內容目錄
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After suffering from cancer, we often worry about some problems during the treatment process, such as whether it recurs? How to deal with various side effects after treatment? Surgical cleaning scope? Whether the new treatment is advisable, etc., but most of them cannot be answered in time.
Today, Mr. Huzhu sorted out several questions that patients often mention, and combined with clinical data to give you some reference~
01. Relapse and drug resistance, can taking traditional Chinese medicine control it?
Adjuvant chemotherapy with traditional Chinese medicine has been verified to improve drug resistance after relapse[1]. Bioactive compounds in traditional Chinese medicine exert antitumor activity by targeting multiple levels and signaling pathways. Therefore, TCM can be used as an adjuvant therapy for cancer [2].
Some tumor patients are often accompanied by bloody ascites, which is also a common recurrence symptom in advanced cancer patients. Therefore, in the treatment of traditional Chinese medicine, the principle of “treat the blood first and then the water, and treat the water first and then the blood. The deficiency caused by the excess treats the reality, and the deficiency caused by the excess treats the deficiency” [3].
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There have been cases of ovarian After the symptoms of cancer recurrence, use Ganlu Xiaodu Dan[4], Xiayuxue Decoction, Ganzhuo Decoction combined prescriptions, etc. to add or subtract according to the syndrome. It is often used in clinical practice to clear away dampness and heat in Shaoyang, and alleviate the side effects to a certain extent.
It can be seen that traditional Chinese medicine can effectively control the recurrence symptoms of ovarian cancer. It should be noted that according to the specific conditions of patients, the prescription of traditional Chinese medicine needs to be adjusted differently. At present, there is no standard traditional Chinese medicine prescription for the treatment of drug resistance after recurrence of ovarian cancer, and it is necessary to discuss with Chinese and Western medicine separately before formulating a personalized treatment plan.
02. After chemotherapy, periosteum hyperplasia, effusion and knee edema, how to relieve it?
Some patients reported symptoms such as periosteal hyperplasia, fluid in the knee, and knee joint pain after chemotherapy. This is actually caused by lymphedema, one of the common side effects after cancer chemotherapy, which is swelling of the extremities and/or parts of the body due to the malfunctioning of the lymphatic system.
Swelling can increase over time, causing swelling and discomfort in the area. If it is not treated in time, it may lead to a decrease in the mobility of the legs, and to a certain extent, the patient’s legs may swell like “elephant legs” [5].
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However, these symptoms can be controlled by drug treatment. You can take anti-swelling drugs for a short time according to the doctor’s advice or use traditional Chinese medicine for external application. In addition, you need to pay attention to the liver and kidney function tests and electrolytes during the treatment, and observe whether the edema progresses. No exceptions etc. If there is a lot of effusion, it should be considered to draw the effusion for testing, and the treatment should be performed based on the clinical results of the patient under the doctor’s advice.
03. What is particle therapy? What are the benefits in fighting tumors?
In gynecological oncology, particle therapy is generally applicable to cervical cancer, endometrial cancer and malignant melanoma originating from the vagina, vulva and uterus. Ovarian cancer is treated with surgery and chemotherapy as the standard treatment. Generally, particle therapy is not required. However, particle therapy can also be considered in case of solitary metastatic recurrence.
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Particles The treatment is generally aimed at patients with refractory tumors who are not suitable for surgical treatment. It can control the tumor, and the local control rate of the targeted tumor is relatively high. Short-term irradiation can also control the local tumor, and the survival rate is expected to be higher than that of the tumor. Traditional treatments have improved. At present, in terms of gynecological tumors, particle therapy has a 50% higher rate than traditional radiotherapy, which shows that it has the characteristics of quick effect and high targeting[6].
04. What is the new therapy boron? How is the effect?
New therapy boron, also known as boron neutron capture therapy (BNCT). It uses the nuclear reaction of neutrons and boron to selectively destroy cancer cells without destroying normal cells, and is effective for cancers that have spread to a single organ, metastatic cancers, and refractory cancers [7]. In addition, it can be treated even after conventional radiation therapy, and it is also effective in the treatment of recurrent cancer.
Kyoto University Research Reactor Research Institute (KURRI) initiated Boron Neutron Capture Therapy for recurrent cancer in patients receiving two Hours later it was irradiated with boron neutrons. The average survival time of the 10 patients was 15.6 months, and one of them was a long-term survivor with a duration of more than 5 years [8].
The combination of BNCT currently applied in clinical In addition to chemotherapy and traditional radiation therapy, it is not yet a widely available cancer treatment and its use is limited in indications. So far, BNCT has been applied in the treatment of the following cancers: glioblastoma multiforme, recurrent lung cancer, breast cancer, etc. [9]. Currently, there are few cases of the new boron therapy used in the treatment of ovarian cancer. It is believed that in the near future, after overcoming all challenges, BNCT will become a convincing way to treat ovarian cancer.
05. Is lymphatic sweep necessary for all operations?
Surgery is the main treatment for ovarian cancer. Lymph node metastasis and residual disease after surgery are important factors affecting the prognosis of advanced ovarian cancer. And “whether lymph nodes need to be removed during surgery” is also a concern of some patients.
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According to my country’s “(2022 2010 Edition) Guidelines for the Diagnosis and Treatment of Ovarian Cancer [10], comprehensive staging surgery for ovarian cancer (applicable to patients with clinical stage I ovarian malignancies) requires resection of bilateral pelvic lymph nodes and para-aortic lymph nodes, and tumor cytoreductive surgery ( Applicable to middle-advanced patients with extraovarian metastases), it is necessary to resect resectable enlarged or suspiciously involved lymph nodes. If the tumor lesion outside the pelvis is ≤ 2 cm, systematic bilateral pelvic and para-aortic lymphadenectomy is performed, and the scope of resection is the same as that of comprehensive staged surgery.
There is no obvious requirement for lymphadenectomy in other cases, such as fertility-preserving surgery, laparoscopic exploration, and Tumor reduction, adjuvant palliative surgery, etc.
For the above questions, I believe that the doubts in the hearts of patients who have read this article have already been answered. Whether it is a new technology that can be applied to ovarian cancer or a solution to recurrence after treatment, it is believed that in the near future, more and more mature medical technologies will provide a complete solution system for these problems, so that patients will no longer be troubled.
Finally, Mr. Huzhu would like to remind everyone that when using any cutting-edge therapy, it is necessary to reach a consensus with the attending doctor in advance. The effect is remarkable to a certain extent, but due to the lack of accumulation of a large amount of clinical data, whether there are side effects and other issues are still open to question. Here is a warm reminder: Frontier therapy is risky, so be cautious when using it for the first time.
Editor in charge: Gynecological Oncology Mutual Helper
Image source: Shetu