Cancer Treatment Modalities and Informed Consent

January 10, 2017 | Author: | Posted in Cancer

When a person’s cancer is treated using only one treatment modality, this is called monotherapy or single-modality therapy. When more than one treatment modality is used, the term is combination therapy or multimodality therapy. Combination therapies can be administered at the same time (simultaneously), one after the other (sequentially), or in alternating cycles. When more than one treatment is administered simultaneously, the specialists involved must coordinate and schedule the treatments carefully. In one common sequential treatment, either surgery or radiation therapy is used first, to remove or shrink the tumor mass. This is followed by chemotherapy to treat any cells that may have metastasized.

Most cancer treatments are designed to cure the disease either by removing the tumor or by killing all the cancer cells. Sometimes, however, cure is impossible. The goal of treatment in these cases is to reduce the patients’ symptoms, improve their quality of life, and prolong their lives. This kind of treatment is called palliative care.

Because different people with the same diagnosis and stage of disease will differ in characteristics such as age or general health, an oncologist must consider the competing risks when determining which treatment is best for each individual. In addition, the oncologist must consider three additional concerns: whether the cancer is confined to the primary (local) tumor, whether other nearby (regional) tissues are involved, and whether cancer cells may have metastasized to distant sites.

Whatever type of treatment you receive, you will be given an informed consent form to read-carefully-and sign. In addition to giving the doctor and the treating institution permission to provide the treatment, this form describes the treatment and all of its likely or possible side effects, which can include physical symptoms (such as nausea), abnormal blood tests (low blood counts), and abnormal results of imaging tests (so that, for example, future x-rays may show an abnormality where a tumor has been treated with radiation). Although the extensive list of side effects in the informed consent form is necessary, in part for legal reasons, it can be frightening. However, most people experience only a few of the side effects described in the form. Many forms, in fact, subdivide side effects into those that are acute and late and those that are common, uncommon, rare, and extremely rare.

Acute side effects occur during treatment and usually disappear a few days or weeks after treatment ends. Their severity is usually graded on a scale of 1 to 5. Grade 1 side effects are usually mild and may be barely noticeable. People who experience Grade 2 or 3 side effects may need a drug such as an antibiotic to cure an infection, an antiemetic to relieve nausea, or a drug to control pain (and methods of controlling pain have been greatly improved). Many people who develop Grade 4 or 5 side effects must be hospitalized-their symptoms may be life-threatening. In some cases, the cancer treatment may need to be changed because of the side effects.

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