General principles of anticancer treatment


 * before determining the therapy it is necessary to set a general therapeutic goal
 * real goal justifies temporary (or permanent) side effects of therapy
 * we generally use the terms curative, palliative and symptomatological treatment
 * sometimes with curative treatment we achieve a palliative effect, very rarely with palliative treatment we achieve a curative effect

Curative intention

 * The treatment is to cure the patient, completely rid him of the tumor
 * cure is a vague concept, often after a perfect "remission" there can be a "relapse", so we are more talking about treatment prolonging the overall survival time
 * therapy must be radical, intensive enough
 * Adjuvant treatment
 * treatment starting after curative primary treatment (usually after surgery)
 * directed against latent cancer, the patient is healthy from an oncological point of view, but we assume the existence of micrometastases
 * The benefit of adjuvant has been proven only in some cancers - breast, GIT, etc.
 * Neoadjuvant treatment
 * eliminates very probable systemic impairment
 * is performed "before" elimination of the primary tumor

Palliative intent

 * The main goal is to improve the quality of life, maintain it or prevent significant deterioration
 * cure cannot be expected, but prolonging life is possible (sometimes for many years)
 * so far, unfortunately, it is the focus of cancer treatment
 * It is not symptomatological therapy or terminal treatment!

Symptomatological intent

 * we do not affect the course of cancer, but only alleviate existing problems

Treatment modalities

 * oncology uses 5 modalities:
 * 1) surgery
 * 2) radiotherapy
 * 3) chemotherapy (+ hormonal therapy)
 * 4) supportive treatment
 * 5) others (phototherapy, immunotherapy, biotherapy, gene therapy, etc.)
 * effects should be either:
 * local (radiotherapy, surgery, phototherapy)
 * systemic (chemotherapy, immunotherapy, gene therapy)

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