When cancer is found, many people's reaction is to treat it quickly, the sooner the better!
In fact, is slow treatment necessarily worse than fast treatment? Is it better to die than to be treated?
Today, Professor Liu Jihong, director of gynecology department of cancer prevention and treatment center of Sun Yat sen University, brings you four truths that must be understood in cancer treatment.
Truth 1: slow treatment is not necessarily worse than fast treatment
After being diagnosed with cancer, many patients will feel anxious. As soon as they come to the hospital, they would like to start treatment immediately and operate as soon as possible.
Liu Jihong said that generally speaking, tumors are actually chronic diseases, and slow treatment is not necessarily worse than fast treatment. Many patients are so anxious that they are not even clear about the diagnosis, so they are anxious to have surgery. This situation is common in clinical practice.
"Treating tumors is not treating colds, but is a major disease that needs precise diagnosis and treatment. It certainly takes some time to make a clear diagnosis and formulate a treatment plan. Some patients say that I have been here for three days, why don't you give me treatment? In fact, the examination needs a process, and the doctor also needs a thinking process to identify the diagnosis and weigh the advantages and disadvantages of the treatment plan. It requires the doctor to decide a patient (especially the relapsed patient) in a few minutes The results may not be ideal. "
Many tumors have genetic characteristics. For example, if a 30-year-old patient with early ovarian cancer needs surgery, the doctor should consider whether the uterus and another normal ovary can be preserved for such a young patient. At this time, it is necessary to determine whether the patient has genetic predisposition and high risk of disease caused by genetic changes through some tests. If there is no pathogenic gene mutation, it is safer to preserve the uterus and the other ovary. At this time, we need to do the investigation of family genetics and tumor history, and also detect whether there are mutations in genetic genes, which takes time.
"Our hospital has a molecular diagnosis department, and it will take two weeks at the earliest to get the results. After the results are available, the doctor can decide whether to do other tests and decide what kind of operation to do. Some patients just don't understand it. Once she is asked to wait for the results, she is very anxious and wants to go to another doctor for surgery. If the operation is really done, the result is that there are other problems when the genetic test results come out, and the patient may need to I'll have a second operation. "
In addition, ovarian cancer often needs to be distinguished from gastrointestinal tumors. If the gastrointestinal tumor is transferred to the ovary, there may be no gastrointestinal symptoms, but there are a large number of ascites, ovarian tumors and other manifestations of ovarian cancer. At this time, the patient should go to gastrointestinal endoscopy to check for gastrointestinal cancer.
If the primary cancer is in the gastrointestinal tract, the treatment plan is completely different.
Liu Jihong said that a good doctor will comprehensively consider the patient's situation.
The so-called diagnosis and treatment, "diagnosis" is the first step. If the diagnosis is wrong, the treatment plan will definitely not be correct. Therefore, there is no need for the patient to rush for several days. Slow treatment is not necessarily worse than fast treatment.
It is more important that cancer can be detected early. Many tumors reach advanced stage. There is little difference between treatment one month earlier and one month later.
Truth 2: sometimes, it is better to treat without treatment than to treat in disorder
"Many patients with advanced tumors may live longer without active anti-tumor treatment." Liu Jihong said frankly.
Many late stage patients strongly request the doctor to give her anti-tumor treatment, but the actual situation is that the patient has been resistant to all drugs, and no treatment has been effective. In this case, the doctor may choose a single drug with low toxicity and small side effects for the patient, or even only use some drugs that relieve symptoms or even comfort.
However, the patients or their families do not understand that there are no conditions for the "aircraft cannon". In this case, the treatment may not only fail to see the curative effect, but also bring toxicity. The patients may even die of toxic reactions or complications.
For example, there is an elderly patient in his 70s who has recurrent cervical cancer. If he only uses painkillers and nutritional support, he may live for another three or five months. However, his family members do not agree and insist on chemotherapy. In the end, the elderly died of severe bone marrow suppression, which is very sad.
There is no drug without toxic and side effects. The body of patients with end-stage tumors is already very weak. On the one hand, strong treatment may not be effective, and on the other hand, there is toxicity of the drug, which will soon run out of oil.
"In the late stage of some patients, supplementary nutrition and palliative treatment are more meaningful than active anti-tumor treatment, so that the survival period of patients will be longer, more comfortable and the quality of life will be better."
Another situation is that in the later stage, many patients or family members prefer to endure the severe pain caused by the tumor rather than use painkillers for fear of addiction. This is an incorrect concept.
"In fact, the survival period of patients is very short, and pain relief treatment is an important palliative treatment. At this time, patients should be allowed to walk the last journey of their lives more comfortably, and do not worry about the addiction of pain killers. On the other hand, there are good slow-release pain killers now, and it is not easy to become addicted."
Truth 3: honey of a and arsenic of B, some of the drugs in the patient group are "poison"
"A considerable number of patients who come to our hospital are late relapse patients, and the treatment should be very individualized. However, the patients like to provide information and compare with each other. I also use what medicine she has used, which is wrong." Liu Jihong said.
Each patient's condition is different, for example, cervical cancer, but the treatment plan for cervical squamous cell carcinoma and cervical adenocarcinoma is not completely the same. If it is cervical small cell carcinoma, it is even different. Or even if one of your indicators is different, the treatment plan given by the doctor is different.
"The patient communication group has a positive effect, which can encourage each other and enhance anti-cancer confidence, but it also has a negative effect. Many times, the medicine provided by a is a 'poison' to B, and it is still necessary to follow the advice of the doctor in charge."
Truth 4: targeted drugs are not omnipotent
"When many patients come to see a doctor, they ask whether I can do without surgery and chemotherapy. Now there are not so many new treatments. Give me targeted drugs!" Liu Jihong said.
So far, surgery + chemotherapy is still the most basic, most important and most standard treatment for ovarian cancer. Some patients do not receive chemotherapy at the initial treatment, or put chemotherapy in a very secondary position, and there is no condition to insist on using targeted drugs for treatment, often the efficacy is not optimistic.
"Targeted drugs are targeted, and the therapeutic effect is good only when there are corresponding targets. For example, the total effective rate of PD-1 antibody for single drug treatment of gynecological malignant tumors is about 10% ~ 20%, and the effective rate will be significantly increased when there are corresponding biomarkers. The effective rate of chemotherapeutic drugs can also reach 80% when ovarian cancer is first treated. Therefore, it is not correct to regard targeted drugs as magic drugs! Drugs must have indications before they can be taken Good results. "
Professor Liu Jihong
Director of Gynecology, cancer prevention and treatment center, Sun Yat sen University
Comprehensive from: cancer prevention and treatment center of Sun Yat sen University, China Medical Tribune today's tumor, medical world
Source:
https://www.cn-healthcare.com/articlewm/20220822/content-1422497.html
