Devising the Plan As with any plan for cancer treatment, the chemotherapy program your doctor recommends will be tailored to the precise stage of your particular kind of tumor , your age, physical condition and any other medical problems. He or she will be generally guided by some specific information.
• What's worked in the past Oncologists rely primarily on experience from clinical trials involving many
patients with similar tumors. They will usually consult reports in medical journals and the research findings
presented at cancer meetings. Since more and more literature on drug treatment is being produced every month,
the updated cancer information provided by the Physician Data Query (PDQ) system of the National Cancer
Institute should also be consulted. Such computer databases are now essential for physicians who want to
keep track of the rapid changes in the field.
Many state-of-the-art treatments are part of clinical trial protocols available at major cancer centers as well
as some community hospitals.
• Drug sensitivity A lot of research over the past 15 years has been devoted to finding ways of predicting
which drugs would kill which tumor cells most successfully. This research has involved growing an individual
patient's cancer cells in the laboratory and testing a whole battery of anticancer agents on them.
This drug sensitivity test program— called a clonigenic assay—may give a doctor some guidance on which
drugs to use. But it's especially useful for indicating which drugs not to use. If a drug doesn't kill single cancer
cells in the lab, then it probably won't be effective in the body. So any drugs that are inactive in a laboratory
test of a patient's tumor cells would not usually be used with that patient.
