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Chemotherapy Goals
Cancer treatment varies depending upon the type and stage of cancer, your overall condition, as well as the goal of treatment: to cure, keep from spreading, or to relieve the symptoms caused by cancer to improve quality of life. You and your physician will consider all of these factors to select the optimal treatment plan.
Comparing cancer treatments, understanding the goals of specific therapies, as well as the risk and benefits they pose, will help you decide which treatment is most appropriate for your situation. The potential benefits must be balanced against the risks of treatment within the context of the overall goal of receiving cancer therapy. Some drawbacks or risks posed by various cancer treatments may include time away from family and friends, uncomfortable side effects of therapy and/or long-term complications or death. Other important considerations are length, convenience and location of treatment.
Chemotherapy Protocols
Adjuvant chemotherapy is given to cure cancer. It is administered after all the “known” disease has been removed surgically, but the chances of recurrence are high. Adjuvant chemotherapy is typical high dose and high intensity for a pre-established number of cycles.
Neoadjuvant chemotherapy is given before surgery. The goal of neoadjuvant treatment is to make an inoperable malignancy operable. Other indications are for making a less invasive surgical procedure possible. It is commonly given for breast, lung, esophageal, head and neck, and rectal carcinomas. Neoadjuvant chemotherapy is often given concurrently with radiation.
Induction chemotherapy is given to induce a remission. Commonly used in the treatment of acute leukemias.
Consolidation chemotherapy is given to sustain a remission. Commonly used in the treatment of acute leukemias.
Maintenance chemotherapy is given in lower doses to assist in prolonging a remission.
First line chemotherapy is treatment determined to have the best probability of treating a given cancer.
Second line chemotherapy is given if a disease has not responded or has reoccurred after first line chemotherapy.
Palliative chemotherapy is given specifically for symptom management to improve quality of life, control the disease, and prolong survival depending on the specific clinical setting.
Remission
Remission, a term used to describe the effectiveness of cancer treatment, means that the cancer has disappeared and can no longer be measured using existing technology. Partial and complete remission are terms oncologists use to describe partial or complete disappearance of cancer after treatment. If a remission is not obtained, a cancer cannot be cured; however, a remission does not always ensure that a cancer is cured. The best ways to evaluate the benefits of treatment are to examine the duration of remission, survival and disease-free survival (cure). Remission rates can be useful for comparing therapies when patients have not been evaluated long enough to know whether the chance of cure or survival is improved.
Side Effects of Cancer Treatment
Dr. Suarez talks about managing side effects. |
Your cancer treatment may include chemotherapy, radiation therapy, surgery, or some combination of all of these or other therapeutic options. Unfortunately, cancer treatments may also damage normal, healthy cells, resulting in side effects. These side effects occur because most cancer treatments cannot distinguish between cancer cells and normal, healthy cells. For example, chemotherapy damages rapidly dividing cells, a hallmark trait of cancer cells. In the process, healthy cells such as blood cells and hair follicles, that rapidly divide, are also damaged. Thus, hair loss and low blood counts are expected with certain types of cancer treatment.
Fortunately, there have been vast improvements in cancer treatments over the years, resulting in the prevention and control of many side effects. Some side effects are very challenging but are short-term and not damaging to your health, however others may be serious and require treatment or may even be fatal. Unfortunately, side effects may also prevent doctors from delivering the prescribed dose of therapy at the specific time and schedule of the treatment plan. This can negatively affect the expected outcome since therapy is based on delivering treatment at the dose and schedule of the treatment plan.
Any treatment involves potential risks and it is not possible to anticipate all side effects. Midnight Sun Oncology patients receive a booklet with information on how to best manage side effects. It is important to keep your doctor informed about side effects that you experience. Prior to beginning treatment, patients should be aware of these potential side effects and keep your doctors informed if you experience them during treatment:
- Acute reaction to the drug
- Low white blood cells, red blood cells, and platelets
- Possible need for blood transfusion
- Increased risk for infection
- Fatigue
- Bleeding
- Hair loss
- Sore mouth/throat nausea, vomiting, diarrhea, constipation
- Secondary malignancy
- Serious damage to tissues around injection site (skin extravasation)
- Sexual effects and reproductive/fertility problems
- Permanent disability and potential death
- Organ damage affecting the brain, eyes, ears, lungs, heart, liver, kidney/bladder, nerve, muscles, bones, etc.
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