Among various malignant tumors, except for systemic tumors such as leukemia and malignant lymphoma, which are mainly treated with chemotherapy, even for solid tumors confined to a certain organ, even if radical resection is performed, postoperative recurrence and metastasis may occur, except for a few early ones that can be cured by local treatment. The reason is that these patients have tiny metastases that are not visible or palpable at the time of surgery and cannot be detected yet, which become the root cause of postoperative recurrence and metastasis and eventually lead to failure of surgery.
1.Radiotherapy (to reduce recurrence rate and local pain)
Since Roentgen discovered X-rays in 1895 and the Curie couple discovered radium in 1898 and used it to treat malignant tumors, radiation therapy for tumors (radiotherapy) has gone through more than a century. In this history of more than 100 years, with the progress of science, radiation therapy for tumors has progressed very rapidly and has become more and more mature, and has now developed into one of the three main means (surgery, radiotherapy and chemotherapy) for the treatment of malignant tumors.
According to the statistics of World Health Organization (WHO) in 1990s, 45% of malignant tumors can be cured, of which 22% are cured by surgery, 18% are cured by radiotherapy, and 5% are cured by drugs and other methods. At present, about 70% of tumor patients need to receive radiation therapy at different stages of the disease process. This shows the importance of radiotherapy in tumor treatment.
(1) What kinds of radiation are used to treat tumors?
Radiotherapy has a history of nearly 100 years, and there are three types of radiotherapy used in clinical practice at this stage: ① X-ray therapy machines and various types of gas pedals that produce X-rays of different energies. ②Radioisotopes emitting α, β, γ rays. ③Electron beams, proton beams, neutron beams, negative meson beams and other heavy particle beams produced by various types of gas pedals.
(2) How should I cooperate with the doctor for radiotherapy?
Radiation therapy is carried out in the radiotherapy department of the hospital. First, the doctor will take the patient to the positioning room and position the patient under the simulator. After positioning, the radiotherapy site will be drawn on the skin or on the fixed film with marker lines, and then the radiotherapy department staff will lead the patient into the radiotherapy room, and after positioning, the radiotherapy machine will be aligned with the radiation site, and usually only 1 – 2 minutes will be irradiated. Before radiotherapy, please wear loose, easy to take off and put on clothes to reduce the time spent in the radiotherapy room. The patient is the only one in the room during radiotherapy. If you have any need or discomfort, please do not move and raise your hand to signal or call out to the staff, who can see or hear the sound through the monitor at the operating table and can promptly meet the patient’s needs.
(3) How long does radiation treatment take?
The length of radiation treatment is determined by the doctor according to the total radiation dose and the different sites and tumor radiation biological effects. Generally it takes 6 – 8 weeks with one irradiation per day, 5 times per week and 2 days rest. This facilitates the recovery of normal cells and tissues and protects your healthy tissues. During radiotherapy, try not to interrupt the treatment to avoid prolonging the treatment time and reducing the effect of radiotherapy. In order to make the toxins released by the necrosis of tumor cells due to radiotherapy to be discharged out of the body as soon as possible, you should drink more water. The daily water consumption should be about 3000ml to increase the urine volume and reduce the systemic reaction.
(4) How to adjust the diet of radiotherapy patients?
When patients receive radiotherapy, more or less some radiotherapy reactions will occur, such as oral mucosal reactions and loss of appetite, etc. Since the appearance of these reactions will affect patients’ appetite, the dietary adjustment of radiotherapy patients is a very important issue, which can make radiotherapy proceed more smoothly. First of all, the patient’s diet should follow the principle of “three highs and one low”. The so-called three high means high vitamin, high protein, high calories, such as lean meat, seafood, fresh fruits, vegetables, etc.; a low refers to low fat; secondly, the patient should eat light and easy to digest food, avoid greasy and spicy, as far as possible to make the taste mellow, so that the patient can easily accept; third: according to the reaction in radiotherapy food adjustment, such as white blood cell decline should pay attention to eat some animal liver, spinach, bean products, etc. Soybean products, etc. If the patient suffers from loss of appetite and indigestion due to radiotherapy, a small number of meals can be given, and the total intake should not be reduced on the premise of eating several times. It is not recommended to avoid eating during radiotherapy.
2.Chemotherapy (to reduce the chance of metastasis and prevent and control metastasis)
Chemotherapy, i.e. chemotherapy, is one of the main treatment methods for tumors, which is the application of chemical drugs to treat tumors. Specifically, it is to inject chemical drugs that can inhibit or kill tumor cells into human body through various ways, such as oral and intravenous injection, to achieve therapeutic effect. In recent years, with the development of new drugs and continuous improvement of combined chemical protocols, chemical progress has been rapid. Chemotherapy alone can make more than ten kinds of malignant tumors get treatment, make more than twenty kinds of malignant tumors get remission, significantly prolong patients’ life or relieve symptoms, and chemotherapy has the advantages of systemic therapeutic effect, eliminating tiny lesions, not needing expensive equipment, easy to popularize, etc. Therefore, chemotherapy has become one of the main means of tumor treatment.
