Cancer cells are highly mutated cells that are able to proliferate rapidly and indefinitely, evade cellular death and migrate throughout the body to form secondary tumors. As cancer progresses, the cells evolve and acquire more and more genetic mutations. Cancer treatment seeks to inhibit essential cellular processes to halt cancer progression and kill cancer cells. In cases of advanced cancer, multiple stages of cancer treatment are required to increase patient survival and quality of life.
First-Line Treatment
First-line treatment describes the first treatment strategies used to remove or kill the tumor. It is also referred to as induction therapy or primary therapy. In the case of many types of cancer, first-line treatment may involve surgery to remove the tumor. The aggressiveness of the surgery as first-line therapy often depends on the severity of the tumor, and cancers without well-defined borders may require the surgical removal of neighboring healthy tissue to successfully remove the cancer. An example of a surgical first-line therapy is a mastectomy, surgical removal of the breast to treat breast cancer. In blood tumors or other types of cancer, first-line treatment may involve chemotherapy or radiation therapy, which will circulate throughout the body and kill the cancer cells.
Second-Line Treatment
Second-line treatment for cancer occurs after first-line treatment if the initial treatment failed. After surgery, a patient may experience cancer recurrence at the site of surgery or other areas of the body, and the cancer recurrence may be treated by chemotherapy or radiation therapy or additional surgeries to remove recurring tumors. Alternatively, patients who previously received chemotherapy may develop cancer recurrence if the cancer becomes resistant to the first-line treatment and may require treatment with additional drugs or targeted therapies. A number of cancer therapeutics are approved by the FDA for use as second-line cancer treatments.
Palliative Treatment
Palliative treatment is a stage of cancer treatment that occurs after first- and second-line treatments have failed. Unlike earlier treatment stages, which aimed at treating cancer and killing tumor cells, the palliative treatment stage seeks to alleviate the symptoms experienced by patients with advanced cancer. Palliative treatment is designed to improve the quality of life of the patient as his cancer progresses. The treatment may be given in the hospital or at home, depending on the patient's condition and wishes. In most cases, palliative care seeks to reduce pain experienced by advanced cancer patients. This can be accomplished by regular use of painkillers such as opioids, which can effectively control even severe pain. Other aspects of palliative care may focus on alleviating nausea, coughing or other causes of discomfort.
