Malignant tumor, which is also commonly known as cancer, is a new organism formed by the abnormal proliferation and differentiation of normal cells in human body under the long-term effect of various carcinogenic factors. With the continuous change of living environment and aging population, the incidence of malignant tumors is increasing year by year, and the threat to human beings is becoming more and more prominent, and now it has become the first killer threatening human health in developed countries and first-tier cities in China. However, with the continuous development of medical science, people’s understanding of cancer is getting deeper and deeper, as well as the treatment methods are continuously generated and improved, the cure rate is also increasing. However, in the face of a wide variety of dazzling treatments, how to choose? Surgery? Radiotherapy? Or chemotherapy? Therefore, as a professional oncology clinician, it is obligatory and necessary for us to establish correct treatment concepts and eliminate misconceptions, so that each patient can receive comprehensive, standardized and individualized treatment plans and get the maximum benefit from treatment, i.e., to make every patient with a possibility of cure For patients with advanced disease who are not likely to be cured, we respect life and science to improve their quality of life, reduce pain and prolong life as much as possible. Comprehensive, standardized and individualized treatment plan is the fundamental principle of cancer treatment in the international arena, in short – “there is no best means, only the best plan” for cancer treatment.
Ask oncologists to formulate standardized and individualized treatment plans
Experts and scholars at home and abroad, through continuous research and summing up, according to the characteristics and rules of different tumors, have organically integrated and applied various methods together to form comprehensive and standardized treatment plans for different tumors, different stages, different types and different patients, so that the effect of tumor treatment can be improved continuously.
The so-called standardized treatment simply means to abide by the treatment principles, and the physicians of different tumor departments collaborate with each other to apply various treatment tools in a correct and orderly manner to achieve the best effect of treatment. Generally speaking, these treatment principles are accepted conclusions derived from many years of clinical studies at home and abroad, and by following these principles, tumor patients can benefit from the current treatment tools to the maximum extent.
Surgery, radiotherapy and chemotherapy are the three main methods of tumor treatment at present. Many tumor patients may have received these treatments successively in the course of their treatment. However, the results of these treatments are very different whether they are standardized or not. In order to standardize tumor treatment and let patients get the best efficacy, global oncologists have jointly developed Clinical Guidelines for Oncology (such as National Cancer Network, NCCN guidelines, etc.) or consensus for various malignant tumors, which become the treatment model that must be followed for standardized tumor treatment. According to the concept of standardized treatment, the treatment plan for each patient needs to be based on the type of tumor, histological typing, clinical stage, expression of tumor markers and the patient’s physical condition, etc. According to the corresponding tumor clinical guidelines, a scientific, standardized and individualized comprehensive plan should be formulated to strive for the maximum treatment benefit. Some tumors may be treated mainly by surgery and supplemented by other means, such as gastrointestinal tumors; some tumors may be treated mainly by radiotherapy and supplemented by other means as appropriate, such as nasopharyngeal carcinoma, nasal NK/T-cell lymphoma, germ cell tumors and some other head and neck tumors; some tumors may be treated mainly by chemotherapy and supplemented by other means as appropriate, such as most lymphomas and leukemias. Some tumors are treated mainly with chemotherapy and, where appropriate, other modalities such as most lymphomas and leukemia. For example, breast cancer usually requires surgery first, followed by chemotherapy according to the situation, radiotherapy at the end of chemotherapy, and endocrine therapy and targeted therapy according to hormone receptor and genetic testing; while locally advanced rectal cancer requires synchronized radiotherapy and chemotherapy before surgery to obtain the best results. Synchronized radiotherapy and chemotherapy have become the common means of local treatment for solid tumors.
Therefore, it is suggested that patients should not panic or follow blindly, but go to regular hospitals, look for professional oncologists, formulate treatment plans suitable for them, and administer treatment in an orderly manner in order to mobilize all positive factors and achieve the best treatment effect.
Common Misconceptions Answer
1.Establish confidence, cancer can be overcome!
Many people think that cancer is an incurable disease, and having cancer is a death sentence, but this is not true. With the continuous development of medical science, the means of tumor treatment are improving, especially the establishment and implementation of the concept of standardized comprehensive treatment, which has gradually increased the cure rate of cancer.
