General principles of anticancer treatment
From WikiLectures
- before determining the therapy it is necessary to set a general therapeutic goal
- real goal justifies temporary (or permanent) side effects of therapy
- we generally use the terms curative, palliative and symptomatological treatment
- sometimes with curative treatment we achieve a palliative effect, very rarely with palliative treatment we achieve a curative effect
Curative intention[edit | edit source]
- The treatment is to cure the patient, completely rid him of the tumor
- cure is a vague concept, often after a perfect "remission" there can be a "relapse", so we are more talking about treatment prolonging the overall survival time
- therapy must be radical, intensive enough
- Adjuvant treatment
- treatment starting after curative primary treatment (usually after surgery)
- directed against latent cancer, the patient is healthy from an oncological point of view, but we assume the existence of micrometastases
- The benefit of adjuvant has been proven only in some cancers - breast, GIT, etc.
- Neoadjuvant treatment
- eliminates very probable systemic impairment
- is performed "before" elimination of the primary tumor
Palliative intent[edit | edit source]
- The main goal is to improve the quality of life, maintain it or prevent significant deterioration
- cure cannot be expected, but prolonging life is possible (sometimes for many years)
- so far, unfortunately, it is the focus of cancer treatment
- It is not symptomatological therapy or terminal treatment!
Symptomatological intent[edit | edit source]
- we do not affect the course of cancer, but only alleviate existing problems
Treatment modalities[edit | edit source]
- oncology uses 5 modalities:
- surgery
- radiotherapy
- chemotherapy (+ hormonal therapy)
- supportive treatment
- others (phototherapy, immunotherapy, biotherapy, gene therapy, etc.)
- effects should be either:
- local (radiotherapy, surgery, phototherapy)
- systemic (chemotherapy, immunotherapy, gene therapy)
