Toxicity of Targeted Therapy

Great strides have been made in reducing the toxicity of cancer drugs. The systemic nature of much chemotherapy resulted in a range of general unwanted effects with variable severity, duration and type.

Targeted cancer therapy is more elusive but it does offer improved patient tolerability. Yet even targeted therapy is not without unwanted side-effects, and although they are frequently much milder they can last longer and greatly impede patient quality of life. This is particularly relevant if they are not treated as more than just bothersome.

Chemotherapy although often life-saving has effects that are too general and way too toxic. For chemotherapy the toxicity tends to last for a short time immediately after administration of treatment. If you get chemotherapy it is usual that you feel very badly for a few days to 1 week and then you start to feel better.

In the case of targeted therapy there tends to be more prolonged toxicity and you are often told to live with it and it is often not pleasant and not easy to do this. The toxicity is everyday and the problems can be infections, such as thrush, diarrhoea and fatigue.

In many cases, chemotherapy and targeted therapy are given together. Then the side-effects are additive and in particular in the case of fatigue this can be a serious problem. It is not just a tiredness and a lack of energy, but an inability to do anything and many can’t even stand up or function at all normally.

Staying in bed is not a solution for this kind of fatigue, especially in the case of targeted therapy as it is given long-term, and this is a prolonged period of suffering and there is little quality of life. Chemotherapy and targeted therapy will prolong survivals but attention needs to be paid to what kind of survival and to address problems like fatigue.

Targeted therapy was initially considered to be the ultimate goal as in theory this reduces toxicity generalized side-effects. However, even though the target is identified it does not always work. In some cases, the tumour may express the target but the tumour is resistant to the target therapy. So it is vital to identify those who will benefit from a specific target therapy so that are none on target therapy and getting the side-effects that lower the quality of life without any benefit.

Living with severe fatigue is difficult for anyone, especially in active people who no longer can work, have social activity or play sports like they did before. If targeted therapy does not work for them, then they will have reduced quality of life for no reason.

Side-effects related to targeted therapies should not be ignored. Assessing how the cancer sufferer feels about the impairment of their quality of life, toxicity and most importantly ensuring target therapy works before administration will limit those suffering from more than bothersome side-effects.


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