Speaking from very recent experience, some things are obviously standard, like "take these pills twice a day" but cancer often comes with lots of ancillary issues, and most treatments come with side effects.
There was a lot of variance in how doctors and nurses treated the side effects, how they spoke to the patient, what other resources they provided, the quality of bedside manner, their attentiveness to lab results and patient health over time, whether they consistently washed their hands, etc.
People don't really die "of cancer" they die of things like blood loss, toxic build up from renal failure, blood clots, or infections acquired in the hospital that attack a weakened immune system, to name a few.
Sure. Anyone with cancer should go to a high volume academic and designated cancer center. The hospital should also rate high in us news and reports and score top marks in nurses, safety and cleanliness. But you can't deviate from FDA guidelines except in very exceptional cases.
Doctors have tremendous latitude in how they treat patients and, as far as I know, there are no "official" guidelines for most diseases (very communicable diseases might be one major exception).
There are guidelines for developing, manufacturing, advertising, and selling drugs. However, doctors can use them off-label. From the FDA (here: http://www.fda.gov/ForPatients/Other/OffLabel/default.htm )
"From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. "
That was my experience of variability for a family member treated within a particular high volume academic hospital and designated cancer center.
But my point is in response to the original parent comment. If you give treatment Y at one top hospital and your control group is everyone getting treatment X at all the other top hospitals, you still have basically anecdotal data.
If I'm very sick and the standard treatments aren't working, would I want to try a protocol that was anecdotally very successful in some clinic? Absolutely. Just because it's not scientifically proven to work doesn't mean it doesn't work.
They do run multi center clinical trials... but yes if your current treatment doesn't work or is likely out of date then you should seek another treatment option (usually a phase 1 or 2 trial)
There was a lot of variance in how doctors and nurses treated the side effects, how they spoke to the patient, what other resources they provided, the quality of bedside manner, their attentiveness to lab results and patient health over time, whether they consistently washed their hands, etc.
People don't really die "of cancer" they die of things like blood loss, toxic build up from renal failure, blood clots, or infections acquired in the hospital that attack a weakened immune system, to name a few.