Stem cell transplant is another type of treatment, most commonly used for blood cancer. This includes removing the patient’s bone marrow (which is where blood cells are produced) using high-dose chemotherapy and sometimes with radiation therapy. This approach is called induction therapy, because it induces the bone marrow into a state that is necessary for the transplant to occur. The actual stem cell transplant occurs when healthy bone marrow is transplanted. Stem cell transplant is part of consolidation therapy, which is the treatment given immediately after induction therapy to prevent the cancer from recurring.
Consolidation may also include additional chemotherapy. There are 2 types of stem cell transplants: allogeneic, which uses healthy matched tissue from a donor, or autologous, which uses the patient’s own tissue taken prior to induction therapy.
Health care providers may discuss the patient’s prognosis, or the expected outcomes, with different treatment approaches. How well the treatment works, or its efficacy, is often described using terms about survival and response. Overall survival is the length of time a patient survives after starting treatment. The amount of time that the cancer does not group or spread after starting treatment is referred to as progression-free survival. The overall response rate or objective response rate is the proportion of patients whose cancer responds to the treatment; a “response” occurs if the tumor shrinks (ie, a partial response) or disappears (ie, complete response). Some tumors will stop growing as a result of treatment but do not shrink; it this occurs, the patient is said to have achieved what is known as stable disease. A remission occurs when the signs and symptoms of the cancer are temporarily or permanently gone; however, the cancer itself may still be present. Cure is when the patient is restored to full normal health and is sometimes used after a patient is cancer-free for at least 5 years – many oncologists bristle at the term “cure”, as it implies the cancer will never recur. A recurrence or relapse occurs when the cancer returns after a period when it could not be detected. Sometimes a recurrence occurs at the original site of the tumor or at other sites.
Sometimes during treatment for cancer, a tumor can stop responding to treatment that at one point triggered a response—when this occurs, the tumor is labeled refractory. Cancer that never responded to a treatment is called resistant or treatment resistant.
Patients will sometimes receive treatment that is termed palliative, which means that it is used to help improve symptoms of the cancer, but is not expected to stop the growth or spread of the malignancy.
Side effects that occur during treatment — which may or may not be due to the treatment itself — are called adverse events or adverse effects. To specify that a side effect is due to the treatment, the term is treatment-related or treatment-associated adverse event. Many side effects are acute, meaning short-term, but some can be chronic, or long-term. Late effects can also occur, which are side effects that occur much later after treatment has been completed.
A common side effect of treatment is fatigue, which is extreme tiredness or the feeling of no energy that results in the inability perform many functions. Nausea is also common and refers to a feeling of discomfort or sickness in the stomach. Some other examples of side effects include mucositis, which is inflammation of the digestive track that often causes sores in the mouth, and stomatitis, which is specifically inflammation of the mouth and also causes mouth sores. Pyrexia refers to fever and pruritis is itchiness.