Can chemotherapy be stopped if the cancer is not shrinking?

Question

Hello doctor,

I have bilateral lung cancer, and after six cycles of chemotherapy, my latest scans show that the tumors have not shrunk, and one area has actually grown slightly. My oncologist wants to switch to a different chemotherapy regimen, but the side effects of my current treatment have been severe, including constant nausea, nerve pain, hair loss, and extreme exhaustion.

I honestly cannot continue with similar treatment if it is not working. I also have type 2 diabetes, which has become difficult to control during treatment.

Can chemotherapy be stopped if bilateral lung cancer is not shrinking?
What happens to the cancer if treatment is stopped?
Would palliative care alone provide a better quality of life compared to continuing a treatment that is not effective?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

It is understandable to feel concerned about the treatment response and the side effects being experienced. If chemotherapy has not been effective after multiple cycles and the disease is showing progression, continuing the same chemotherapy regimen may not provide additional benefit. In such situations, oncologists often consider changing the treatment approach.

One important next step is to undergo genomic (molecular) testing. This helps identify specific mutations in the cancer cells, which may allow the use of targeted therapy or immunotherapy. These treatments are generally more precise and may have fewer side effects compared to conventional chemotherapy.

For example, targeted therapies may include medications such as Erlotinib or Osimertinib if specific mutations are present. Immunotherapy options may include drugs like Pembrolizumab, depending on tumor markers. These treatments are selected based on individual test results.

Given the presence of type 2 diabetes, managing side effects from chemotherapy can be more challenging, and alternative treatments may be more suitable.

If further active treatment is not desired or not beneficial, palliative care is a valid and important option. It focuses on relieving symptoms such as pain, nausea, and fatigue, and aims to improve overall quality of life rather than targeting the cancer itself.

Stopping chemotherapy may allow the cancer to progress over time; however, this decision should balance treatment benefits against quality of life. Many patients choose palliative care when treatment side effects outweigh the potential benefits.

Participation in clinical trials may also be considered, as they can provide access to newer therapies and sometimes include free testing and treatment.

It is strongly recommended to discuss these options in detail with the treating oncologist to make a decision that aligns with medical needs and personal preferences.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.