After the first cycle of chemotherapy, many patients' families are waiting for an answer: is the drug working? It is difficult to determine which direction the treatment is going at a time when the patient is lying there, appears to be very reactive and sick。
Oncologists have seen too many such cases, patients and family members are waiting for news, but there are signs that can be observed on a daily basis without waiting for video review。
The mechanism of chemotherapy is to stop cancer cells from dividing and even dying by disrupting the tumour cell breeding cycle. This process does not work immediately, and the time window for it varies greatly from drug to tumour type to delivery programme。
The symptoms are decreasing. That's the most direct hint
Symptoms caused by tumours are directly related to the size, activity and degree of partial intrusion of the tumor itself. Symptoms of oppression, pain levels, and local discomfort tend to change as a result of the reduction of the tumor or inhibition of activity。
If a lung cancer patient had an apparent chest pain and a short breath, the intensity and frequency of the symptoms would gradually decrease when chemotherapy was effective; the right upper abdominal pain and abdominal discomfort of patients with liver tumours is also a common positive sign。
In the early stages of chemotherapy, there may be short periods of increased fatigue, oral mucousitis and digestive tract responses, which are signs of drug toxicity and do not mean that the treatment is ineffective。
It's a process that needs to be patiently observed to distinguish between chemotherapy side effects and the symptoms of the tumor itself. The symptoms associated with tumours continue to decrease after chemotherapy, while the drug side effects are significantly reduced during the week break, a pattern that leads to treatment。
A follow-up study of the quality of life of patients with non-small cell pulmonary cancer shows that after the end of the second cycle, there was a decrease in pain and respiratory difficulties in the group of patients who treated effective patients, which was significantly better than those who rated progress in the disease, with a sharper difference between the two groups at the end of the third cycle. The trajectories of symptoms are clinical signs of prognosis。
Deterioration of tumor markers
Oncological markers are not diagnostic tools, but are of real value in treatment monitoring. The dynamic trends in these indicators tend to be more significant than the single values for common markers, such as foetal protein for liver cell cancer, cancer antigens for colon cancer and partial lung cancer, sugar antigens 199 for pancreas and tumours。
When chemotherapy is effective, tumour cells die, the genus is reduced, and corresponding marker levels are reduced. It is important to note that the early stages of chemotherapy are sometimes marked by a short sexual increase due to the large number of tumour cells falling apart, before moving down, which is not a treatment failure, but rather a transitional manifestation of the lethal effect。
Each cycle of the chemotherapy process assesses the relevant markers, compares the baseline values with each result and draws trends that are more of a clinical value than the single point values. When doctors assess the effects of treatment, the dynamic trends and visual assessment of the markers are combined and cannot be viewed in total isolation from an indicator。
Video alerts to stable or shrinking
There is a specific set of criteria for the evaluation of the efficacy of real tumours, which is commonly used and is classified into four levels of complete mitigation, partial mitigation, disease stabilization and progress, based on changes in the diameter of the disease. The partial mitigation was determined to be a reduction of more than 30 per cent in the diameter of the target stove compared to the baseline。
Not every effective patient can see a significant reduction in two cycles, and the initial response to chemotherapy by some tumors is "stabilization" and not continuing to grow, which is also a clinically significant result. The combination of disease stabilization and partial mitigation constitutes an indicator of disease control rates, which are equally important for the future。
Before reviewing the images, the patient and his family can see whether there has been any change in the size of the swelling that was previously felt; whether the lymph nodes of the surface have been reduced; and whether the symptoms that had arisen as a result of the swelling pressure have been reduced. These subjective perceptions, although less accurate than images, have some reference value for trend judgement and should not be completely ignored。
Physical and day-to-day functions are restored
Malignant neoplasms consume a great deal of energy and nutrition in the human body, and there are widespread manifestations of sexual wasting, powerlessness and reduced appetite, which are directly related to the metabolic activity of tumour cells. When the tumor is effectively inhibited by chemotherapy, the "oncology depletion effect" is reduced and the physical state of the patient tends to improve。
There are standardized assessment tools for the state of physical performance, and the lower the values represent the better the eastern oncology concertation group's performance scores are commonly used for clinical purposes, ranging from zero to four。
Effective chemotherapy allows some patients to rate their health from poor levels to improve during treatment, a change that, although minor, is closely related to the overall prognosis. Research data show that patients with improved physical capacity are more resistant to subsequent treatment and benefit from overall survival。
The changes that are more readily observed in everyday life are whether the patient is moving, whether the appetite has recovered or whether the quality of sleep has improved. These details are placed in the context of chemotherapy and are not simply emotional improvements, but a real reflection of the reduction of the physical metabolic burden at the functional level。
The combination of reduced symptoms, low signs, stable or reduced images and recovery of physical function is a more powerful and comprehensive indication that chemotherapy is functioning. Ultimately, of course, the efficacy of the treatment depends on a standardized image assessment and a combination of clinical findings, which do not allow decisions to change the treatment programme。
Chemotherapy is a long and time-consuming road, and anxiety waiting results in a normal mood. Attention to these details is not intended to substitute for the doctor's assessment, but rather to give patients and families a more proactive view of the treatment process and more understanding and assurance during the waiting days。
