What if the chemotherapy doesn't work?

A fellow caregiver asked...

What if the chemotherapy doesn't work?

Expert Answer

Ernest Rosenbaum, MD, is an oncologist affiliated with Stanford University and with the Comprehensive Cancer Center at the University of California, San Francisco, where he has developed protocols for supportive care and clinical practices.

The goal of chemotherapy is to stop a tumor from growing and to stop cancer from recurring and spreading to other parts of the body. There are many different chemotherapy drugs, and if one doesn't work your oncoogist will most likely try another. This is quite common either because the body becomes sensitized to a chemotherapy drug and it stops working, or because the side effects are too hard to tolerate. Talk to your doctor, tell her your fears, and ask her to outline very clearly the prognosis for your cancer and the treatment options available. Ask her to list for you all the options available, and at what point you and she would conclude that treatment has not been effective.

At some point, however, for many cancer patients, it becomes clear that chemotherapy has ceased to be effective. At that point the pain and discomfort of the side effects outweigh any benefit the patient is receiving from the drug, and the oncologist will likely recommend discontinuing chemotherapy. Talk to your doctor, tell her your fears, and ask her to outline very clearly the prognosis for your cancer and the treatment options available. Ask her to list all the treatment options she would consider trying, and at what point you and she would conclude that treatment has not been effective. If you don't like the answers or simply would like more information, it's often a good idea to get a second opinion at this point.

At this point, the goal of medicine becomes making the patient comfortable and pain-free, so the rest of the time he or she has available can be spent as meaningfully as possible. This is known as palliative care, and it can be very effective in keeping cancer symptoms at bay.