Nerdy Science Blog

Chemotherapy had been used with one of the two intentions: the hope to cure cancer, and the hope to prolong life. Palliative chemotherapy/care means chemotherapy which is taken without expecting it to be curative. In other words, palliative chemotherapy is a form of medical treatment that concentrates on reducing the severity of the disease symptoms, rather than trying to provide a cure. This means that most of the time, palliative chemotherapy are only offered to patients with incurable cancer, preferably to patients with excellent performance status and a tumor sensitive to chemotherapy.

Just like treating cancer, cytotoxic drugs are also used in palliative chemotherapy. They attack cells during cell divisions. They could be phase specific and cycle specific. Phase-specific drugs kill cells only when they are given during a certain phase of cells’ cycle. By prolonging the treatment using such drugs, the number of cells killed increases because cells divide randomly. Cycle-specific drugs target cells during any phase of the cells’ cycle, thus the number of cells killed increases when the dosage of such drugs increase. Other Antimetabolites are given as well. These anti metabolites could interfere with the incorportation of nucleic acid bases into the DNA.Given the potential toxicities of the chemotherapeutic agents, it is important to educate patients about the side effects of the drugs consumed. The main challenge for both the doctors and patients would be balancing symptom relief and treatment’s side effects. It is also crucial for the doctors to maintain a holistic view of patients with cancer and help patients to achieve the best possible quality of life.

The main goals of palliative chemotherapy are:

1. To relieve symptoms. By reducing a tumor, symptoms like shortness of breath and pain could be reduced. The effects of palliative chemotherapy in relieving symptoms vary, depending on the location of the tumor..
2. To improving quality of life. There are studies and clinical trial data showing that such chemotherapy could improve the quality of life of the patients, and unlikely to result in any major survival advantage
3. To slow the progress of cancer.

The survival benefits of palliative chemotherapy tend to be modest, and are usually measured in months rather than years. Even though such treatment could support the patients but usually there are always a wide gap between the patient’s hope and what is achievable. A United Kingdom based study shows that palliative chemotherapy could help to extend a patient’s life, who is suffering from non-small-cell lung cancer, for up to 2 months. 3 to 6 months for those suffering from pancreatic cancer. 5 to 9 months for those suffering from colorectal cancer.

In most countries, palliative care is provided by a team, consisting of doctors, nurses, nursing assistants, physiotherapist, social workers, volunteers and family members. The team would focus on optimizing the patient’s comfort. In the UK, palliative care includes inpatient care, day care, home care, and outpatient services. Palliative care may range from managing physical signs and symptoms of the patients, to treating depressions, to the care of patients during their last days and hours.

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