The World Health Organization (WHO) announced in 1995 that the cure rate of tumor is 45%, of which the role of surgery is 22%, the role of radiotherapy is 18% and the role of chemotherapy is 5%. By 2006, the cure rate had increased to 55%, with surgery at 27%, radiation at 22%, and chemotherapy at 6%. For some cancers, the effect is even more encouraging. With the popularization of early screening and the implementation of standardized tumor treatment, the mortality rate of breast cancer has dropped dramatically and the cure rate has increased significantly, according to the Shanghai CDC, the 5-year survival rate of breast cancer has reached 89,9% in 2010; the 5-year survival rate of nasopharyngeal cancer has increased from 8% in 1955 and 54% in 1983 to 86,9% in 2006. The five-year survival rate of nasopharyngeal cancer has increased from 8% in 1955 and 54% in 1983 to 86% and 9% in 2006; the data in 2008 showed that the five-year recurrence-free survival rate of prostate cancer has reached more than 80%; the cure rate of early radiotherapy alone for cervical cancer has reached more than 90%, and the five-year survival rate of standardized treatment in the middle and late stages has reached 50%-70% ……
Therefore, it is recommended that patients should build up confidence, maintain a positive and optimistic attitude and a healthy lifestyle, summon up the courage to fight against the disease, believe in science, establish the scientific concept of standardized treatment, receive regular treatment and overcome cancer!
2. Surgical removal is not equal to tumor cure!
As mentioned above, there are various therapies for treating tumors, such as surgery, radiotherapy, chemotherapy, endocrine therapy, targeted therapy, interventional therapy and Chinese medicine therapy, which need to be selected according to the nature, development degree and systemic status of tumors. As a systemic disease, malignant tumor is often prone to spread to the surrounding and distant metastasis. Surgery is only to remove the tumor visible to the naked eye, except for a few early stage patients, most patients need to consider the overall situation, draw up a comprehensive treatment plan according to the stage and other specific conditions, and implement necessary adjuvant therapy, such as radiotherapy or chemotherapy, to ensure that local recurrence and distant metastasis do not occur, so as to achieve the purpose of cure.
3.Radiotherapy is not a helpless choice, but an active treatment!
Many patients believe that as long as they can operate, there is hope for treatment, and once radiotherapy means that it is too late and lose hope, which is a great misconception! Without radiotherapy, relying on surgery alone, except for a few early stage patients, most of them will have local recurrence and metastasis, resulting in treatment failure and losing the best time for cure. Because malignant tumors and normal tissues often do not have clear boundaries and often interpenetrate each other, and surgery cannot expand the resection area without limitation, and those hidden tumor cells invisible to the naked eye are difficult to be removed, so it is often necessary to further kill the residual lesions through postoperative adjuvant radiotherapy; and for patients with greater possibility of distant metastasis, chemotherapy is a necessary means to prevent metastasis. Therefore, radiotherapy is a necessary part of standardized comprehensive treatment, not a helpless choice.
4.Radiotherapy and chemotherapy are not terrible!
Radiotherapy (radiotherapy for short) is the application of high-energy rays to kill cancer cells in a certain area of the body, while chemotherapy is the killing of cancer cells by chemical drugs. Together with surgery, they constitute the three major means of cancer treatment. Due to the poor accuracy of traditional radiotherapy technology in terms of positioning, field and dose, tumor tissues are not accurately irradiated and normal tissues are not effectively protected, resulting in poor efficacy and side effects; while the old chemotherapy drugs are highly toxic and ineffective, and there are no effective adjuvant drugs to reduce toxic side effects, making the chemotherapy process more painful and difficult to tolerate. Therefore, people have long had a strong fear of radiotherapy.
