Whether it is a doctor or a patient, the best effect of tumor is the topic that everyone is most concerned about. From an economic point of view, the cost of treatment should be rewarded. From the perspective of life, the unsatisfactory effect often means that survival is threatened. The best news was undoubtedly told by the doctor during the ** process (the tumor is completely gone. Of course, since there are no tumor foci in the body, why continue? At this time, is it necessary to adjuvant chemotherapy or targeting**, immunization**, etc.? Today we're going to talk about that.
The tumor is completely in remission ≠ healed
As the saying goes, "the tumor is completely gone" is medically known as "complete remission" (CR for short). It refers to the situation in which the patient does not find tumor lesions in the body through imaging examinations such as CT, MRI, PET-CT, etc., as well as biopsy.
It is an important indicator of cancer**, but it is not the only criterion.
Because complete remission does not mean that there are really no cancer cells in the body, but the sensitivity of current medical methods and imaging methods is limited, and it can only be detected to this extent. Perhaps there is still a hidden, small, very little "cancer" in the patient's body that has not been discovered. And these invisible cancer cells are likely to lead to metastasis in the future.
Taking gastric cancer as an example, in a survey of more than 1,300 patients who underwent gastric cancer surgery in more than 100 hospitals in China, it was found that within 2 years after gastric cancer, the probability of patients was as high as 608%。
Only some tumors with early stage or very low malignancy, such as thyroid cancer, do not need follow-up after surgery. Prophylaxis** is recommended for the remaining patients.
Prophylactic**
To deal with this kind of "unwarranted" cancer foci, the idea is similar to "you can't see how dirty the floor is, but it can always be cleaner by wiping it more".
Therefore, some systemic modalities are most often used, such as targeting, radiotherapy, immunity, endocrine, etc. In addition, there are also some local areas with high incidence, such as head and neck squamous cell carcinoma, lung cancer, esophageal cancer, etc., which may require radiotherapy to the surgical area to focus on consolidation.
Although the tumor is "unwarranted", the basis for the criterion ** is conclusiveWhat to receive after surgery**, how many cycles have been carried out, and how many cycles have been carried out to reduce the rate of tumor **, and other big data provide a basis for the patient's standard**.
How effective is preventive**?
Tumor disease is a cellular chronic disease, it is characterized by a long course of disease, late detection, difficult to **, many tumor clinical symptoms are not obvious, early diagnosis is not easy to diagnose, and metastasis is very rapid, some patients are diagnosed when they find that it has metastasized, cancer is difficult to treat, the most difficult is to control ** and metastasis. Even if early detection, early diagnosis, and early diagnosis have won the best opportunity for patients, it is necessary to control the metastasis of malignant tumors.
The continuity of the system after discharge is the key to ensuring that cancer patients do not metastasize.
After discharge, due to the detachment from the direct, strict, high-frequency monitoring and high-intensity medical treatment measures of the cancer hospital, due to the lack of strict and continuous professional observation between the two cycles of "regular" examination, when the patient feels that the condition is not good, the metastasis has often occurred, and even is already very serious. Tumor is a long-term process, and surgical chemoradiotherapy is only the first step in a long march. Only by continuing to do a good job after being discharged from the hospital can we effectively control the tumor and metastasize, and achieve the purpose of prolonging the patient's life!
When will it stop**?
In the face of "unwarranted" and undetectable potential risks, we collectively refer to them as auxiliary**. There are three main considerations for the medication and cycle of adjuvant **:
Tumor stage. **Size.
*Cycle length.
01.Adjuvant chemotherapy
Generally speaking, for common clinical malignant tumors such as lung cancer, gastric cancer, esophageal cancer, colorectal cancer, and ovarian cancer, the specific number of chemotherapy treatments should be judged according to the size of the tumor, the type of tumor, and the degree of differentiation.
The number of postoperative adjuvant chemotherapy is usually 4-6 times. 4 times of intravenous chemotherapy for lung cancer are generally recommended, and 6 times of intravenous chemotherapy for gastrointestinal tumors are recommended. For breast cancer, if the AC-TH regimen is used, chemotherapy is generally 8 chemotherapy sessions, and malignant lymphoma is also mostly 8 chemotherapy sessions. The number of times can be adjusted according to the patient's condition and tolerance.
If the doctor has recommended a specific course of chemotherapy, it is not recommended to stop it without reason.
Assuming that chemotherapy destroys 50% of the tumor cells each time, then, ideally, after the first course, there are still 50% of the tumor cells left, after the second course, there are 25% left, and after the third course125, the fourth 625%..The last remaining trace of cancer cells can be eliminated by the autoimmune system. If chemotherapy is stopped for no reason, there are too many remaining cancer cells that cannot be eliminated by the immune system, which greatly reduces the effectiveness of prevention**.
02.Targeting**
Targeted for tumor prevention. Depending on the patient's risk level, the length of time to take the drug varies. Medium-risk people generally need to eat for one year, and high-risk people may need to eat for three years.
The specific length of taking the drug should be judged comprehensively according to the type of tumor and the patient's condition. If the patient wishes to stop taking the drug, it is important to communicate with the treating physician first. Because after the patient who targets ** is completely remissiond, the mutation is still there, and if the drug is stopped without authorization, the lesion may appear again, resulting in **.
03.Immunization**
At present, once PD-1 PD-L1 immunization** takes effect, it is not recommended to discontinue the drug at will. Guidelines at home and abroad clearly point out that after **sex** (such as surgery, concurrent chemoradiotherapy, etc.), when PD-1 PD-L1 is used as an adjuvant**, the use time is 1 year.