What Is Palliative Chemotherapy?

Cancer specialists (oncologists) recommend chemotherapy in one of two situations. For some cancers, chemotherapy can completely get rid of the cancer with a good chance that it will never come back. Examples include certain types of lymphoma, leukemia and testicular cancer, among others. For most cancers that have metastasized (spread beyond the original cancer site), chemotherapy cannot cure the cancer. However, chemotherapy may be helpful in shrinking the cancer, improving or completely eliminating distressing symptoms caused by the cancer for a period of time and helping you live longer. The use of chemotherapy in these situations is called palliative chemotherapy.

What information do you need from the oncologist to help you decide if palliative chemotherapy is right for you or your loved one?

Here are some important questions to ask:

1. What is the Response Rate of the proposed chemotherapy?

   Response Rate refers to the likelihood that your cancer will improve from the treatment. A Response Rate of 30% means that if 100 patients like you were treated, 30 patients would have their cancer shrink by one-half or more. For some cancers, the term response rate can be expanded to include those patients whose cancer did not shrink, but also did not grow. Talk to your oncologist to understand exactly how he/she is using the term response rate for your cancer.

2. What is the Median Duration of Response of the proposed chemotherapy?

   The Median Duration of Response tells you how long your cancer can be expected to respond to the chemotherapy, before the cancer starts growing again. For most cancers where palliative chemotherapy is used, this number ranges from 3-12 months. The longer the response, the longer you can expect to live.

3. What side effects can I expect?

   Although the treatment of chemotherapy side effects has vastly improved in the past 20 years, every patient responds differently. Ask your doctor to describe the most likely symptoms you will experience during chemotherapy treatment.

4. How long must I continue treatment?

   Standard practice is to wait for one-two full cycles of treatment (a typical cycle lasts 3-4 weeks) before looking at the cancer’s response to it. If your cancer is responding to the treatment, your doctor will likely recommend continuing the chemotherapy until the cancer stops growing or you develop unacceptable side effects from the treatment.

Final tips:

• Don’t be afraid to ask these and other questions-it is your body, you have a right to know as much information as possible about your cancer and your treatment options.
• Seek out a second opinion if you feel you are not getting clear and honest information from your doctor.

Reference

Adapted from Weissman DE, Palliative Chemotherapy. Fast Fact and Concept #14; 2nd Edition, July 2005. End-of-Life Palliative Education Resource Center, www.eperc.mcw.edu.