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Overview of Cancer Therapy

By

Robert Peter Gale

, MD, PhD, Imperial College London

Last full review/revision Sep 2020| Content last modified Sep 2020
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Curing cancer requires eliminating all cells capable of causing cancer recurrence in a person's lifetime. The major modalities of therapy are

Systemic cancer modalities include

Often, modalities are combined to create a treatment program that is appropriate for the patient, based on patient and tumor characteristics as well as patient preferences. These modalities can be combined with the primary treatment at the same time or used before or after. The primary purpose of adjuvant therapy, which is given after, and neoadjuvant therapy, which is given beforehand, is to prevent cancer recurrence and increase survival.

Overall treatment should be coordinated among a radiation oncologist, surgeon, and medical oncologist, where appropriate. Choice of modalities constantly evolves, and numerous controlled research trials continue. When available and appropriate, clinical trial participation should be considered and discussed with patients.

Treatment decisions should weigh the likelihood of adverse effects against the likelihood of benefit; these decisions require frank communication and possibly the involvement of a multidisciplinary cancer team. Patient preferences for how to live out the end of life (see Advance Directives Advance Directives Advance directives are legal documents that extend a person's control over health care decisions in the event that the person becomes incapacitated. They are called advance directives because... read more ) should be established early in the course of cancer treatment despite the difficulties of discussing death at such a sensitive time.

Response to cancer treatment

Various terms are used to describe the response to treatment (see table Defining Response to Cancer Treatment Defining Response to Cancer Treatment Curing cancer requires eliminating all cells capable of causing cancer recurrence in a person's lifetime. The major modalities of therapy are Surgery (for local and local-regional disease) Radiation... read more ). Disease-free or progression-free survival often serves as an indicator of cure and varies with cancer type. For example, lung, colon, bladder, large cell lymphomas, and testicular cancers are usually cured after 5 years of disease-free survival. However, breast and prostate cancers may recur long after 5 years, an event indicating tumor dormancy (now a major area of research); a 10-year disease-free interval is more indicative of cure in these cancers.

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