With the implementation of precise radiotherapy technology, the efficacy of radiotherapy has been significantly improved and the side effects have been significantly reduced, especially in the past ten years, radiotherapy equipment has been continuously introduced and radiotherapy technology has become more and more precise, especially the application of advanced radiotherapy technology such as stereotactic, image guidance, four-dimensional radiotherapy and image tracking, which makes radiotherapy technology as precise and effective as a scalpel although it is non-invasive and painless. According to WHO statistics, about 60-70% of tumors are treated in different ways at different times and for different needs, including radical radiotherapy, neoadjuvant and adjuvant radiotherapy, decompensated radiotherapy, acute radiotherapy, systemic radiotherapy, etc. The treatment is based on the following principles
In recent years, chemotherapeutic drugs have been continuously introduced, which not only improve the efficacy but also significantly reduce the toxic side effects, and the adjuvant chemotherapeutic drugs that reduce the toxicity and side effects of chemotherapeutic drugs have also been updated, which makes the tolerance of chemotherapy significantly improved, and the common side effects can be avoided or significantly reduced, so that most patients can easily complete the whole process of chemotherapy. Of course, strict control of the indications for chemotherapy according to the patient’s specific situation is also one of the principles of standardized treatment.
Therefore, it is recommended that patients should fully understand the importance and necessity of radiotherapy and chemotherapy, eliminate the fear of radiotherapy and chemotherapy, and actively cooperate with the treatment with a good attitude to obtain the desired curative effect!
5.Tumors that are not sensitive to radiotherapy should also be treated with radiotherapy!
Cancer cells of different tissue sources, different pathological types and even different clonal sources do have different radiosensitivity, but insensitivity does not mean that they cannot be treated with radiotherapy. Radiation sensitivity is only a reference factor for the radiotherapist to decide the dosage of radiation therapy prescription, but not a condition to decide whether radiation therapy should be given or not. Moreover, the efficacy of radiotherapy for sensitive tumors may not be good, while the efficacy of radiotherapy for insensitive tumors may not be poor. For example, although prostate cancer is a tumor with poor radiotherapy sensitivity, with the development of precise radiotherapy technology and the improvement of radiotherapy dose for prostate cancer, its five-year survival rate is up to 80% or more.
Therefore, whether you need radiotherapy or not should listen to the advice of the radiotherapy specialist.
6.X-knife (or Gamma Knife) is not a panacea!
Stereotactic radiotherapy is accurate, high-energy and focused, and its radiotherapy dose forms a knife-like dose drop at the edge of the tumor, thus achieving a high dose in the tumor area and a low dose in normal tissues, and achieving a treatment effect like surgical resection, so it is commonly known as X-knife (or Gamma Knife). However, this technology is not a panacea, and it is mostly applied to small tumors with clear shape and boundary, while for tumors with larger size, irregular shape and unclear boundary with normal tissues, the phenomenon of insufficient tumor infiltration boundary will occur, which will not only fail to obtain the proper curative effect, but also bring difficulties for the next treatment, and delay the treatment. Therefore, X-knife (or Gamma Knife) needs to strictly grasp the indications, and if necessary, combine with other radiotherapy techniques in order to avoid the shortcomings of the strengths and play its proper role. It is recommended that patients should listen to the advice of experienced radiotherapy experts before radiotherapy and choose the appropriate radiotherapy technology.
7.Don’t miss the treatment because of partial hearing and partial belief of prescription!
It is often said that “biased prescriptions and experimental prescriptions can kill famous doctors”. There are many single prescriptions, partial prescriptions and experimental prescriptions for cancer treatment widely circulated in Chinese medicine books and folklore, but so far, the observation of folklore single prescriptions and experimental prescriptions for cancer treatment can only be seen in individual cases, and the majority of patients cannot repeat the efficacy of individual patients, let alone observe the efficacy of a considerable scale like standard treatment.
The direct therapeutic effect on tumor is very limited, only as an auxiliary means, and cannot replace the standard treatment, which is the unanimous evaluation of experts and scholars on the treatment of tumor by TCM. Therefore, it is undesirable to rely on single prescriptions or experimental prescriptions to treat cancer, especially those who claim to “cure cancer with panacea” under the guise of prescriptions should be more vigilant and prevent from being cheated, so as not to spend money and miss the treatment time!
All in all, cancer patients should remember: it is not terrible to have cancer, standardized treatment is the way, prescriptions are not advisable, trust doctors and relaxation is important, and advocating science is the right way.