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In chemotherapy, cytotoxic agents are used to kill or stop the growth of cancer cells (Macmillan). The goal of chemotherapy is to shrink and slow down cancer cells. If this isn’t possible, it is to try to stop their growth. This information might suggest that chemotherapy would only be suitable for non-small lung cancer in its early stages. However, chemotherapy has also been used to treat patients with NSCLC. When cancer is advanced, chemotherapy can shrink a painful tumour, improving the quality of life for patients (American Cancer Society 2016). It can be hard to evaluate the effectiveness in such cases because the treatment’s goal is different. The delivery of treatment depends on where the NSCLC patient is in his or her disease.
EvaluationChemotherapy is a systematic treatment, meaning it affects the whole body (What is chemotherapy? (c2016). It is therefore inevitable that chemotherapy will affect normal body cells and nerves, as well as cancer cells. The doctors and patients must decide if chemotherapy is worth the risk. In the case of patients who are weak or unwell, the cells may be damaged and this will worsen the condition.
The only exception is if chemotherapy is administered by mouth or injection. Regional chemotherapy is more targeted and only targets cancer cells within a specific area. Systematic chemotherapy, on the other hand, affects both healthy and cancerous cells. The effects of the treatment should be milder and less harmful for the patient. By stage Iv, which is the most severe stage of NSCLC cancer, the cells have spread throughout the body and are not easily visible on scans. NSCLC in stage Iii or Iv is treated mostly with isolation chemotherapy, because by this stage survival is rare, only 6%. By stage iv the survival rate is even lower, at 4%.
In such cases, chemotherapy may be used to enhance the patient’s life quality. In this situation, chemotherapy that is administered systemically can help eliminate cancer cells in the bloodstream that cannot be detected by scans.
It is common to prescribe chemotherapy for NSCLC Stage iv (citation) as, although NSCLC is not curable at this stage, there is a desire to improve a patient’s overall quality of health. Combination chemotherapy is the term used to describe it because a number of drugs are combined. Cisplatin & carboplatin have the highest rate of use in combination, but this can lead to a variety of side-effects. Cisplatin or carboplatin can increase the chances of a patient contracting an infection.
Because of the weakened system, you are more susceptible to infection, including pathogens which would normally not be harmful. NSCLC sufferers are at a higher risk of infection than healthy people. Cancer patients have a low neutrophil white cell count (Cancerorg 2015). The addition of carboplatin or cisplatin would increase the risk of infection. This would make patients more susceptible to infection and complicate future treatment.
There is also a level toxicity in the drugs that are used in chemotherapy. Therefore, it is very important to choose the right dosage. If you use too little or too much of the drug the treatment may not be effective and will have side effects. For example, nausea and diarrhoea. Cisplatin may also temporarily impair male fertility. If all sperm are destroyed by chemotherapy, this can be permanent.
There are four types of surgery to treat NSCLC: Lobectomy, Pneumonectomy and Sleeve resection (American Cancer Society, 2016). Pneumonectomy means removing the entire lung. The most effective surgery is a lobectomy, which involves the removal of an entire lung lobe.
American Cancer Society decided that the best treatment option for NSCLC is surgery “if surgery is possible” (American Cancer Society 2016). The fact that surgery can be very effective in certain circumstances and not in every case is worth noting. Once NSCLC has reached the advanced stages, surgery is rarely chosen as the most effective treatment. This is because it works best if the tumor is small and cancer is not spread throughout the body.
When cancer has spread or metastasized to other areas of the body, it can return after surgery. The cancer will not be cured by surgery alone at stage iii or iv. American Cancer Society mentioned in the article that “surgery is used often along with other therapies” to remove tumors (American Cancer Society, 2016). Adjuvant therapy, which is when surgery is used with chemotherapy to treat cancer, can produce very good results (Cancernet).
Cancer cells in other parts of your body can be targeted with chemotherapy. This increases the effectiveness of the treatment and decreases the chances of cancer returning. The same would apply to the risks of adjuvant treatment as they do for the second choice of treatment.
Patients who undergo chemotherapy as a complement to surgery will not only suffer the negative effects of the treatment, but they will also experience the side-effects. Adjuvant therapies can be detrimental to patients if they are administered without need.
Cancernet, 2017) explains that chemotherapy and surgery are recommended only for patients in stage iB NSCLC. This is because cancer has already advanced to a more advanced stage and requires chemotherapy for a reduced risk of cancer returning. The recovery time after lung surgery depends on the amount of lung tissue removed and how well the patient was before treatment.