(1) Why should chemotherapy be formulated?
When oncologists give chemotherapy to tumor patients, they will choose suitable chemotherapy regimens for different tumor types, and the chemotherapy regimen is usually a combination of one or several chemotherapy drugs. Why is the combination of several drugs used? Because the main purpose of chemotherapy is to maximize the killing of tumor cells and at the same time to reduce the toxic side effects of chemotherapy drugs on normal cells in human body. Therefore, oncologists will consider the killing power of drugs on tumor cells, the toxicity of drugs, the effect on the proliferation phase of tumor, and the tolerance of individual patients, and select the optimal plan for treatment from the scientific chemotherapy plan.
(2) What is the purpose of chemotherapy?
Chemotherapy can inhibit the development of tumor cells and kill them to a certain extent. (1) It can cure some malignant tumors. Such as acute and chronic malignant lymphocytic leukemia, choriocapillary epithelial cancer, Hodgkin’s disease, testicular cancer, etc. ②It can assist surgery or radiation therapy to improve the treatment effect. ③It can reduce the number of tumor cells and control the development of tumor for a certain period of time. ④Ease the symptoms and reduce the pain of patients.
(3) What is chemotherapy cycle and chemotherapy course?
According to the toxic side effects of chemotherapy drugs and the recovery cycle of human body, it is called a cycle from the first day of chemotherapy drug administration to the 21st or 28th day, i.e. 3 – 4 weeks. Chemotherapy drugs are not administered every day during a cycle, but usually for the first 1 – 2 weeks, with a break at the end of the cycle. Individual regimens require 6 weeks for a cycle. Some tumors require 4–6 cycles of chemotherapy to be considered a course of treatment.
(4) What preparations should be done before chemotherapy?
Chemotherapy is one of the main treatment tools for tumors. Before chemotherapy, patients should prepare well in the following aspects: ① Psychological preparation, firstly, to understand the chemotherapy medication according to their disease condition, so as to have a good idea; secondly, to understand the general knowledge of chemotherapy, to avoid psychological tension, you can do qigong, listen to music and other forms of relaxation to eliminate the tension. ② Pay attention to rest and diet allocation, before chemotherapy patients should maintain sufficient sleep time every day, generally not less than 8 hours of sleep a day for adults, while the diet pay attention to the color and flavor of dishes, to ensure adequate protein intake, eat more things rich in vitamins, easy to digest, eat more fruits and vegetables, less fried food, pay attention to diet allocation. ③Keep your body and mouth clean. ④Cooperate with physicians to do some necessary tests, such as blood routine, liver and kidney function, ECG, ultrasound, chest X-ray, etc., and CT or MRI if necessary. Since chemotherapy has toxic side effects such as nausea, vomiting, diarrhea, hair loss, damage to liver function and decrease in white blood cells, many patients regard chemotherapy as a daunting path, believing that chemotherapy is not enough to make things happen, and will weaken the body that already suffers from serious illness or has just undergone major surgical trauma. Therefore, many patients regard chemotherapy as a daunting path, believing that it will weaken the body that has already suffered from serious illness or has just undergone major surgical trauma. This situation is common in daily medical practice.
In fact, among the current effective treatments for cancer, surgery and radiotherapy are local treatments, while chemotherapy is the only systemic treatment. Therefore, chemotherapy is a systemic treatment that focuses on “eliminating evil”, while Chinese medicine is a systemic treatment that focuses on “helping the righteous”.
In particular, it should be pointed out that chemotherapy is only a general term for all kinds of chemotherapy, and all kinds of tumors, even different stages of a certain tumor, must be treated with different drug regimens, otherwise not only is the treatment ineffective, but even harmful. The chemotherapy of cancer is definitely different from the antibiotics used for certain infectious diseases, not only based on drug sensitivity tests, but also as long as a certain bacterial infection, often a variety of antibiotics are effective. Unfortunately, there are not many non-oncology doctors who can grasp the knowledge of chemotherapy for cancer, which will undoubtedly increase the fear of chemotherapy for cancer patients. Therefore, cancer patients should not do chemotherapy blindly, and should find a professional doctor who has knowledge of chemotherapy to make a chemotherapy plan. As for the side effects caused by chemotherapy, such as vomiting, hair loss and white blood cell decline, there are good anti-vomiting drugs such as 5-HT3 receptor antagonists, leukocyte-raising drugs such as G-CSF, and preventive measures to protect liver and kidney functions, which can better control the adverse effects of chemotherapy, and anti-vomiting drugs can even be given before chemotherapy without vomiting and other uncomfortable reactions, and hair can be regenerated after chemotherapy. Therefore, there is no need to be afraid of chemotherapy.