How to choose the right cancer treatmentVienaMed
How to establish an oncologic treatment plan
Receiving an oncological diagnosis immediately raises many questions: What treatment is appropriate? Is surgery needed? Is chemotherapy mandatory? Are there newer therapies? Should a second opinion be requested?
In modern oncology, treatment is not determined by a single rule. Each patient and tumour have their own peculiarities, and the therapeutic plan must be adapted as precisely as possible to the medical situation.
Why can two patients with the same diagnosis receive different treatments?
Even if the diagnosis seems identical, two cases may have very different characteristics.
To establish treatment, physicians shall consider several factors, including:
the exact type of cancer;
tumour location;
stage of disease;
the size and extent of the tumor;
any metastases;
the results of histopathological examination;
the molecular profile and tumour biomarkers when indicated;
age and general health status;
other existing conditions;
previous treatments;
treatment objectives.
Therefore, the mere name of the diagnosis is not sufficient for the choice of a therapy.
The correct diagnosis is the first step
A good oncology plan begins with a precise diagnosis.
Depending on the situation, the evaluation may include imaging investigations, laboratory tests, biopsy and histopathological examination of tumour tissue.
In certain types of cancer may be necessary and Molecular or genetic tests of the tumor, which may identify certain changes relevant to the choice of targeted treatment or immunotherapy.
Sometimes, before changing or starting treatment, it may also be useful to re-evaluate histopathological samples in a centre with experience in oncology.
Cancer stage influences treatment
One of the most important information is the stage of the disease.
In the case of a localised tumour, treatment may aim at complete removal of cancer and may include, for example, surgery and / or radiotherapy.
In other situations, treatment prior to surgery may be recommended to reduce tumour size, or after surgery to reduce the risk of relapse.
In the case of advanced or metastatic disease, therapeutic strategies may include systemic therapies such as chemotherapy, immunotherapy, targeted therapies or hormone therapies, depending on the type of cancer.
What is the role of tumour biomarkers?
Oncology has evolved greatly in the direction of personalized treatment.
Today, in certain forms of cancer, doctors not only analyze where the tumor occurred, but also its biological and molecular characteristics.
Identifying certain biomarkers can help determine the probability of a patient responding to a specific therapy.
This information may influence the choice between:
chemotherapy;
immunotherapy;
targeted therapies;
Hormonal therapies;
combinations between several types of treatment.
The necessary tests, however, differ greatly from one type of cancer to another and should be recommended individually by the medical team.
Oncologic treatment can combine several methods
An oncological plan may include one or more forms of treatment.
Surgery
It may be recommended to remove the tumor when the location and stage of the disease allows for intervention.
Chemotherapy
It uses medicines that act on tumour cells and can be given before or after surgery or as the primary treatment in certain cancers.
Radiotherapy
It uses radiation to destroy tumour cells and may act as a curative, adjuvant or symptom control, depending on the situation.
Immunotherapy
It helps the immune system to recognize and combat tumour cells. It is effective in certain types of cancer and only for certain categories of patients.
Target therapies
It acts on specific molecular mechanisms involved in tumour development. For their use it may be necessary to identify certain genetic changes or biomarkers.
Hormone therapy
It is used in certain hormone-sensitive cancers, such as some types of breast or prostate cancer.
Find more details about one of the options in the article about immunotherapy in cancer.
Why is the multidisciplinary team important?
Oncological treatment frequently involves collaboration between several specialists.
Depending on the diagnosis, the case may be analysed by:
Oncologist;
surgeon;
radiotherapist;
radiologist;
anatomopathologist;
nuclear medicine specialist;
geneticist;
other specialists relevant to the patient’s situation.
In a multidisciplinary assessment, physicians may jointly analyse the results of investigations and determine the order of treatment.
For example, one of the important questions may be whether the patient should be operated immediately or whether it is more appropriate to start oncological treatment first.
Choice of oncologist counts
The doctor’s experience in treating that type of cancer is important, but it is not the only criterion.
For the patient it also matters:
clear explanation of the diagnosis;
presentation of treatment alternatives;
discussing benefits and risks;
recommendations based on medical evidence;
the possibility of working with other specialists;
the existence of a clear monitoring plan.
The patient should understand why a specific therapy is recommended and what its objective is.
When can a second oncology be useful?
A second opinion does not necessarily mean that the initial diagnosis or treatment is wrong.
It can provide an additional check and help the patient to better understand the options available.
It may be useful especially when:
the diagnosis is complex or rare;
there are several treatment options;
major surgery is recommended;
the proposed treatment has important adverse effects;
disease progressed during treatment;
there is the possibility of modern therapies or clinical trials;
The patient wishes to confirm the plan before starting treatment.
However, it is important that the request for a second opinion does not lead to undue delays in treatment.
I’ve detailed it separately. when a second oncological opinion may be useful.
Custom treatment means more than just choosing a medicine
The personalization of oncological treatment involves the integration of all relevant information about the patient and the tumor.
A fair therapeutic plan may pursue different objectives: healing the disease, reducing the risk of relapse, controlling cancer as long as possible or relieving symptoms and maintaining quality of life.
Therefore, treatment should be reassessed as necessary.
The results of the investigations, the tumour response to treatment and patient tolerance may result in continuation, modification or replacement of therapy.
Oncological evaluation in Austria through VienaMed
For patients who want a further assessment of the diagnosis or treatment plan, VienaMed facilitates access to doctors and medical centers in Austria.
Depending on the case, the process may include the analysis of existing medical documents, scheduling necessary consultations and investigations and the coordination of evaluation by appropriate specialists.
The aim is to obtain a clear picture of the diagnosis and therapeutic options available for the specific situation of the patient.
Do you need a second oncology?
If you have received a diagnosis of cancer and you want confirmation of the diagnosis or evaluation of the treatment plan in a medical centre in Austria, the VienaMed team can help you organize the medical process.