Can chemotherapy be done “comfortably”?

In today’s world where the incidence of malignant tumors continues to rise, chemotherapy, as an important treatment tool, can not only make most advanced tumor patients live longer, but also help many early stage patients to be completely cured, which can be considered as “a great achievement”. However, in many people’s inherent concept, chemotherapy is “very uncomfortable” and can cause adverse reactions such as nausea and vomiting, bone marrow suppression, liver and kidney function damage, hair loss and so on, which often makes patients avoid chemotherapy and even delay the treatment. So, is chemotherapy necessarily “uncomfortable”? In fact, after decades of research, “chemotherapy” adverse effects control has been done very well, “comfortable” chemotherapy is no longer a dream, it is time to “name” chemotherapy.  So how can we finish chemotherapy “comfortably”?  1, detailed assessment, personalized on the one hand, we must conduct a comprehensive assessment of the patient. For example, if the patient’s kidney function is not good, the efficacy of using A drug is 100 points, the pressure on kidney function is 100 points, the efficacy of using B drug is 90 points, the pressure on kidney function is 30 points, the doctor will choose B drug. drug. On the other hand, the chemotherapy regimen should be evaluated. Since chemotherapy regimens consist of two or more drugs in combination, the adverse effects of different regimens are “very different” and the physician will refine the assessment of possible adverse effects based on the characteristics of the drugs and the effects of the combination. For example, the regimen is classified as “highly emetogenic”, “moderately emetogenic”, and “less emetogenic”, and an antiemetic regimen is developed accordingly. For patients who are very concerned about their appearance, doctors try to avoid drugs that may cause hair loss. On the basis of comprehensive and detailed assessment, each patient is given a “personalized” chemotherapy regimen to achieve high efficiency and low toxicity.  2, prevention-oriented, proactive preventive blocking of malignant, vomiting “pathway” is an important means to reduce the occurrence of malignant, vomiting adverse reactions. For nausea, vomiting, once the chemotherapy drugs stimulate the intestinal tract and other parts of the emesis factor “one step ahead” to occupy the “command” of vomiting, and then use antiemetic drugs, the effect is very poor, and if the antiemetic drugs in advance to occupy If antiemetic drugs occupy the “command” and block the “switch” of vomiting, it will “get twice the result with half the effort”. Therefore, the order in which multiple antiemetic drugs are used in an antiemetic regimen is quite “specific”. Specifically, we can use the NK-1 receptor antagonist aripitant, the second-generation 5-hydroxytryptamine receptor antagonist palonosetron, and the central and peripheral blockade of the relevant neuroreceptors for prevention. In patients with significant leukocytopenia and thrombocytopenia after chemotherapy, the degree of myelosuppression can be mitigated by the advance use of colony cell stimulating factor, erythropoietin. In order to protect vital organs, detoxification and supportive treatments are used, such as the use of dextropropionamide to protect cardiac function and hepatoprotective drugs to reduce liver toxicity. For chemotherapy-induced hair loss, although there is no good treatment, there is good news: after chemotherapy is stopped, the hair grows back quickly and is sometimes darker and thicker than before.  The “standard” refers to the prevention and treatment of adverse reactions, such as antiemetic, detoxification, protection of bone marrow function and other treatments mentioned earlier, which is essential to achieve “comfortable” chemotherapy. In addition to treating the symptoms, “treating the root” is also very important, and this “treating the root” refers to the control of the patient’s disease and improvement of the body’s function, through anti-tumor therapy to reduce the tumor load, and nutritional therapy to improve the patient’s physical condition, including improving sleep and relieving psychological burden. In other words, we are not only treating the “disease”, but also the “person”, in order to achieve a greater degree of comfort in chemotherapy. The effects of drugs will continue for some time after chemotherapy is stopped and may cause delayed adverse reactions, such as bone marrow suppression and liver function impairment, etc. Therefore, to keep patients comfortable during chemotherapy, we need to conduct dynamic assessment and intervention before, during and after chemotherapy to control the whole process.  Of course, although the current medical tools and measures allow many patients to enjoy “comfortable” chemotherapy, there are still some unsatisfactory aspects, such as not allowing all patients to spend chemotherapy comfortably, and the level of comfort needs to be further improved. For example, chemotherapy is not yet comfortable for all patients, and the level of comfort needs to be further improved. Relatively speaking, if chemotherapy is given to experienced oncologists, there is a greater assurance that patients can complete chemotherapy “comfortably” and have a better quality of life.