As the article says, for adjuvant chemo “the expected benefit is low.” So it’s not a black-and-white decision whether to live or not, it’s a decision to take additional treatment that may make a difference – but quite likely won’t make a difference – and very likely will wreck the patient’s body enough that they’re less likely to be able to hold on to a job in the future.
It’s not an easy decision, to be sure. But it’s certainly a real decision.
In many ways, it’s like the arguments that led up to health professionals recommending against many forms of cancer screening – it’s possible that for some people there’s a benefit, but for most people the chance of a benefit is tiny, and the chance of a bad outcome is higher, so the screening was worse than not screening.
