How will I know if the therapy is working?

Regardless of the form of treatment you receive, close cooperation with your oncologist is necessary during the application of therapy, which includes frequent check-ups. Check-ups are important on the one hand because of possible side effects of treatment, in order to recognize them in time and treat them if necessary, and on the other hand to assess the effect of the applied therapy. A therapy that tests show to be ineffective is contraindicated.

To assess the effect of treatment, your oncologist will specify what needs to be done, and most often these are blood tests (tumor markers) and imaging tests (CT, MR, PET/CT, X-ray). You can get a more detailed explanation of the aforementioned tests in a separate article. It is important to remember that not only the current finding is important, but also its comparison with the interim finding. It is precisely this change in the finding in a certain time interval that can say the most about how successful a certain type of therapy that was applied during that period is. From the above, it is advisable to always perform the examination in the same place (preferably on the same device and with the same diagnostician reading), in order to avoid possible errors due to differences in devices. Examinations are performed on average every 2-4 months during therapy for most patients, but this cannot be longer if the stability of the disease has been established and these are therapies that require a longer time to achieve an effect. Patients should not be afraid of the radiation dose received due to frequent examinations, because the benefit achieved by an adequate assessment of the disease is much greater than the potential risks.

Figure 1. PET/CT is one of the most commonly used imaging tests in oncology. The image shows a tumor process in the upper part of the pharynx (nasopharynx).

The assessment of the effect of treatment is not a subjective category, but is carried out according to precisely defined rules. Today, the most widely used are the so-called RECIST (Response evaluation criteria in solid tumors) criteria, which have been established through use in large clinical studies with the aim of using clear and precisely defined rules to standardize the assessment of the effect of therapy among various physicians. In addition to the above, there are many others, because it has been shown that no single criterion is 100% reliable or adequate for all types of oncological therapies, given that there are significant differences between them in the mechanism of action and thus the way in which they achieve their effect.

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