Dear Doctor,

From the family and friends of one of the chemotherapy patients who fell on the wrong side of the “low risk” of DPD Deficiency/5-FU toxicity:

There are volumes of general medical, pharmacological and pharmacogenetic information supporting pre testing of patients who will be administered 5-fu.  Research clearly supports the benefits.

There are also hundreds of stories from patients and loved ones describing the pain, suffering and death brought on by the untested use of 5-FU. These testimonials beg for testing.

We believe while it may not be your job to change your industry’s system, it is your role to thoroughly educate and reduce likelihood of injury in any treatment you provide.

We believe you must go beyond the obligatory informational brochures your company provides and offer the truest information. You have an awesome responsibility as the expert we come to and trust for guidance in the complex business you perform.

We also believe it is not your job to forego presenting all the possibilities based on your opinion of our financial hardship or your perceived risk level of the treatment.

Legally, DPD Deficiency testing may not be included in the standard of care for chemo treatment. As witnesses to the gruesome outcome of this genetic defect, we believe it is morally wrong for you to continue with the business as usual approach.

Of course, if a patient learns they have DPD Deficiency, it may limit their choices for treatment. It would be far better to know the odds and fight cancer with dignity, respect and choice.

For us, the “three-to-eight percenters”, your choices and recommendations will certainly affect the rest of our lives. You play a pivotal role in the education and treatment of your patients. Remember us when you make those decisions.