Читать книгу Cancer is a Word, Not a Sentence - Miriam Stoppard - Страница 25

In this section, I’m going to put it all together, to help you build up an assessment of the risks and benefits in your case. To do that, you must first understand the objective of the whole exercise, and ask some important questions. (I know, sometimes it seems the questions will never end. In a way that’s true. But each question, and every answer, gets you further along the path of knowledge and control.)

 What is the main objective of the treatment?

 Is cure a realistic objective?

 Is the idea to try to reduce the chance of the cancer recurring or spreading?

 Is the objective to try to control the disease itself?

 Is the objective to reduce symptoms caused by the disease?

To help you make sense of this, we are going to divide up the main objectives of treatment into seven broad categories, and I’ll give one or two examples of cancer situations in which that treatment approach would be used.

The details of the treatment plan are often so complicated that it is easy to lose sight of the overall goal. So a reminder of the main game-plan is helpful.

In practical terms, then, you can think of the major objective of the treatment plan as being in one of these seven categories:

1. THE BIOPSY OR INITIAL SURGERY IS ALL YOU NEED.

There are a few cancers in which, if the cancer is limited to a small area, the biopsy or the initial surgery is all that is necessary at present. In these situations, the area of cancer is very small and is completely contained inside the tissue that was removed at surgery, and in the case of certain cancers at this particular stage, the chance of its spreading is zero. In other words, the entire risk has been removed. This is not a common situation, but it does happen.

Most people are relieved and delighted to hear that they do not need any further treatment. But a few might worry that they are getting substandard treatment, or even that they are being ‘brushed off’ and not getting what they need. So it is worth knowing that this is the correct and standard form of treatment in a few well-defined situations. Here are some examples:

Pre-invasive cancer of the cervix (when the cone biopsy has removed all the malignant cells);

Early stage colon or rectal cancer (when the cancer has not penetrated through the dividing layer of the bowel wall, called the muscularis mucosa);