What should friends around me do if they get cancer?

When the pathological stage has been determined, the next step is to determine the treatment plan. I only have experience in concomitant treatment of non-small cell lung adenocarcinoma, and the following experience can only give a general reference in the direction. Please make a decision according to NCCN guidelines and expert consensus and your own situation. ?

At present, there are three mainstream treatment schemes for advanced cancer:?

① chemotherapy. ?

② Radiotherapy. ?

② Targeted therapy. ?

Objectively speaking, there is no obvious difference among the three treatment schemes. From the specific analysis of indications and adaptive population, we should not kill any of them with a stick before diagnosis (for example, no chemotherapy/radiotherapy/targeted therapy anyway). ?

Chemotherapy?

That is, the abbreviation of chemical drug therapy is a treatment method that uses chemical drugs to prevent the proliferation, infiltration and metastasis of cancer cells until they are finally killed. It is a systemic treatment method, which is generally treated by intravenous drip of chemical drugs, and the chemotherapy cycle varies according to the specific condition and scheme. The side effects of chemotherapy vary according to different regimens and patients' tolerance. For example, most chemotherapy regimens combined with platinum will cause bone marrow suppression and so on. ?

What I want to say is, don't smell chemotherapy. There are some advanced tumors at present. In the latest edition of the guidelines, it is clearly stated that chemotherapy is the first-line treatment, because this kind of tumor cells are the most sensitive and rapid to chemotherapy, and the corresponding treatment effect is also the best. For example, small cell lung cancer in lung cancer is progressing rapidly. If it is delayed because of fear of chemotherapy, the consequences may be unimaginable. Of course, chemotherapy also has a corresponding adaptation population. If the patient's physical condition does not meet the requirements, the hospital will not give chemotherapy to the patient. It should be noted that chemotherapy also has a drug resistance cycle. ?

Radiotherapy?

That is, tumor radiotherapy is a method to treat malignant tumors by using radiation such as α, β and γ rays generated by radioisotopes and particle beams such as X-rays, electron beams and proton beams generated by various X-ray therapy machines or accelerators. Similarly, radiotherapy also has corresponding indications, people and side effects. For example, for patients with multiple brain metastases from lung cancer, whole brain radiotherapy is an effective treatment method, and the treatment effect can last for about half a year; Radiotherapy is also a common and effective treatment for bone metastasis caused by tumor. My mother has a metastatic tumor in her right brain. The main side effects of chemotherapy combined with whole brain radiotherapy are general weakness, dizziness, nausea and vomiting, loss of appetite. However, radiotherapy has inhibited brain progress for half a year, and the effect is still good. Because my mother is sensitive to bone metastasis, we didn't have radiotherapy for bone metastasis. )?

Targeted therapy?

Targeted therapy is to design corresponding therapeutic drugs at the cellular and molecular level, aiming at the identified carcinogenic site (this site can be a protein molecule in tumor cells or a gene fragment). After the drug enters the body, it will specifically select the binding effect of the carcinogenic site, so that the tumor cells will die specifically without affecting the normal tissue cells around the tumor. ?

Compared with chemotherapy, targeted therapy is a new treatment method, and its biggest feature is pertinence. Relatively speaking, its side effects are less than those of systemic chemotherapy. Similarly, targeted therapy also has indications to adapt to the population. Different targeted therapies will produce different side effects according to different targets, and these side effects will be fully explained in the instructions of targeted drugs. The biggest disadvantage of targeted therapy is its high cost, and the average drug resistance period ranges from half a year to one year. After drug resistance, we can only choose chemotherapy or the next generation of targeted drugs. ?

Note: At present, the first-line treatment of some advanced cancers is targeted therapy. If this situation is mentioned in the guideline \ consensus, please ensure that qualified patients have a comprehensive genetic mutation test. This kind of test requires the patient's biopsy tissue, and it usually takes three to four weeks to get the test results. Whether genetic testing is needed or not, it is necessary to fully communicate with the doctor before determining the plan. If the genetic test has a positive result, it's best to ask whether there are any clinical drugs in China. (Targeted drugs are expensive, and there are technical problems that cannot overcome drug resistance. )?

How to choose or understand the treatment plan given by the doctor? ※? ?

1) Refer to NCCN diagnosis and treatment guidelines and expert consensus. ?

2) According to the content of 1), learn more about the treatment scheme recommended by doctors. ?

3) In the case of multiple choices, you can consult more practitioners (oncologists, oncologists, new drug research and development teams ...) and elderly patients and their families. ?

Other treatments include immunotherapy and palliative surgery, which are popular in recent years. Immunotherapy has a broad prospect, but the technology is still limited at present, and the time for large-scale application is not yet ripe. People who can afford it can try, but there is no need to make a big bet. Palliative surgery is generally to improve the quality of life of patients. ?

PS: The purpose of writing this article is definitely not to make people make decisions beyond doctors, but to prevent patients and their families from falling into an uninformed state when making any treatment plan in the hospital and to cooperate with doctors more actively; In rare cases, I have my own understanding and judgment on the possible differences in treatment schemes. (For example, before my family opened pathology, the doctor raced against time to give my mother chemotherapy according to the consensus on the treatment of non-small cell lung cancer at that time. It was no problem at that time, but it was not the only choice. My family and I knew nothing about this, and as a result, we missed the best opportunity for targeted treatment and paid a painful price. )?