Chemotherapy usually helps shrink tumors and treat them effectively. Some examples are lymphomas, leukemias, and testicular cancers. For cancers that have metastasized (when the disease spreads to different parts of the body), chemotherapy is required in combination with other treatment modalities. Palliative chemotherapy helps in increasing the life expectancy of metastatic cancer patients. 

Some important things to keep in mind while choosing palliative chemotherapy

Response rate refers to the likelihood that the tumor will improve after treatment. A response rate of 20% will mean that if 100 patients were treated, then 20 will have their tumors shrink by half or more. Your medical team will be able to provide you information that is unique to your cancer.

Median duration tells you how long a patient is expected to respond positively to treatment before the tumor starts to grow again. In the majority of palliative chemotherapy cases, this number is between 3 and 12 months. A longer response indicates a longer life expectancy.

Side effects of palliative chemotherapy

The severity and the kind of side effects that affect one after chemotherapy have considerably improved over the past two decades but general symptoms that prevail are fatigue, hair loss, weight loss, loss of appetite and changes in blood count. But symptoms that arise usually depend on the nature of chemotherapy itself and the kind of tumor that is being treated. You may ask your medical oncologist about the specificities of your treatment and how they can be managed.

Who needs palliative chemotherapy?

Palliative chemotherapy is usually given for stage 4 cancer patients where the intent of treatment is not curative & for patients who do not respond to curative chemotherapy, where treatment has a focussed goal of achieving complete remission and/or prevent a recurrence. The use of chemotherapy in advanced, late-stage cancer remains a disputed matter in the medical community. The moot point is whether to pursue aggressive treatment or focus on comfort measures only. 

Studies of chemotherapeutic palliation

No chemotherapy regimen has shown to be a ‘gold standard.’ Studies conducted with trials in different cancers have shown varied results after chemotherapeutic palliation. 

Evidence to aid the use of palliative chemotherapy has been assessed scientifically, within randomized trials like the above. The debate about the quality of life is gaining momentum. However, unlike survival and life expectancy, quality of life is subjective, which makes analysis problematic. 

Considering the pros and cons

Before making a decision for palliative care, the components of quality of life, general health and the age of the patient must be taken into consideration. The effect that palliative care will have on a tumor will vary from case to case. 

There are no straitjacket solutions to treating cancers and talking to your doctors to gather as much information as you can about your case uniquely. Quality of life is profoundly personal, and one must take time to examine one’s needs and desires.

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