October 26, 2000
Treating Metastatic Disease
Kathleen Allen, RN
Treating metastatic disease is vastly different than treating presumed residual disease in the adjuvant, post-op, newly-diagnosed patient setting. The realistic goal of adjuvant chemo is to rid the patient of the disease. The realistic goal in treating metastatic disease is to beat it back for as long as you can. These goals ARE different.
In treating metastatic disease, a principle is to not make the treatment worse than the disease, thus good treatment becomes "finesse"...the use of a series of hormonals, for instance, or as in your question, low, frequent doses of chemo which enable you to take it more often.
Treating for cure for testicular cancer, for instance, requires very big guns and harsh therapy (ask Lance Armstrong about the intensity of his!!)...and if cure is the reasonable goal, it becomes worth it, for most patients, to try. The current best therapy for newly-diagnosed, node-positive BC is AC x4, Taxol x 4, and this is BIG therapy.
I don't know if this helps, and it's my understanding only...and I'm sure it raises questions about treatment philosophy...but I always suggest that each patient have a frank discussion with their treating Onc about the goals of treatment in their particular case. Makes for better understanding on both sides if each is talking the same language.
P.S. Please emphasize the importance of frank discussion with one's treating OncMD...about the reasonable goals of therapy in each person's particular case! It may not seem so to the patient, but in oncology, one size does not necessarily fit all!!