An article on Medscape, published on August 5, 2025, discusses “Oncology’s Side Effect Disconnect.” Publications about chemotherapy clinical trials describe side effects and toxicities, but when these drugs are used in the community, side effects are typically more common and more severe.

    Clinical trials are run with carefully-selected patients whose only problem is their cancer. Patients in community settings are often sicker and more likely to suffer side effects.

    Publications exaggerate benefits and downplay toxicities, calling them “manageable” or “tolerable,” even when the patient would disagree. The article goes into detail about some of the gamesmanship that occurs. For example, if patients dropped out of a study, the authors may not mention that the cause was intolerable side effects.

    Most studies are funded by industry, and billions of dollars are at stake, so there is a great deal of pressure to make the medications sound as good as possible. The article is depressing, but I am happy to see Medscape airing issues that those in the medical field have known about for a long time.