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Curative intent vs palliative treatment

Tests to decide treatment

Once a person is told that they have cancer, there are a lot of other tests that they may need. These tests are done to try and answer two simple questions:

  • Can we try and cure the cancer?
  • Is the person fit enough to have this type of treatment?

Unfortunately, more than half of the people who are diagnosed with oesophageal or gastric cancer cannot be treated to try and cure it, because either it is too advanced, or the person is not fit enough to survive the treatment that would be needed.

What is 'curative-intent' treatment?

If the team think a person will be fit enough to have major treatment, a number of different tests will be done to see how advanced the cancer is. If these tests show that the cancer is not too advanced, then the team will talk to the person about having 'curative-intent' treatment.

For many of our patients, this means having chemotherapy followed by surgery, with further chemotherapy after recovery from the operation. Studies examining different combinations of treatment have found that for most patients, this gives the best chance of getting rid of the cancer in the long-term. However, even with this treatment, the cancer can come back at a later time. Most often, this happens in the first 1-3 years after surgery. This is why we describe this type of treatment as 'curative-intent'. We hope to get rid of the cancer forever, but unfortunately we know it can come back even with the best available treatment.

What is palliative treatment?

If we cannot try and cure a person's cancer, then the treatment we give is focused on helping a person have the best quality of life. As we are focusing on quality of life, rather than on cure, we use the phrase 'palliative treatment'.

There are lots of different palliative treatments that a person may receive. Some patients have palliative chemotherapy, to help contol the cancer and any symptoms it may be causing. Other treatments include radiotherapy, or endoscopy (insertion of a telescope into the body). For example, if a patient has difficulties eating and drinking, we may do an endoscopy to insert a special tube called a stent. Treatments like these allow us to manage the different symptoms that patients have even when we cannot get rid of the cancer itself.