All stories, Cancer Classroom( Decoding cancer)

Understanding cancer treatment….by a simple example.

Cancer treatment is very difficult but yes, still possible. We may not be able to reach to complete eradication of the disease, but still, a decent local control so that it may stop being a life-threatening worry for future, is a possibility in cases that are detected early.

symptoms for cancer - cancerx

Most of the times, making patients and family understand this problem of not eradicating the tumor and need for close follow up even after complete treatment gets very difficult.

Here is an example to elicit the practical problem.

Treating cancer is like a plumbing job in a room where we have a wash basin with an erratic tap (the main source of water) with a long connecting pipeline. Depending on stage a patient is diagnosed, the doctor (plumber) is asked to repair the damages. In early stage and good tumors (head and neck like larynx, breast, lymphoma, cervix, prostate, etc) its just the leaking tap, which is easy to close and also can be sealed permanently with modern treatment techniques. Job well done….akin to almost complete cancer cure.

But the majority of cancers, especially in third world and developing countries are diagnosed late, where there is a leaking tap with a spill on the floor, limited spread from the primary site (oligometastasis) or disseminated (multiple metastases away from the primary organ).

Difficult to manage but with a good combination of multimodality treatment, or combination therapy, it is possible to seal the tap by local therapy (surgery or radiation) and mop the floor dry (chemotherapy or systemic treatment).

Some of these locally advanced tumors, actually are further complicated by the situation which is complexed with a heavy floor spill along with multiple holes in the connecting pipeline over and above the existing leaking tap. This is the worst case scenario.

The plumber, that is the treating cancer doctor or the oncologist, has to dedicate time detecting these minor leaks, trying to mop puddles of water here and there, only to find new pockets every now and then. Frustrating for the doctor and more so for the patient, as each plumbing activity is time taking and also involves some financial burden each time.

The end results in the larger outlook may not appear good in the last case as disease never gets over and keeps troubling, resulting in complaints from the one who is at the receiving side of all this, the patient.

Along with this is the practical problem faced by the caregiver to how to multi-task and cater to all the problems together, which may not be medically possible. This is also because each plumbing job in itself is with some side effect on the patient.

So there needs to be a thin balance between the decision for curative, palliative (symptom control) or no treatment at all, as per the situation we are faced with.

This example may to some bit explain how the caregiver, the doctor has to walk the thin line between cancer care and treatment and disease-related ailments, trying to alleviate the patient of his sufferings. Doing so, we win some…we lose some.  Some patients get completely cured. For some, we are able to extend life. For others, we lose the battle.

In the end, its the effort that counts and only the patience, hard work and trust between the doctor and patient pays off!!

More on cancer treatment in our next post.

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The article has been authored by Dr. Ashu Abhishek, Fortis Hospitals. To view his profile, click here

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