Cancer is gradually becoming a chronic disease that requires a long-term joint effort from both doctors and patients to face. In the process of receiving anti-cancer treatment, it would be helpful for patients and their relatives and friends to know more information about it, so that they can cooperate with medical staff to implement appropriate treatment and maintain a high quality of life while obtaining long-term disease control. Therefore, in addition to the knowledge of anti-tumor treatment, some information and ideas about supportive cancer treatment can help to reduce patients’ pain and improve their quality of life.
I. What are the main components of tumor treatment?
The treatment of tumor includes two main components, one of which is indispensable. The second is supportive treatment, also called symptomatic treatment, which aims to relieve patients’ various symptoms and heart pain, make patients comfortable as much as possible, help patients receive anti-tumor treatment smoothly and maintain a better quality of life.
In the process of tumor treatment, only by taking into account the above two aspects, can we obtain satisfactory results. Neglecting either aspect cannot be called a qualified treatment. In the past, the focus of both doctors and patients in cancer treatment was mainly on anti-tumor treatment, and not enough attention was paid to supportive treatment, and patients’ various symptoms and pains were not paid attention to and effectively treated, which resulted in anti-tumor treatment leaving patients with mostly painful, unbearable and even unbearable memories. A few patients also interrupted or refused further treatment due to unbearable side effects related to treatment, which affected the overall efficacy of tumor treatment. These painful experiences are witnessed by patients’ family and friends, and then become public impression and consensus, which invariably increase people’s fear and avoidance of cancer, and gradually form a vicious circle, which is very unfavorable to cancer patients’ cooperation with treatment.
The rapid development of modern medicine is not only reflected in many specific research results and treatment methods, but also in the respect and care for patients’ personality. Supportive treatment for cancer is a vivid interpretation of this advanced medical humanistic concept, a sign of returning to rationality in cancer treatment, and a concrete embodiment of medical humanitarianism. We believe that through the joint efforts of doctors and patients, the level of supportive treatment for cancer patients can be improved, human patients can actually enjoy the fruits of medical progress, and gradually reverse the painful memory of cancer and anti-cancer treatment among the public.
II. How to carry out targeted supportive treatment?
Cancer not only threatens patients’ lives, but also brings them various uncomfortable symptoms and pains. The medical community has reached a consensus on relieving these pains and agreed that it is the basic right of patients. Therefore, for patients with cancer, communicating with their doctors at all times and actively informing them of their symptoms will help them to carry out timely treatment, and we do not advocate patients to endure pain and other symptoms.
The main purpose of supportive treatment is to relieve patients of various uncomfortable symptoms and make them as comfortable as possible to face the disease and life with a positive attitude. Supportive treatment should be started as early as possible, and the earlier the patient receives supportive treatment, the more benefit the patient will have. The main tasks and contents of supportive therapy vary for tumor patients in different stages and phases. According to the different stages of tumor, supportive treatment mainly includes two stages: first is the best supportive care stage. Second is palliative treatment stage.
What is the best supportive treatment for tumor?
Early stage tumor patients can obtain curative effect through comprehensive treatment such as surgery and post-operative adjuvant therapy, doctors often call this stage of supportive therapy as best supportive therapy. Its purpose is to help patients receive anti-tumor treatment smoothly and eventually cure cancer.
The main components of optimal supportive treatment include the control of tumor-related symptoms, the management of comorbidities of anti-tumor treatment, and the rehabilitation treatment after the end of overall treatment. For example, patients with early stage lung cancer cannot eat normally for a few days after surgery, and will suffer from postoperative pain, possible and and cough and constipation during bed rest; patients receiving postoperative adjuvant chemotherapy are often combined with anorexia, nausea and vomiting, reduced white blood cells, anemia and weakness. Therefore, active nutritional support, effective pain treatment, prevention of infection, relief of constipation, and correction of anemia and leukocyte depression are the main elements of supportive treatment during this period. In western developed countries, the negative psychological impact of cancer diagnosis and treatment on patients is highly valued, and psychological counseling throughout the overall treatment process is also a component of supportive treatment. Thus, supportive treatment is not only limited to symptom control, but also includes psychological counseling and meeting spiritual needs of patients.
IV. What is palliative care?
Middle and late stage tumors account for most of the cancer patients. In addition to the necessary surgery, they often need to receive radiotherapy to control cancer progression, prolong life expectancy and achieve long-term survival. This stage is often long and can last for months or even years. The supportive treatment during this stage is called palliative care. Palliative care is the main treatment for patients with advanced tumors and always the only treatment for patients with terminal tumors. Its purpose is not only to improve symptoms, but also to prolong survival through palliative antitumor treatment, such as palliative radiotherapy or chemotherapy.
According to the information published by the World Health Organization in the 1990s, the main elements of palliative care include: pain and other symptom control is the primary task of palliative care; pay attention to the psychological and spiritual aspects of patients’ needs; and help patients face life with a positive attitude. Palliative care can not only improve patients’ quality of life, but also may have a positive impact on the treatment of their diseases, so it should be carried out as early as possible and combined with other treatments that prolong patients’ life.
V. What is the significance of palliative care for lung cancer patients?
In 2010, oncologists at Massachusetts General Hospital published the results of their clinical study on lung cancer patients, which formally showed that palliative care could prolong the survival of lung cancer patients. Their study randomized patients with advanced lung cancer into two groups, one receiving only antineoplastic therapy and the other receiving palliative care combined with antineoplastic therapy, and found that patients in the combined palliative care group lived longer. The results of this study have received widespread attention from oncologists around the world and have prompted doctors and patients to update the concept of oncology treatment and better integrate palliative care into the overall anti-tumor treatment so that more patients can benefit.
