Combination of treatments for better outcome

Multiple modalities of cancer treatment

Madam A was diagnosed with Carcinoma of Uterus Stage 3. She underwent a radical surgery to remove her uterus, ovaries and lymph node. As she was in a locally advanced stage, she was offered a combination of treatments ranging from chemotherapy, external beam radiotherapy and brachytherapy. After explaining the treatment protocol to her, she was started with chemotherapy and radiotherapy (CCRT).

She completed CCRT with grade 2 skin toxicities i.e., skin peeling and redness. She was planned for brachytherapy subsequently but she defaulted treatment.

Patients often ask me why they need so many treatment modalities to treat their cancer. It is important to note that once a cancer is diagnosed in an early stage, the treatment needed will be lesser compared to a cancer diagnosed at a later stage. Treatment protocols recommended is based by medical science and trials proven in hundreds or thousands of patient population before it is recommended to others.

For Mdm A, radiotherapy is for local control as uterine cancer tends to occurs locally when more than half of the uterus is involved. CCRT is for radiotherapy sensitization which makes radiation more efficacious. Brachytherapy is an internal form of radiotherapy. It is combined with external beam radiotherapy as the dose required to cure the cancer can’t be given fully by external beam in fear of radiating the bowels. Adjuvant chemotherapy is given subsequently to increase the survival as she was diagnosed at a later stage and risk of recurrence is higher from the involved lymph node.

Each treatment has its own reasons and benefits. A combination therapy is needed to cure her cancer and to have a better survival rate.

Cancer awareness always states early detection saves lives but I would also stress out that early detection saves your pocket as it requires lesser treatment.

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