An Informative Article on Chemotherapy, Curative or Pallitive?

A must read
for everyone, in my opinion.

Interesting
I may be one of those people who consider it life-extending but not curative...

I find that doctors are remiss also on the time-limits of the chemo. Most drugs I have taken are expected to work, if they work at all, only for a time. The cancer just seems to adapt. We need to know how long these times are in order to make decisions of which to take.

angec said:

Actually, I am still trying
Actually, I am still trying to find out which RCC drugs DO NOT have the chemo agents in them. I was lead to believe that Votrient does not have any. Am I correct? I have received different responses from different doctors and am not sure either way. My next step would be to call the manufacturers themselves and see if they even know. One thing TW is spot on about is that the immune system is our best defense and we need to safeguard it as much as possible.

Chemo
Ange, there are others with real knowledge who can amplify and/or correct what I'm about to say, but I'll take a stab.

There are quite a few different methods of combating cancer. Some have only local application, e.g. surgery and some of the high energy methods such as stereotactic radio-surgery or HIFU (High Intensity Focused Ultrasound) or cryoablation, while some are systemic, such as some drugs or mind-body medicine pratices such as meditation.

Of the drugs used, there are categories with widely different mechanisms of action. The older chemotherapy drugs (cytotoxics) such as doxorubicin and gemcitabine involved a scattergun approach in which the unwanted cancer cells plus a lot of the good guys get hammered. So, there is a lot of collateral damage to the immune system.

Another category of drugs is immunotherapeutic ones that endeavour to boost the performance of the immune system - interferon and interleukin (IL2 for instance).

Then there are the much newer "targeted agents", springing from a deeper knowledge of biological processes, which aren't designed to attack cancer directly or to boost our immune systems, but rather to disrupt the way in which cancer works and survives.

There are more and more ways in which to seek to do this. The anti-angiogenics aim to cut off the blood supply that nurtures a tumour so that it perishes or, at least stops growing, or shrinks. There are possible adverse effects in areas where you don't want this - e.g. in pregnancy, where you don't want the placental function compromised - hence the drug pamphlet warnings for e.g. Votrient about not taking it if you're pregnant.

Other drugs are designed to operate on proteins that facilitate the way in which cancer cells can hide or protect themselves and thus are aimed to re-expose the enemy cells to the defences of our immune systems' weaponry. Anti-PD 1 (Programmed Death) and anti-PDL (Ligand) 1 such as MDX-1106 and MDX-1105 (now known as BMS 936558 and BMS 936559, since Medarex (MDX) was bought by Bristol-Myers Squibb (BMS) are in this category.

So, a drug like Votrient, an anti-angiogenic targeted therapy, is quite different from the older category of chemotherapy drugs. Consequently, Votrient wouldn't have the bad cytotoxic implications of the old chemo drugs for your Mom and might therefore be very much more gentle and suitable for her.

This is just a layman's attempt to clarify matters, as I know you appreciate, but I hope it's accurate enough to help you to see your way a bit more clearly.