If Cancer Treatments Stop Working

Cancer treatments can help stop cancer cells from growing or spreading. Sometimes treatment works well and helps you feel better. Other times it doesn’t work well or stops working altogether. This could happen because the tumor keeps coming back or because another type of treatment has stopped working.

Your doctor may recommend additional treatments. You may want to ask about clinical trials. Some people find out about clinical trials later. They are part of research studies where there is a chance to try something different. Your doctor can tell you what kinds of things are being studied.

Signs That Chemo Isn’t Working: How to Make The Decision

Chemotherapy is a powerful cancer therapy that uses drugs to destroy malignant cells. It can shrink a primary tumour, kill cancer cells that might have broken off the original tumour, and prevent cancer from spreading. However, it doesn’t always work. And sometimes it makes things worse.

Here are some signs that chemotherapy isn’t working as well as expected.

Tumors don’t shrink. If you’re having trouble getting rid of a lump or swelling, your doctor may think you’ve been taking too much medication or that there’s something wrong with your immune system. You’ll want to talk about these options with your doctor.

Cancer cells develop resistance. Even though the drugs seem to be killing the cancer cells, they keep coming back. This happens because some cancers are able to build up a tolerance to the drugs. They become tolerant to the drug, meaning that they continue to grow even though the drug is present. Other times, the body develops a mechanism to protect itself against the effects of the medicine. For example, your white blood cells may start to attack healthy tissue around the tumour rather than just attacking the cancer cells. Your body may also produce proteins that make the cancer cells less sensitive to the drugs.

The side effects go away. Sometimes people feel better while taking chemotherapy. They lose weight, gain energy, and feel generally healthier. But this is temporary. Eventually, the symptoms return. These include nausea, vomiting, hair loss, fatigue, mouth sores, skin rashes, and changes in taste and smell.

You experience different side effects. Each person reacts differently to each type of chemotherapy. So what works for one person may not work for another. Side effects vary depending on how long someone takes the drugs, whether they take them every day, and the strength of the drugs.

Your doctors may recommend changing treatments. A change in treatment could mean switching medications, adding additional medications, or stopping certain medications altogether.

What are my other options?

If chemo doesn’t seem to be helping your cancer, there are other treatment options. But it’s important to know what those options are — and whether they work well for you. There are many different types of treatments for cancer, including chemotherapy, radiation therapy, targeted therapies, immunotherapy, hormone therapy, stem cell transplants, surgery, and others. Some treatments work better than others depending on the type of tumor, how far along it is in its development, and other factors. Your doctor may recommend one option over another based on his or her experience treating similar patients. You may want to ask about other options because some people find certain therapies helpful while others don’t.

Chemotherapy works by killing off rapidly dividing cells, such as those found in tumors. Chemotherapies used most often include cisplatin, carboplatin, paclitaxel, gemcitabine, docetaxel, irinotecan, vincristine, cyclophosphamide, fluorouracil, capecitabine, tamoxifen, and trastuzumab. Radiation therapy uses high energy x-rays or gamma rays to kill cancer cells. Radiotherapy includes external beam radiotherapy, brachytherapy, stereotactic radiosurgery, proton beam therapy, and neutron capture therapy. Targeted therapies use drugs designed to target specific molecules involved in cancer growth and survival. Examples of targeted therapies include imatinib mesylate, gefitinib, erlotinib, sunitinib

Targeted therapies

are drugs that target specific changes in cancer cells. They’re still relatively new, but there’s evidence they could be effective against many cancers.

These therapies, which aren’t available for all types of cancers, can:

• Make it easier for your immune systems to find cancer cells.

• Make it harder for cancer cells — including those that haven’t spread — to multiply and grow.

• Stop the formation of new blood vessel networks that support cancer growth.

• Directly kill targeted cancer cells.

Immunotherapies

The term “immunotherapy” describes treatments that harness the body’s natural defenses against disease. This includes vaccines, antibodies, cytokines, and cellular therapies. Although immunotherapies are not always used alone, they work best when combined with traditional chemotherapy or radiation treatment. Immunotherapies target specific aspects of the immune response, including activating the immune cells themselves, boosting the activity of existing T cells, or blocking inhibitory signals that prevent the immune system from attacking tumors.

Adoptive Cell Transfer

In adoptive cell transfer, doctors take white blood cells called lymphocytes from a healthy donor, modify them in some way, and reinsert them into the patient. Lymphocytes are part of the immune system; they protect us from infection and help our bodies recognize and destroy foreign invaders such as bacteria and viruses. Doctors often harvest lymphocytes from patients undergoing stem cell transplants because those cells are usually depleted during the procedure. They can then modify the harvested cells to make them less likely to cause graft versus host disease, a potentially life-threatening complication of transplantation.

Bacillus Calmette-Gurin

Bacillus Calmeterte-Guerin (BCG), or bovine tuberculosis vaccine, works by stimulating the body’s immune system to produce substances that kill tumor cells. BCG is given intradermally—under the skin—and injected into the chest wall. Once it reaches the lungs, BCG stimulates the production of interferon gamma, a substance that activates macrophages, one type of white blood cell. Macrophages engulf and digest dead cells and microorganisms. In doing so, they release chemicals that recruit additional macrophages and activate killer T cells. As a result, tumors shrink.

Checkpoint Inhibitors

A checkpoint inhibitor blocks certain molecules on the surface of immune cells that normally keep the immune system from attacking normal tissue. Checkpoint inhibitors have revolutionized the treatment of several types of cancers, especially melanoma, lung cancer, bladder cancer, kidney cancer, head and neck cancer, and prostate cancer. Checkpoint inhibitors work by preventing the immune system from turning off the signaling pathway that prevents the immune system from destroying tumor cells.

Hormone therapy

Certain cancers, including some types such as breast and prostate cancers, grow because of hormones. Hormone therapy, or endocrine therapy, is one way to treat those kinds of cancers. This treatment works by blocking the hormone receptors, which stops the growth of the tumor.

Radiation therapy

High doses of radiation can destroy certain types of cancer cells. This type of treatment is called “radiotherapy.” If you’re having trouble breathing or swallowing, talk to your doctor about getting this treatment.

This treatment is usually given as part of a combination of treatments known as chemotherapy. Chemotherapy drugs are used systemically throughout your body. They work by killing fast-growing cells such as those found in cancerous tumors.

Radiation therapy works differently. It uses high doses of ionizing radiation to kill cancer cells in one specific area of your body. In some cases, radiation therapy can help relieve symptoms caused by cancer, including pain, nausea, and shortness of breath.