I use good medicine, I have been taking it according to the regulations, how come it has not worked lately?
Doctor, I always take medicine on time, why do cancer cells still metastasize and spread?
This is a problem that often occurs in the later stages of cancer drug treatment patients, and many people cannot understand this. Thinking that they are obviously rational drugs, cancer cells can not control must be the effect of the drug is not good.
In fact, cancer patients taking targeted drugs or immune preparations, the drug effect declines, not the fault of the drug itself, but the patient's emergence of "drug resistance"!
The so-called drug resistance, understood in the most popular words, is that patients take a drug for a long time, and cancer cells are less and less sensitive to it, so the effect of the drug continues to decline. In clinical view, the causes of cancer resistance are often related to the following points:
1. Hormones
Clinically, some patients need to receive related hormone therapy, especially breast cancer patients generally need to receive hormone therapy.
In the process of treatment, estrogen may interact with estrogen receptors on the surface of cancer cells to transmit information that allows cancer cells to grow, but hormone drugs can block this effect, or reduce estrogen levels, which in turn plays a role in inhibiting the proliferation of cancer cells.
However, in the process, cancer cells can cause abnormal mutations in estrogen receptors, and cancer cells cannot receive the division and growth information sent by estrogen, which eventually leads to the development of hormonal drugs to become resistant;
2. DNA
When targeted drug therapy is carried out, targeting epidermal growth factor receptors may have a certain effect on cancer cells, reduce the genome stability characteristics of cancer cells, and increase genetic heterogeneity, prompting cancer cells to develop drug resistance. Related research investigations have also shown that targeted drugs increase the error rate of DNA damage repair in cancer cells, thereby increasing the risk of drug-resistant mutations;
3. Immune resistance
Immunotherapy produces two specific types of drug resistance, primary and acquired. The so-called primary drug resistance refers to the fact that cancer cells do not respond to the treatment drug at the beginning, which is related to factors such as poor autoimmunity, immunosuppression of the microenvironment of cancer cells, and decreased immunogenicity of cancer cells.
Acquired ad age, on the other hand, refers to an initial response to immunotherapy, but after receiving treatment, the cancer foci developed drug resistance, which is related to changes in the microenvironment of the foci.
That being the case, what should patients do in the face of drug resistance?
1. Targeted drug resistance
Targeted drug resistance is clinically divided into three conditions, namely slow resistance, local resistance, and total resistance. Since there are many types of drug resistance, patients also need different treatments and treatments. Depending on the patient's different drug resistance, choose the appropriate treatment regimen.
It should be emphasized here that if the lesion is not significantly enlarged at all when the patient performs ct examination, but the tumor marker is elevated, the patient needs to re-conduct genetic testing, once the genetic mutation problem is found, the drug needs to be changed immediately, and if there is no mutation, it can continue to be treated with medication;
2. Immune drug resistance
Resistance develops during immunotherapy, and patients require combination therapy, that is, to add radiotherapy or chemotherapy to immunotherapy. In this way, the immunogenicity of the tumor can be enhanced, so that it can play a synergistic anti-cancer effect. In addition, patients can also combine targeted therapy, which can both kill cancer cells and induce an immune response.
Written in the end: The emergence of drug resistance in cancer patients in the process of drug treatment is one of the most common clinical situations, and it does not mean that the patient has reached the point of incurable treatment. What patients need to do is to seek medical treatment in time and choose to change patients in combination with other treatment methods according to the doctor's recommendations, so that the cancer can be controlled within a certain range.