In the January issue of Blood, a study shows that in rare cases of chronic myelogenous leukemia (CML), treatment with Gleevec can be discontinued.

The researchers think that some patients treated with Gleevec (imatinib mesylate) that go into extended remissions can stop the drug. They add that patients continue strict monitoring for relapse.

Twelve patients were put into remission with Gleevec for over two years. Six of these patients experienced a relapse within five months after being taken off the drug. When Gleevec was restarted, residual disease again declined.

The other six patients remain in remission after nine to twenty four months follow up.

Despite these results the researchers say 'we do not widely recommend imatinib discontinuation at the present time".

I do have a few questions myself that the article did not address:

Does Gleevec have severe side effects that warrants stopping it at all?

Do they think that Gleevec can potentially cure the patient and some might be able to stop treatment all together?

Some women opt to remove their ovaries to prevent breast cancer recurrence. I considered it -- and then decided I would not take such an extreme measure when I wasn't all that sure I was done having children.

Now, ovary removal may not be necessary -- because a new chemical equivalent of surgery allows women to temporarily shut down their ovaries while preserving their fertility.

The shutdown of the ovaries is called chemopause, and women who choose to go this route receive monthly injections -- considered a super-hormone treatment -- of a drug that blocks the male hormone testosterone and is often used to treat prostate cancer.

Chemopause has big advantages. It doesn't require surgery. And it's not permanent. Women who want to have children can stop the treatment in order to conceive. And women who have trouble with side effects can discontinue use of the surgery-sparing drugs.

The ovary-suppressing drugs -- triptorelin, goserelin, leuprolide, and buserelin -- can be used in place of or on top of standard chemotherapy and hormone therapy and are showing promise in their ability to decrease incidences of breast cancer recurrence.

Medical professionals agree there is value in ovarian suppression. Studies show women whose periods do not return after chemotherapy -- which often causes early menopause -- have lower relapse rates than women whose periods resume. So shutting down the ovaries and stopping menstruation may not be such a bad idea -- and not such an extreme measure either.

It's a question that could face any one of us at any time -- the question over whether to pay the high cost of cancer treatment, when it could send us into debt, or to discontinue treatment in order to save money for the family members who will survive us. Dying of lung cancer, Carolyn Hobbs was confronted with this exact question when considering a new biotechnology drug -- Erbitux -- that she learned cost $1,800. The drug may have extended her life but she determined it wasn't worth it -- and she refused the treatment.

During the last decade, expensive new treatments -- some upwards of $50,000 -- have given some patients their first real fighting chance against disease. The problem with these treatments, however, is that most patients will only survive an extra few months. A lucky few may survive for years. For some, maybe the small fortune these few months or years cost is worth it. For others, squandering their life savings on an extended death sentence is not worth it.

For me -- right now -- I believe I would do anything possible to ensure a longer life. And according to one poll, nearly one-third of Americans faced with death would also do anything possible to survive just a bit longer. This percentage is up from one-fifth in 1990. So I have some company in my corner. But I have not walked in the shoes that require this type of decision. I can only speculate about how I might approach this life-and-death decision. And hopefully, I will never have to make it.