What does 'maintenance or on-going chemotherapy' mean?
What happens when your medical team suggests a regimen of maintenance or ongoing chemotherapy? It can be daunting to deal with the fact that, despite your treatment, you need further intervention to manage your cancer, going forward.
This time round things may be different. Maintenance therapy for advanced cancer is not intended to cure your cancer but rather, to try to give you the best quality of life you can have, for as long as possible. So, your doctors will work with you to ensure that your treatment is tailored and managed according to your needs.
“Not all cancers require maintenance chemotherapy (or treatment),” explains Medical Oncologist, Dr Sze Wai Chan. “This is usually applicable to stage IV cancers and aims to maintain control and stability of your cancer with the focus on preserving quality of life to enable you to continue to live relatively symptom-free. The ultimate goal of this approach is also to prevent an earlier relapse and therefore improve survival, giving you the best chance of enjoying life for as long as you possibly can. And because of this, your doctors will do their best to ensure that your maintenance treatment is relatively non-toxic or gentle with the least amount of side effects.”
She continues, “Depending on your type of cancer, your medical team may prescribe maintenance treatment that is not chemotherapy, hormonal blockades or targeted therapies (such as erlotinib in lung cancers; and bevacizumab in ovarian cancers). However if you are prescribed treatment maintenance using chemotherapy this needs to be personally tailored to you and your cancer, bearing the following in mind:
- The type of cancer and specific clinical factors
- What treatment you may have already had
- The effectiveness of these treatments
- Your ability to tolerate the side effects.
Remember that maintenance treatment usually involves the least toxic forms of chemo. “These types of chemo,” explains Dr Chan, “have the least side effects and can be tolerated for prolonged periods of time. If maintenance therapy is an option your medical team will discuss why they feel it will be of benefit to you, its aim and what side effects you can expect, both in the short and long term. In some forms of chemo, the side effects can be ongoing minor issues and can be quite unpleasant, such as dry hands and feet, chronic tiredness, and sometimes chronic oral ulcers. These side effects should be discussed upfront so you know what to look out for and you should always tell your team the minute they manifest so that they can be managed accordingly”.
Some key questions for you to discuss with your medical team
Dr Chan suggests asking your medical team the following questions before starting with maintenance therapy:
- What is the purpose of the maintenance treatment?
- What are the benefits and what are the risks?
- What side effects can I expect and how will these be managed?
- How long will my maintenance treatment carry on for - is there a cut-off date?
- How often will I be monitored?
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