Cancer treatment is not one-size-fits-all, and the goals of therapy may be different across individuals who require treatment. To personalize cancer treatment means to consider:
the individual’s type of cancer;
the location and extent of disease;
the unique molecular or genetic characteristics of both the cancer and the person, when applicable, and
integrate these and other clinical aspects with the patient’s care goals and preferences to determine the most appropriate treatment approach.
The overall goal of cancer-directed therapy will generally fall under one of the following aims:
To cure. When cancer is early-stage, or localized and has not spread, treatment will likely be given with a view to completely eradicating the cancer. In some situations, even when cancer has spread, it may still be curable.
To reduce recurrence. After initial therapy has been given to remove the cancer, additional treatment may be given to decrease the chance of the cancer coming back.
To control the cancer (palliate) when a cure is not achievable. Many therapies work to keep cancer as small or low-level in the body as possible, for as long as possible, when disease is not able to be completely eradicated. Palliative cancer treatments may also be given to relieve pain or other symptoms caused by the cancer.
Chemotherapy is cytotoxic or cell-killing medicine commonly given through an intravenous infusion into the bloodstream, though it can sometimes be given by other routes, like by mouth or in a pill form. A hallmark of cancer cells is that they can rapidly divide to grow and spread, and because chemotherapy generally affects actively dividing cells in the body, it is an effective treatment for many cancers. There are many different types of chemotherapy, and an agent that works in one type of cancer may not be effective in another type.
3. Precision Oncology
Precision medicine or precision oncology customizes cancer treatment based on knowledge of how the disease is influenced by each person’s unique genes, environment, and lifestyle, as well as the specific molecular or genetic alterations driving the cancer.
The genetics of both the patient and the cancer itself, in other words, may influence treatment decisions. The goal of precision oncology is to select, when possible, the most exact or accurate therapy for a particular person facing a particular cancer.
Two types of genetic testing are often utilized in precision oncology:
Side Effects
While some degree of fatigue is common with many cancer treatments, the potential side effects and complications one might anticipate from cancer treatment depends on the specific type of therapy prescribed. Undergoing treatment for cancer can take both a physical and emotional toll, and consulting with your care team will equip you with the most useful information on how to prevent, monitor, and manage any anticipated side effects specific to your treatment. Your care team will also advise when to call your doctor or seek emergency medical attention.
Practical Considerations
Common concerns around cancer treatment may include how much it will cost, transportation to/from appointments, how to care for children, other dependents, or pets during treatment, how to attend to other self-care needs, and whether time away from work will be required. Many resources are available to assist people facing cancer and their families/caregivers, and the best place to start is to share any concerns with your care team.
Supportive Care
Supportive care encompasses a multitude of ancillary services or treatments that may be offered alongside cancer-directed therapy that are aimed at preventing or mitigating the physical and/or emotional burden cancer can have on the person and their family/caregivers.
Supportive care may include a dietician for optional nutrition, a medical social worker or spiritual counselor for emotional and psychosocial support, physical or rehabilitative therapists, a care manager to help coordinate care across different settings, and/or medical subspecialists in palliative medicine and hospice, who are skilled in the management of complex symptoms and provide multidimensional care in the setting of serious illness, to name a few. Different elements of supportive care may be helpful at different time points during a person’s cancer journey. The goal of supportive care is to optimize quality of life for people facing cancer and help them thrive, not simply survive, during their cancer experience.
Advance Care Planning
Planning for future healthcare is also important, and discussing any preferences with loved ones as well as with the care team is vital to ensure treatments are aligned with the patient’s personal values and care goals. Documentation of personal wishes for future healthcare in an advance care directive or living will may also help patients and families gain peace of mind. Members of the cancer team and/or a supportive care team can help navigate conversations around advance care planning with patients and families, and individuals facing cancer are always encouraged to be proactive and enquire about it if their doctor does not bring it up first.
Cancer research is moving at a rapid pace, with new discoveries being made and novel treatments emerging faster than ever before. Clinical trials, which are an integral part of cancer research, involve eligible, consenting individuals who participate in an organized study of promising new diagnostic, therapeutic, or survivorship approaches. Clinical trials may ultimately benefit not just the individuals on the study, but the larger population, and at a minimum, advance knowledge that furthers our progress in the fight against cancer.
Cancer therapeutics have never been more effective, and the ongoing intensive efforts in the research laboratory and in clinical trials promise to continue us on this trajectory. While this is exiting and can be transformative, several factors may lead to delays in deploying the latest advances across the wider U.S. cancer population.
The gap between cancer discovery and the implementation of new advances into clinical practice everywhere may result in some people not receiving the best possible treatment for their cancer. Every individual facing cancer deserves awareness and access to the most suitable cancer treatments and/or clinical trials for their unique situation. Furthermore, optimal cancer care comprises not just cancer treatment, but many other aspects of care, such as supportive measures, that promote the well-being of the patient and their family/caregiver.
The National Cancer Institute (NCI)-designated Comprehensive Cancer Centers (NCI-CCCs) lead the nation in cancer discovery and delivery of comprehensive care in a multidisciplinary setting. NCI-CCCs have achieved ongoing recognition from the National Cancer Institute for maintaining rigorous standards for state-of-the-art cancer research involving a well-coordinated combination of high-quality laboratory research, population science, and clinical research.
Studies have shown that patients receiving care at NCI-CCCs have superior survival outcomes, which is attributed to the prolific research and clinical trials offered at these centers as well as the disease-specific expertise of the oncologists, multidisciplinary teams, and resources at NCI-CCCs. There are currently over 50 NCI-CCCs, including AccessHope partners City of Hope, Dana-Farber Cancer Institute, Winship Cancer Institute of Emory University, Fred Hutchinson Cancer Center, and Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
Comprehensive insights by oncology subspecialists from AccessHope’s network of NCI-CCCs into a patient’s multifaceted treatment plan may help bridge the cancer knowledge gap and facilitate optimal cancer care for that person. AccessHope offers individualized insights and recommendations to patients and their treating oncologists with the aim of knowledge-sharing and partnering to improve outcomes and quality of life for patients, no matter where they live.
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