Documentation of Effectiveness of Psychosocial Interventions: Discussion of Dr. Miller’s Paper

Abstract

The clinical research treatments of childhood cancer present an impressive array of achievements, but an equally impressive array of consequent medical and psychosocial problems. The change in the five or more year survivor rate in acute lymphocitic leukemia (ALL) is indeed impressive: before 1966 only 10–15% of children survived five years, whereas now 95% can expect an initial remission, and as of 1975 60% survived more than five years. Further, most solid tumors have similarly responded: in the 1950s less than 20%, whereas in the 1970s 60–80% survived disease free. Miller emphasized that the refinement of treatment protocols that contributed to this change were only possible through multicenter clinical research trials using random patient assignments.