Curative intent vs palliative treatment
Tests to decide treatment
Once a person is told that they have cancer, there are a lot of
other tests that they may need. These tests are done to try and
answer two simple questions:
- Can we try and cure the cancer?
- Is the person fit enough to have this type of treatment?
Unfortunately, more than half of the people who are diagnosed
with oesophageal or gastric cancer cannot be treated to try and
cure it, because either it is too advanced, or the person is not
fit enough to survive the treatment that would be needed.
What is 'curative-intent' treatment?
If the team think a person will be fit enough to have major
treatment, a number of different tests will be done to see how
advanced the cancer is. If these tests show that the cancer is not
too advanced, then the team will talk to the person about having
'curative-intent' treatment.
For many of our patients, this means having chemotherapy
followed by surgery, with further chemotherapy after recovery from
the operation. Studies examining different combinations of
treatment have found that for most patients, this gives the best
chance of getting rid of the cancer in the long-term. However, even
with this treatment, the cancer can come back at a later time. Most
often, this happens in the first 1-3 years after surgery. This is
why we describe this type of treatment as 'curative-intent'. We
hope to get rid of the cancer forever, but unfortunately we know it
can come back even with the best available treatment.
What is palliative treatment?
If we cannot try and cure a person's cancer, then the treatment
we give is focused on helping a person have the best quality of
life. As we are focusing on quality of life, rather than on cure,
we use the phrase 'palliative treatment'.
There are lots of different palliative treatments that a person
may receive. Some patients have palliative chemotherapy, to help
contol the cancer and any symptoms it may be causing. Other
treatments include radiotherapy, or endoscopy (insertion of a
telescope into the body). For example, if a patient has
difficulties eating and drinking, we may do an endoscopy to insert
a special tube called a stent. Treatments like these allow us
to manage the different symptoms that patients have even when we
cannot get rid of the cancer itself.