Postremission therapy
Postremission therapy, sometimes referred to as consolidation therapy, is a phase of cancer treatment that occurs after the initial therapy has successfully brought about a remission of the disease. It is designed to kill any remaining cancer cells in the body and prevent a relapse.
Background
While the initial treatment phase, commonly known as induction therapy, aims to achieve remission by reducing the signs and symptoms of the disease, there may still be a small number of cancer cells present. Postremission therapy is crucial to ensure these residual cells are eradicated, reducing the risk of relapse.
Rationale
The need for postremission therapy arises from the understanding that:
- Microscopic amounts of disease, undetectable by conventional methods, can still lead to relapse.
- The body's natural defenses, even aided by the initial therapy, might not be sufficient to eradicate all remaining cancer cells.
Types of Postremission Therapy
The specific type of therapy recommended can vary depending on the type of cancer, the patient's overall health, and other factors:
- Chemotherapy: Powerful drugs are used to kill cancer cells or prevent them from dividing.
- Radiation therapy: High-energy x-rays or other types of radiation are employed to destroy cancer cells.
- Stem cell transplant: Replaces the blood-forming cells in the bone marrow that have been killed by chemotherapy and/or radiation therapy.
- Targeted therapy: Uses drugs or other agents to identify and attack specific cancer cells without harming normal cells.
- Immunotherapy: Boosts the body's natural defenses to fight cancer.
Indications
Postremission therapy is commonly indicated for:
- Acute leukemias: Especially acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL).
- Certain aggressive Lymphomas.
- Some solid tumors, depending on their risk of recurrence.
Considerations
There are several factors healthcare providers consider when prescribing postremission therapy:
- Type and Stage of Cancer: More aggressive cancers might require intensive therapy.
- Age and Overall Health: Older patients or those with significant co-morbidities might receive less aggressive treatment.
- Response to Induction Therapy: The patient's response to initial treatment can influence the choice and intensity of postremission therapy.
Side Effects
Postremission therapies, like other cancer treatments, can have side effects:
- Fatigue
- Nausea and vomiting
- Increased susceptibility to infections
- Hair loss
- Mouth sores
- Changes in appetite
- Skin reactions (for radiation therapy)
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Contributors: Prab R. Tumpati, MD