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All genetic risks appeared magnified by childhood exposure to alkylating agents, a common class of chemotherapeutics.

For instance, in acidic environments, doxorubicin -- one of the current leading chemotherapeutics -- goes through what's known as ion trapping.

It also significantly reduces the effectiveness of chemotherapeutics.

Other tumour-resident bacteria can metabolize chemotherapeutics, which further contributes to drug resistance.

As a specialist in geriatrics and palliative medicine, and above all as an internist, I am sure of several important facts: We all will die; many very ill patients know they are dying and are afraid to discuss it; many doctors are afraid to discuss dying with patients; and recklessly administered chemotherapeutics — with little or no hope of benefit — may shorten life and increase suffering through side effects.