LEGACY DRUGS: PRESENT HARM
Why “Frontline” Chemotherapy Is Stuck in the Past
For all the promises of medical innovation, one truth remains unspoken in cancer care: most frontline chemotherapy drugs in use today are decades old — some older than the patients receiving them.
Despite billions spent annually on cancer research ($15B - 2024), standard chemo protocols still rely on compounds developed during the Cold War. These aren’t just time-tested. They’re time-locked.
The Illusion of Innovation
In any other industry, tools this old would be labeled “legacy” — replaced by safer, more targeted technologies. But in oncology, these compounds are still standard-of-care.
Why?
Because they’re profitable.
Because they’re reimbursable.
Because questioning the standard means questioning the system.
Hospitals draped in the language of “cutting-edge” still dispense cisplatin (1965), a 60-year-old compound, without updated survival metrics. Patients are offered 5-FU (1957) or methotrexate (1947) as if they’re modern marvels. Many of these agents were born from military chemical research, as described in our Mustard Gas Chronicles.
Consider This…
Modern cancer care asks something no other branch of medicine—or consumer service—dares to ask: Consent to harm in order to receive help.
Radiation is a known carcinogen. So is chemotherapy. Nearly every frontline drug still in use today, from cisplatin to cyclophosphamidebis classified as a Group 1 carcinogen by the World Health Organization. These are substances scientifically proven to cause cancer in humans.
Yet these agents are still administered daily. Not as a last resort. As protocol. This is the only health system that treats a condition with substances that can cause the same condition.
And then it gets worse.
If the treatment fails, providers get paid to try again.
If the treatment causes new harm, the system gets paid to fix that too.
If the patient is disabled by the treatment, there is no tracking system, no restitution, and no liability.
There are no national registries of treatment failure. No safety audits for long-term harm. No mandated reporting for quality-of-life loss. If harm happens, it happens off the record buried in the silence of “side effects” and the language of “standard of care.”
Now consider this: If your car mechanic replaced your brakes, and those brakes failed, causing a wreck.
Who would be accountable?
What would the liability be if you were injured?
Or if someone died?
Would we tolerate a system that shrugs, recharges you, and sends you back on the road with no questions asked?
That’s cancer care. Except the cost is not a vehicle—it’s a life. And the industry has insulated itself from consequence by embedding injury into the contract (informed consent). You don’t just sign up for treatment. You sign up for risk—permanent, documented, and predictable risk.
And once you sign, the system washes its hands.
No follow-up for what you lost.
No admission for what they broke.
No audit for who it helped—and who it hurt.
“It’s the only industry where the failure becomes its next paycheck.”
What We Aren’t Told
What patients rarely hear is that these drugs were never designed for precision. They target all fast-dividing cells — not just tumors, but the gut, hair, blood, brain. The side effects (or Known Effects) are not bugs — they are features of the mechanism: nausea, fatigue, sterility, memory loss, secondary cancers.
“We’re still using 70-year-old poisons and calling it progress.”
And the data? Most of these drugs were grandfathered in before modern trial standards existed. Outcome tracking is inconsistent. Long-term harm is underreported. Yet these compounds dominate treatment plans nationwide.
It’s Not About the Science. It’s About the System.
It’s not that better treatments don’t exist. It’s that they’re not always covered, not incentivized, not built into the throughput models of modern oncology. Institutions run on throughput. And legacy drugs fit the system perfectly.
References
Amjad M.T., Chidharla A., Kasi A. “Cancer Chemotherapy.” StatPearls [Internet]. 2023 Feb 27. Highlights the history of chemotherapeutic agents, including early alkylating and platinum‐based therapies. NCBI
https://www.ncbi.nlm.nih.gov/books/NBK564367/?utm_source=chatgpt.com
DeVita V.T. Jr & Chu E. “A History of Cancer Chemotherapy.” Cancer Research. 2008;68(21):8643–53. Detailed timeline of chemotherapy development—including older agents still in use today. PubMed+1
https://pubmed.ncbi.nlm.nih.gov/18974103/?utm_source=chatgpt.com
Falzone L., Salomone S., Libra M. “Evolution of Cancer Pharmacological Treatments at the Turn of the Third Millennium: What Has Been Achieved and What Has Been Foreseen.” Frontiers in Pharmacology. 2018;9:1300. Offers an overview: old cytotoxic drugs, rise of targeted therapies, and the legacy of older agents. Frontiers
“Discovery – Methotrexate: Chemotherapy Treatment for Cancer.” National Cancer Institute. April 30, 2014. Covers methotrexate’s development and continued use, emphasizing how some drugs date back decades. Cancer.gov
https://www.cancer.gov/research/progress/discovery/methotrexate?utm_source=chatgpt.com
HOPA Timeline – “1978: Cisplatin enters the fight to treat cancer.” History of Hematology/Oncology Pharmacy. Details cisplatin’s approval and its age relative to modern therapies. hoparx.org
https://www.hoparx.org/about-us/history/hematology-oncology-pharmacy-timeline/?utm_source=chatgpt.com