|
How Does a Doctor Choose Which Chemotherapy Drugs to Administer?
- Research: Chemotherapy was introduced for the
first time in the 1940’s. For the next two decades, it was mainly
used as an investigational treatment procedure. However, a lot more
information about chemotherapy has been gathered in the last 3 decades
and a variety of effective drugs are now available. Over the years,
doctors have documented responses and carried out clinical trials
in order to compare conventional treatment procedures with new ones.
Information gathered on chemotherapy has helped establish specific
treatment protocols (class of drugs, dosage and usage schedule)
depending on the type and stage of the cancer and other details
about the patient’s tumor. Currently, standard protocols have
been established for most forms of cancer, allowing doctors to
choose the right chemotherapy for cancer patients.
- Response rates: During the process of evaluating
chemotherapy information and selecting a protocol for a particular
patient, doctors will take into account the response rates of chemotherapy
drugs and their documented effectiveness in various stages of cancer.
Response rates are expressed in percentage terms and they indicate
the total number of patients whose tumor will react (shrink or disappear)
to the administered drug/drugs. Response rates are ascertained through
research. For instance, a particular form and stage of cancer may
have a response rate of 70% in relation to a specific drug or combination
of drugs. This implies that 70% of patients with this form and stage
of tumor will respond (the tumor shrinks or disappears) to this
drug or drug combination. However, it also implies that 30% of the
patients with similar condition will show no response or will only
display minimal response. Responses to chemotherapy treatment can
be either complete or limited (these assumptions are based on the
form of cancer and the related protocol). Response duration is another
factor that influences drug selection. It is a measure of the effective
response duration of the administered drug/drugs. For every drug
protocol, an average response duration has been documented through
research. Doctors select protocols that have the highest response
rates and longest documented durations.
- The patient’s health: Chemotherapy drugs have
toxicities. They should be administered with care even when the
individual may be of sound health. Tolerating certain chemotherapy
protocols may not be possible for individuals who are very old and
weak or those who have medical complications. In such cases, the
treatment benefits should be compared with potential risks prior
to choosing the treatment procedure. In certain cases, doctors may
prescribe a single drug instead of a standard drug combination.
In other cases, the patient and the doctor may choose to forego
chemotherapy and, instead, focus efforts on improving quality of
life.
When selecting a
chemotherapy treatment, there is no single, correct choice. All
treatment protocols have their own distinct benefits and drawbacks,
and there can be more than one effective option. Moreover, treatment
options may change with time. A chemotherapy treatment considered
good at a particular time may not remain the preferred choice at a
later time.
Even though doctors make use of the most
recent chemotherapy research and choose combination
protocols with the highest expected response rates, it is still
difficult to guarantee the desired response. For any patient, predicting
the outcome of a chemotherapy treatment is impossible. However, there
has been a dramatic improvement in response rates and since new drugs
are regularly being developed, the outcomes will keep on improving.
This website is sponsored by Brad Cooper* of The
Cooper, Hart, Leggiero, & Whitehead, PLLC. Cooper, Hart, Leggiero, & Whitehead is located in The Woodlands, Texas
(Greater Houston Area) and can be reached toll free at 1-800-998-9729
for more information on mesothelioma. Brad Cooper is not a medical
doctor. The information on these pages is for the education of mesothelioma
patients and their families regarding potential medical and legal
options. Patients are advised to consult with a medical doctor.
* Licensed
by the Supreme Court of Texas.
|