6. Why is pain relief the first priority of palliative care?
The symptoms of patients with mid- to late-stage cancer are complex and diverse, and pain is the most common symptom. Continuous pain brings great suffering to patients and their relatives and seriously affects patients’ quality of life and even survival. Therefore, WHO has made pain relief treatment the top priority of palliative care for oncology and promulgated the Three-step Pain Guidelines for Cancer Pain to the world in the 1980s, with the aim of promoting the concept of active pain relief and alleviating the pain of cancer patients worldwide. Valuing patients’ pain and actively giving analgesic treatment is a concrete manifestation of medical humanitarianism.
The basic principle of the WHO analgesic guidelines is to provide pain relief in a stepwise manner, that is, doctors should assess the patient’s pain before providing pain relief treatment, and then provide appropriate pain relief treatment accordingly, and about 80% of cancer pain can be satisfactorily relieved by medication. Opioids are commonly used by cancer patients for pain relief, and the opioids commonly used in China include morphine, oxycodone and fentanyl. The fear of addiction to these drugs has been one of the main reasons that hinder effective pain relief treatment, but here we would like to tell you that cancer patients using these drugs for pain relief under the guidance of doctors will not become addicted.
The concept of cancer pain relief in China is still relatively backward, and the concept of pain tolerance is still common. The public can long see reports from film and media about cancer patients who endure severe pain and continue to work or live tenaciously. Although the strong will of cancer patients is touching, the media ignore the fact that they endure great pain without good control, and even praise such endurance intentionally or unintentionally. In any case, this kind of praise poem is inappropriate. Because making cancer patients pain-free is something that modern medicine can already do, and it is the duty of doctors. More importantly, it is the most basic right of every cancer patient to ask for pain-free.
VII. Combination of Chinese and Western medicine in cancer treatment is the way to achieve the above goal
According to the viewpoint of combining Chinese and Western medicine, all methods of treatment have their indications and limitations, and the treatment methods of Chinese medicine and Western medicine have their own advantages and disadvantages. Therefore, it is not only reasonable but also imperative to combine Chinese and Western medicine to complement each other’s strengths and improve the therapeutic effect. For tumor clinic, the starting point of advocating the integrated treatment of Chinese and Western medicine is based on the full evaluation of the advantages and disadvantages of Chinese and Western medicine anti-tumor methods, and the planned integrated application of Chinese and Western medicine methods to bring their respective advantages into play, so as to obtain the maximum therapeutic effect and at the same time, make the toxic side effects disappear or be minimized, so that patients can get better quality of survival and longer survival period.
At present, the main methods of treating tumors are surgical resection, radiation therapy, chemical drug therapy and biological therapy, while there are also unique Chinese medicine therapy, qigong therapy and acupuncture therapy in China. The treatment method of western medicine alone has better effect in eliminating local lesions and striving for eradication, but there are many toxic side effects and the damage to pathological and normal tissues are not distinguished; there are more medical original diseases caused by the treatment, such as surgical sequelae and complications, radioactive inflammation and sequelae, toxic hepatitis, bone marrow suppression and immunosuppression; the quality of survival and behavioral status of patients are poor after treatment; surgery, radiotherapy and chemotherapy cause the organism to suffer from the disease. In contrast, Chinese medicine can help to eliminate evil and fight tumors. On the contrary, Chinese medicine can improve the immune function of the body, reduce the toxic side effects of western medicine, reduce the production of medical diseases, improve the systemic symptoms, and make the tumor patient have a better quality of survival, thus improving the efficacy. However, simple Chinese medicine treatment also has the disadvantages that it is difficult to eradicate the lesions completely, the effect of killing tumor cells is not strong enough, and the target of local lesions of tumor is not very high. Qigong and acupuncture treatment are also used as adjuvant therapy due to various conditions. For this reason, it is necessary to replace the previous Western medicine treatment or Chinese medicine treatment by the integrated treatment of Chinese and Western medicine. The combination of the two can synergize with each other and complement each other’s strengths to improve the long-term efficacy of tumor treatment.
Integrative treatment of Chinese and Western medicine has been gradually valued and applied, but it is not yet common enough. Sometimes, patients often apply Chinese medicine treatment spontaneously while receiving Western medicine treatment. Some patients dare not cooperate with TCM treatment or carry out the treatment secretly by themselves due to the prejudice and opposition of competent physicians, so that it is difficult to truly carry out planned and reasonable integrated treatment of Chinese and Western medicine, which greatly reduces the efficacy. Thus, the concept of integrated treatment of tumors with Chinese and Western medicine should be established not only in the consciousness of patients, but also, and more importantly, in every tumor clinician.
In conclusion, the synergistic and complementary effects of two or more therapies in the integrated treatment of Chinese and Western medicine can obviously strengthen and improve the therapeutic effect; reduce and minimize various toxic and side effects, complications and sequelae in the treatment; consolidate the therapeutic effect and prevent recurrence and metastasis; regulate and restore the functions of the body and organs; alleviate the systemic and local symptoms caused by tumors; eliminate the adverse effects of patients’ thoughts and behavioral states caused by various factors; and improve the therapeutic effect of patients. It can also improve the quality of life of tumor patients and prolong their survival period. Through this comprehensive therapy, we can achieve more ideal results in the treatment of tumor.