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Home :: Cancer treatment
Cancer Treatment . First-line Pain Medications Various Cancer therapies:
Aims of treatmentCancer treatment requires the cooperation of a multidisciplinary team to coordinate the delivery of the appropriate treatment (surgery, chemotherapy, radiotherapy and biological/endocrine therapy), supportive and symptomatic care, and psychosocial support. While all members will have the patient's care as their central concern, someone, often the oncologist, has to take responsibility for the coordination of the many professionals involved. Central to this endeavour is the involvement of the patient through education as to the nature of their disease and the treatment options available. An informed choice can then be made, even if in the end it is simply to abide by the decisions made by the professionals. Good communication embodies a humane approach which preserves hope at an appropriate level through empathy and understanding of the patient's position. Our patients offer us a privileged entry to their lives at a time of crisis, which can provide a powerful, positive and adaptive response when handled with sensitivity and respect. It can also provide us, their carers, with a humbling and yet sustaining illumination of the human condition. Curing cancerFor most solid tumours local control is possible but not sufficient for cure because of the presence of systemic (microscopic) disease, while haematological cancers are usually disseminated from the outset. Improvement in the rate of cure of most cancers is thus dependent upon earlier detection and effective systemic treatment. The likelihood of cure of the systemic disease depends upon the type of cancer, its chemo-/hormonal sensitivity, and tumour bulk (microscopic or clinically detectable). A few rare cancers are so chemosensitive in adults that even bulky metastases can be cured, e.g. leukaemia, lymphoma, gonadal germ cell tumours, and choriocarcinoma. For most common solid tumours such as breast and colorectal cancer, there is no current cure of bulky (clinically detectable) metastases, but micrometastatic disease treated by adjuvant chemotherapy (see below) after surgery can be cured in 10-20% of patients. Measuring response to cancer treatmentA measurable response to treatment can serve as a useful early surrogate marker when assessing whether to continue a given treatment for an individual patient. It is also useful in early clinical trials, when investigating whether new treatments will be worth investing the resources for randomized trials. Response to treatment can be subjective or objective. A subjective response is one perceived by the patient in terms of, for example, relief of pain and dyspnoea, or improvement in appetite, weight gain or energy. Such subjective response is a major aim of most palliative treatments. Quantitative measurements of these subjective symptoms form a part of the assessment of response to chemotherapy, especially in those situations where cure is not possible and where the aim of treatment is to provide prolongation of good-quality life. In these circumstances, measures of quality of life enable an estimate of the balance of benefit and side-effects to be made. Objective response to treatment is measured either as a complete response, which is a complete disappearance of all detectable disease clinically and radiologically or partial response, which is conventionally defined as more than a 50% reduction in the size of the tumour. The term 'remission' is often used synonymously with 'response' which if complete means an absence of detectable disease without necessarily implying a cure of the cancer.
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