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- test of a patient's tumor cells would not usually be used with that patient.
- These tests may be useful in selected patients, but are not yet the final solution to the problem of drug
- selection. Their usefulness is limited by a number of factors:
- • The tumor may not grow in the laboratory, or only certain drug-sensitive cells may grow.
- • There may be differences between the way the drug works in the body and the way it works in a test tube. In
- the body, the drug can be bound and inactivated, eliminated by the kidneys or not be allowed to get through
- the P-glycoprotein "gate" on the cell surface.
- • These test procedures apply only to one or, at most, two drugs tested one at a time. But chemotherapy cures
- are generally produced only by combinations of many drugs.
- • The possibility of using other therapies There is no one absolutely right choice in cancer therapy, and the
- treatments recommended can change over the course of the illness. One reasonable choice at a particular time
- may not be appropriate at a later time.
- A woman whose breast cancer recurs in a non-vital place, for example, may have several options. Her
- doctor may recommend: surgery, radiation treatment to the region to possibly control the cancer for years,
- hormone treatments, simple chemotherapy, complex chemotherapy or even doing nothing until the cancer
- grows and starts to bother her in six months' or a year's time.
- Each treatment option has advantages and disadvantages, and there may be more than one option that is
- sensible.
