Outstanding Cancer Treatment Principles & Yoga for Cancer Video

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Treatment decisions take into account many factors, including the likelihood of cure or of prolonging life when cure is not possible, the effect of treatment on symptoms, the side effects of treatment, and the person’s wishes. People undergoing cancer treatment hope for the best outcome and the longest survival with the highest quality of life. However, people must understand the risks involved with treatment. They should discuss their wishes regarding medical care with all of their doctors and should participate in decisions about treatment (see Advance Directives).

. Chemotherapy is usually the only way to treat any cancer cells that have spread (metastasized) beyond the original (primary) site. Using combinations of chemotherapy drugs may help eliminate the original cancer and, at the same time, eliminate cancer cells elsewhere in the body, even when there is no sign of those cells.

Even when a cure is impossible, symptoms resulting from the cancer can often be relieved with treatment that improves the quality of life (palliative therapy). For example, if a tumor cannot be removed surgically, radiation to the tumor may shrink it, temporarily reducing pain and symptoms in the immediate vicinity of the tumor (local symptoms).

Because treatments are complex, specific approaches to care, called treatment protocols, have been developed to ensure that people receive the safest and most effective care. Treatment protocols ensure that people receive a standard approach derived from careful scientific experiments. Protocols are typically developed and refined through clinical trials. A clinical trial allows doctors to compare new drugs and treatment combinations with standard treatments to determine whether new treatments are more effective. Often, people with cancer are offered the opportunity to participate in such a trial, but not all people with cancer are eligible (see What Participants Need to Know About Clinical Trials).

RESPONSE TO TREATMENT

While being treated for cancer, the person is assessed to see how the cancer is responding to therapy. When a cancer disappears for any length of time after treatment, a person is said to have had a complete response (remission).

The most successful treatment produces a cure. A cure means that all evidence of cancer disappears and does not return over a long period of observation. With some forms of cancer, doctors consider people cured if they remain disease-free for 5 years or longer. With other forms, a longer period is required.

With a partial response, the size of a tumor as seen on imaging studies such as x-rays, computed tomography (CT), and positron emission tomography (PET), is reduced by more than half, although it remains visible on imaging studies. With a partial response, the person usually has fewer symptoms and may have a prolonged life, although the cancer grows back in most cases.

In some people, treatment does not lead to a complete or partial response, but the cancer may not grow or spread and the person may experience no new symptoms for an extended period of time. This response is also considered beneficial. In the least successful experience, the tumor continues to increase in size or new sites of disease appear despite treatment.

Sometimes a cancer completely disappears but returns later (relapse). The interval between these two events is called the disease-free interval. The interval from diagnosis of cancer to the time of death is the total survival time. In people who have a partial response, the duration of response is measured from the time of the partial response to the time when the cancer begins to enlarge or spread again.

Some types of cancer, such as breast cancers or lymphomas (tumors of the lymph nodes), respond well to chemotherapy or radiation therapy and are termed responsive. Other cancers, such as melanoma (a skin cancer) or malignant brain tumors, respond to chemotherapy or radiation therapy in only a few people and are termed resistant. Tumors of the intestinal tract and lungs often respond to chemotherapy at first but become resistant later despite continued treatment.

Some cancers produce proteins that are detectable in the bloodstream. These substances are termed tumor markers. An example is prostate-specific antigen (PSA). PSA levels increase in men with prostate cancer. Most tumor markers are not specific enough to be useful in screening (detecting a cancer before a person develops symptoms) because a number of disorders other than cancer can cause these substances to appear in the blood. However, tumor markers (such as PSA and cancer antigen [CA] 125 for ovarian cancer) can help doctors assess a person’s response to treatment. If the tumor marker was present before treatment but no longer appears in a blood sample after treatment, the treatment has probably been successful. If the tumor marker disappears after treatment but later reappears, the cancer has probably returned.

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