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Harrison's Principles of Internal Medicine, 18e
| Part 7. Oncology and Hematology > Section 1. Neoplastic Disorders > |
Chapter 85. Principles of Cancer Treatment
Sections: Principles of Cancer Treatment: Introduction, Principles of Cancer Surgery, Principles of Radiation Therapy, Principles of Chemotherapy, Biologic Therapy, Gene Therapies, Acknowledgments, Further Readings.
Topics Discussed: cancer therapy; cancer treatment and chemotherapy; medical oncology; therapy of neoplastic diseases.
Excerpt:"The goal of cancer treatment is first to eradicate the cancer. If this primary goal cannot be accomplished, the goal of cancer treatment shifts to palliation, the amelioration of symptoms, and preservation of quality of life while striving to extend life. The dictum primum non nocere may not always be the guiding principle of cancer therapy. When cure of cancer is possible, cancer treatments may be undertaken despite the certainty of severe and perhaps life-threatening toxicities. Every cancer treatment has the potential to cause harm, and treatment may be given that produces toxicity with no benefit. The therapeutic index of many interventions is quite narrow, and most treatments are given to the point of toxicity. Conversely, when the clinical goal is palliation, careful attention to minimizing the toxicity of potentially toxic treatments becomes a significant goal. Irrespective of the clinical scenario, the guiding principle of cancer treatment should be primum succerrere, "first hasten to help." Radical surgical procedures, large-field hyperfractionated radiation therapy, high-dose chemotherapy, and maximum tolerable doses of cytokines such as interleukin (IL) 2 are all used in certain settings where 100% of the patients will experience toxicity and side effects from..."
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