Choice of treatment Flashcards
what is radical treatment
an attempt to kill/remove all the malignant cancer cells
Why is radical treatment used
to cure or gain long term control of the cancer
what is palliative treatment
this is to improve the quality of life for a patient with no impact on their survival
why is palliative treatment used
to relieve symptoms of cancer
- bone pain
- dysphagia
- dyspnoea
why is surgery not suitable sometimes
could be a very deep position or very close to critical structures.
surgery might be mutilating
why are some tumours not suited for RT
- tissue has poor tolerance to radical radiation
- dose limiting structures might be very close
how does size affect the treatment
larger the tumour the lower its radio curability
has more radioresistant cells
how spread influence the treatment choice
if its metatasises treatment might need to take place at various locations
operability depends on
fitness for surgery (too obese or medical illness)
patient choice
the tumour must be removed with a clear margin of normal tissue
how does radio-sensitivty and chemo-senesitivity limit options
some tumours might not be radio-sensitive enough
why does the histology matter
undifferentiated tumours are more aggressive than well differentiated
this affects the management of the tumour
clearance of resection margins affect wether more treatment is needed
if margins are clear it is not needed
after surgery we need post-operative RT to prevent recurrence
what factors are the patients
- age and general health
- morbidity and mortality
- function and cosmesis
- reliability of follow up after treatment
- preference of patient
why does age affect treatment choice
both RT and chemo resistant dimishes with age
some patients may not be able to cope with the treatment
morbidity and mortality
some treatment may have unacceptable risks of morbidity and mortality
