After tumor radiotherapy and chemotherapy, how do you know if there is any effect? The doctor teaches you to judge from three aspects
Someone once asked me such a question: In the advanced stage of liver cancer, three courses of chemotherapy have worked well at the beginning, but in the later stage, instead of shrinking, it has grown. Should I stop the treatment?
The answer I gave was: stop chemotherapy. Regarding this kind of problem, there are actually many possibilities, but for this patient, chemotherapy has obviously been ineffective, and it is meaningless to continue, so I recommend stopping the treatment.
Zhang Xiaodong, Chief Physician of the Department of Gastroenterology, Peking University Cancer Hospital, said: Chemotherapy is not for tossing patients, but to help patients shrink tumors to create opportunities for cure and improve quality of life. This is the main role of chemotherapy. If it is really inappropriate Chemotherapy, doctors will not force.
In many cases, the death of cancer patients is not due to chemotherapy, but is caused by the ineffectiveness of chemotherapy and the uncontrollable disease progression. What does this sentence mean? Some cancer patients are often encountered in clinical practice. They refuse treatment at first and take various "magic medicines". Cancer is another disease that races with the timing of treatment. If you miss the best time, you will be gone. If you say that chemotherapy is tossing at this time, do you think it is appropriate?
Therefore, for chemotherapy, everyone must have a correct understanding. You can refuse chemotherapy for various reasons, but don't give up chemotherapy because you are misled! As long as chemotherapy is used reasonably, it is of great help to the treatment of cancer patients. Therefore, chemotherapy must be carried out in time!
---Why does the tumor grow after chemotherapy?
Some cancer patients think that chemotherapy caused the tumor to grow after chemotherapy. In fact, this idea is wrong. In fact, it is not chemotherapy that causes the tumor to grow, but the tumor is not sensitive to chemotherapy and cannot be controlled by chemotherapy. It causes the tumor to grow just as long without chemotherapy and possibly faster, so the logic must be right. Simply put, when the tumor grows after chemotherapy, it is ineffective chemotherapy.
---How to judge whether chemotherapy is effective?
Due to the individual constitution of each cancer patient and the efficacy of the drugs used, the time to see the effect after chemotherapy is also different. Under normal circumstances, each chemotherapy course is 2 to 3 cycles (sometimes 4 to 6 cycles), and each cycle is 3 to 4 weeks. It may start to respond after two or three days of treatment, and one treatment may last for about 3 months. , the specifics have to vary from person to person, and there is no clear statement.
To judge whether chemotherapy is effective, you can judge from the following points:
Symptoms: If chemotherapy is effective, the symptoms caused by tumor compression will generally ease and disappear. For example, in patients with middle esophageal cancer, due to the influence of the tumor compressing the trachea, symptoms such as swelling and coughing appear. After chemotherapy, the coughing symptoms disappear, and the treatment can be preliminarily judged to be effective, because conversely, if the tumor does not become smaller, the symptoms may not be relieved. Bar?
Signs: For example, in central lung cancer, when the tumor compresses the lobar bronchus, the lobe to which it belongs is atelectasis, and there is no breath sound on auscultation, but after chemotherapy, the lung lobe opens up and the breath sound is restored, which means it is effective.
Imaging: This is the most direct and objective indicator for judging whether cancer radiotherapy and chemotherapy are effective. Just like when we take pictures, we can see the changes intuitively. For solid tumors such as lung cancer and liver cancer, there is a RECIST evaluation system, which is mainly divided into four criteria: complete remission CR, partial remission PR, stable SD, and progressive PD according to the change in tumor diameter and duration. The first three are generally judged to be effective, and PD is invalid.
Chemotherapy is not effective, what should I do?
When the effect of chemotherapy is not satisfactory and you want to improve the effect, you can try the following methods:
● Eliminate obstacles: such as smoking, nicotine in smoke can affect the effect of chemotherapy, so quitting smoking is a major measure to improve the effect of chemotherapy.
●Do a good job in nursing care during chemotherapy: maintain a happy and optimistic attitude, which can bring positive effects to chemotherapy. In addition to the patient's own mentality, family members and medical staff should be more considerate and concerned about the patient, and encourage them to cooperate with the disease. Fight, strengthen confidence, cooperate with medical staff to actively treat; pay attention to dietary conditioning, due to the influence of chemotherapy, the patient's body resistance is weak, but also pay attention to dietary hygiene and nutrition, try to achieve a balanced diet, and ensure that an appropriate amount of staple food, vegetables and Fruits and other foods, a balanced diet can help increase the body's energy, help rebuild damaged tissues, and ensure the body's normal immune level; pay attention to keeping the living environment clean and hygienic, keep the indoor air fresh, properly ventilated, and maintain adequate ventilation sleep time.
●Marker material selection therapy: Dr. Charles Sawyer of the University of California, USA, etc., through some molecular markers to determine which chemotherapy drugs are most suitable for patients, thereby improving the effect of chemotherapy.
●Improve the accuracy of chemotherapy: Studies have shown that genetic testing can make breast cancer patients most benefit from T/AC chemotherapy, which can improve the accuracy of chemotherapy through genetic testing, thereby helping to improve the effect of chemotherapy.
Generally speaking, for cancer treatment, in order to obtain a basic guarantee for the curative effect, it is recommended to choose an experienced doctor from a large regular hospital, so that the doctor can also formulate the most appropriate treatment plan according to the specific situation of the patient, so that the curative effect will naturally be reduced. more ideal.
Further reading: Not all cancer patients can get chemotherapy
Although chemotherapy is very helpful for cancer treatment, not every patient is suitable for chemotherapy, especially some cancers that are not sensitive to chemotherapy. Comparison of the sensitivity of different cancers to chemotherapy:
Cancers that are highly sensitive to chemotherapy: such as neuroblastoma, choriocarcinoma, childhood acute lymphoblastic leukemia, Hodgkin's disease, testicular germ cell tumor, neuroblastoma, Wilms tumor, etc. Most of these cancers can be cured by chemotherapy. achieve better results.
Cancers that are moderately sensitive to chemotherapy: such as acute myeloid leukemia, adult acute lymphoblastic leukemia, small cell lung cancer, gastric cancer, and osteosarcoma. These cancers may be ideally achieved through comprehensive treatment of surgery or radiotherapy combined with chemotherapy. Effect.
Cancers that are not sensitive to chemotherapy: such as bladder cancer, prostate cancer, endometrial cancer, kidney cancer, melanoma, head and neck cancer, multiple myeloma, etc. Chemotherapy is not recommended for these cancers, not only is the effect unsatisfactory, but also Because chemotherapy is also toxic, it may bring more health problems to patients.
Summary: Chemotherapy is not so magical and unbearable. Only patients who are suitable for chemotherapy and rational use can achieve ideal therapeutic effects. In order to achieve this to the greatest extent, it is recommended that patients go to a regular university. Hospital to see a doctor.
References:
[1] "Zeng Shiqiang died of cancer and refused chemotherapy. Oncologist: chemotherapy is not to toss the patient". Global Network. 2018-11-13
[2] "How to judge the effect of cancer radiotherapy and chemotherapy? 》. Dr. Liu Yongyi. 2019-02-27