful and I have no secondaries, but I would like to watch out for any problems.
The liver, lymph nodes, and bones are the most common areas involved in the spread of cancer, but cancel can spread almost anywhere in the body from its original site. The type of cancer will also determine where it may spread, as some types of cancer cells appear to spread more easily to one part of the body than another.
The lymph nodes are responsible for dealing with waste products and infection, and there are direct channels from them to every part of the body. Cancer cells can spread very easily along these channels, and so with most cancers, the nearest group of lymph nodes is often surgically removed, irradiated or treated with cancer-killing drugs.
The liver is responsible for processing the blood to remove abnormal and dying cells, waste products and toxins. This too can therefore be easily affected by cancer cells. Bone marrow is responsible for producing many of the infection- and cancer-fighting cells in the body, and may itself be infilttated by cancer cells that destroy its correct function.
Secondary cancer is certainly harder to treat than primary, but it is not an inevitable death sentence because modern anti-cancer drugs, the new radiation techniques available and delicate surgery can still remove and control many of these growths.