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Cancer chemotherapy | Ch 9 | |
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From the very beginning of its evolution, cancer can present remote metastases. It is therefore resistant to local treatment (such as surgery or radiotherapy). Medical treatment of cancer, particularly anti-cancer chemotherapy, is prescribed in order to impede such evolution.
We now know a great deal about the action of chemotherapy and the rules for prescribing it, but in many circumstances, experimental questions remain for which precise data collection is needed in order to optimise its use.
Molecular biology discoveries made in the 1970’s following President Nixon’s Cancer Plan are now producing (30 years later!) new therapeutic avenues without a cytotoxic effect on the cells. Rather than destroying cancerous cells, they endeavour to slow down their metastatic evolution or the development of remote metastases, thus reducing their death potential.
These new aspects will be explained in chapter 11. This chapter only concerns 'classical' cytotoxic chemotherapy in 2005.
General principles
Main chemotherapy drugs
Chemotherapy Indications
Principles for poly-chemotherapy
Chemotherapy Toxicity
Practical aspects of chemotherapy
Chemotherapy resistance
Although I have tried to regularly update this teaching website, it is quite possible that new medications or new indications are not yet described. On the other hand, the exchange of personal points of view has always been one of the bases of this course. I would therefore be very grateful for any kind comments in order to improve this work.
This is also, and first and foremost, a French website and slight differences may exist among the various English speaking countries in terms of indication, dosage and brand names of chemotherapy products.
North American websites are also most useful : the, the . I also used the website of European Agency for Medication as well as the excellent (in French) website.
North American websites are also very useful: the NCI Drug Dictionary, the NCI cancer topics. I also use the European Agency for Medication’s website (EMEA) as well as the excellent (in French) Pharmacorama website.
Anticancer chemotherapy should be integrated into a multidisciplinary approach and cannot be considered following the conclusion of one isolated (however excellent he/she may be) physician!
Being often under experimentation, it is at best conducted within research or evaluation networks.
In spite of remarkable progress and the incredible hopes (and fears) of patients, chemotherapy remains, for many major cancers (like lung, head and neck, colon, ovary or kidney) a therapy offering modest results. The medical oncologist should therefore remain modest in his (her) approach.
Chemotherapy requires quite a range of aptitudes, and therefore a motivated and attentive medical team, with trained nursing staff, meticulous pharmacists, and experienced assistants.
Psychological aspects of patient care should also be taken into account throughout treatment: the frontier between curative and palliative treatment is often blurred.
Other chapters of this website
- Natural history of cancer
- Cancer prevention
- Cancer screening
- Cancer diagnosis
- Tumour markers
- Principles of Cancer Classification
- Cancer surgery
- Cancer radiotherapy
- Cancer chemotherapy
- Cancer hormonotherapy
- Other cancer therapies
- Multidisciplinary approach of cancer patients
- Psychological aspects
- Post-therapeutic follow-up
- Palliative care in cancer
- Cancer emergencies
References |
Index |
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