Nowadays, cancer is one of the most serious problems in medicine.Specialists try to discover new treatments. In clinics, the patients with cancer that start a new treatment are closely followed. Physicians determine the optimal dose which have the minimal side effects and offers the most numerous chances of survival. Because doctors make often adjustments, the treatment given to the patients does not always match with the treatment that studies found it to be the most effective. That’s why sometimes people receiving the treatment doesn’t feel very well, even if that treatment is supposed to save their life. If the patients have to get chemotherapy it is very important to respect the recommended doses and schedule, and it is also important to know the reasons why this rules are not respected.
There are a lot of cases when different types of cancer, like breast cancer or even the Non- Hodgkin’s lymphoma, are not correctly treated and it is not given the appropriate supportive therapy. It was proved that if those patients were treated appropriately and the treatment guidelines were followed, they would have a good chance of survival and possible cure.
The Non- Hodgkin’s lymphoma is a very aggressive type of cancer or the most common type of lymphoma. In lymphomas are affected the lymph glands and nodes that are anywhere in the body. So this kind of cancer can occur everywhere in the body. There is also a Hodgkin’s disease that can often occur in younger patients. The incidence of the Non- Hodgkin’s lymphoma is bigger in older patients, most frequently around age 60, but latest it can occur in younger people too. There is no explanation why this is one of the cancers that affects more and more individuals over the last 20 years.
Even if it is a very aggressive form of cancer it is very responsive in treatment and potentially curable cancer, which is a resemblance with the Hodgkin’s disease. An appropriate treatment can give the patients the chance to be cured and to live a normal life. This is justified for more than half of the patients.
So it was proved that the aggressive disease is more responsive to treatment which is a kind of a paradox which can be seen in many forms of rapidly growing cancers. The cells in this cancers are rapidly dividing, but they tend to be more responsive to treatment. The scientific explanation for this phenomenon is that the chemotherapy drugs are most active against rapidly growing cells.
The whole treatment in Non- Hodgkin’s lymphoma can last for about four to five months. If there is an early stage disease, the patient may get a shorter course of chemotherapy. This method must be combined with radiation therapy to the affected area. Because the cancerous cells may be anywhere in the body the biggest part of the patients with cancer needs to be treated systemically with chemotherapy. Chemotherapy is a combination of four or five drugs. The whole treatment program can run over a period of about four to five months.
Even if this form of cancer is a curable one, there are people with Non-Hodgkin’s lymphoma who being under-treated.
This under- treatment means a substantial dose reductions or treatment delays during their chemotherapy. This is one of the reasons why some of this patients presents side effects and they don’t get cured. It was proved in clinical trials that patients who receive the appropriate treatment do better than patients whose treatment is compromised by reducing the doses or not respecting the schedule. So the chances of long-term survival and cure are influenced by the way the treatments are being given.
There are some situations when reductions in doses of the treatment are unavoidable. This happens when there are older patients, or patients with a higher stage of disease, patients who aren’t able to care for themselves. in this circumstances the treatment have to be delayed too.
The best moment to give the appropriate treatment are the early stages of the disease. Preventative care is very important. Specifically treatment to boost low white blood cell counts caused by chemotherapy, are more likely to receive the dose on time and to receive fuller dose intensity than those patients who didn’t receive these agents. There many reasons,not only cancer, for which patients received these medications from the beginning.
Another cause of under- treatment is the situations when the patient doesn’t tolerate the chemotherapy the way it was expected to be. So it increases the concern about side effects. There are situations when the reduction in dose of the treatment is established from the very beginning, before the patient had received any kind of treatment. This is a conscious decision of the doctor who consult the patient and gets to the conclusion that he won’t tolerate the chemotherapy well. Other reductions in doses of the treatment occurs after starting therapy, because of the side effects. In this case reducing the dose is a strategy to reduce the side effects of treatment. This has negative results because it is very sure that to this patients the disease will come back months or years later.
Supportive care is very important. Older patients, patients who have more intensive symptoms from their disease or a higher stage of disease, need a type of a more aggressive supportive care. If they are supported in a right way it is also recommended to be treated the same as younger patients are. This increases their chances to be cured.When giving the supportive care it is important to analyze the risk factors. This are the patient’s age that can easily lead to more side effects or in the most cases determine the physician to reduce the doses or schedule of the treatment, even before starting it. Giving the right supportive care enables the patients at a higher risk to receive the full treatment.
Supportive care helps physicians and patients with cancer to control nausea, vomiting and infections that can result because of the low white blood cell count. These are one of the most common side effects of the toxicity of the chemotherapy. Supportive care includes treatments that can improve the blood counts and also reduce the risk of infection. So if the patients seem not to tolerate the chemotherapy well, it is recommended to use the supportive care and not to modify the doses and schedule in treatment. This way the patient will be allowed to go through the full program.
There are different kinds of treatments available and it is very important for the patients recently diagnosed Non- Hodgkin’s lymphoma to ask an oncologist about the side effects of those treatments and what can be done to diminish and to prevent them. It is very important for this patients to get the full treatment and to know that the target is to minimize side effects and to increase the effects of the appropriate treatment.
