Understanding your treatment is part of the care
Each treatment is chosen based on the diagnosis, the tumor's characteristics, the clinical condition and the needs of each patient.
The path, step by step
Knowing what may come next helps ease uncertainty.
First consultation
Review of the diagnosis, tests already performed and medical history. Room for your questions.
Defining the plan
The tumor's characteristics, stage and clinical condition guide the options, in a shared decision.
Treatment underway
Prescription, assessment of response and attention to possible side effects throughout the stages.
Follow-up
Follow-up visits and monitoring tests, keeping care going over time.
Similar diagnoses may call for different paths
Two tumors that look alike under the microscope may behave in different ways. The subtype, the stage of the disease, the biomarkers identified in testing, previous treatments and the clinical condition all help guide each decision.
Options that may be part of your care
What follows is general information. The indication is always individual and defined during a consultation.
Chemotherapy
Medications that act on dividing cells. It may be used at different points in care: before surgery, after surgery, or in the treatment of advanced disease.
When it may be considered
It depends on the type and stage of the tumor, the biological profile identified through testing and the goals defined for that point in treatment. In some situations it is combined with other therapies.
What the routine looks like
Sessions are usually organized in cycles, with intervals between them to allow the body to recover. The number of cycles and the route of administration are part of the plan defined during the consultation.
Possible effects and management
Fatigue, nausea, changes in appetite, hair loss and changes in blood cells are among the most commonly reported effects, and they vary according to the regimen used. There are preventive medications, dose adjustments and monitoring tests before each cycle.
Hormone therapy
It works by reducing hormonal stimulation of tumors that carry hormone receptors, a common situation in certain types of breast cancer and in gynecologic cancers.
How hormone sensitivity is identified
Analysis of the tumor tissue, by immunohistochemistry, shows the presence of hormone receptors. This information is what allows this type of treatment to be considered.
Duration and routine
It is generally a continuous treatment, over periods measured in years, which makes adherence central to the outcome. In some situations it involves periodic injections rather than daily use.
Possible effects and management
Hot flashes, sleep changes, joint pain and effects on bone health are among the most commonly reported. Follow-up looks at tolerance, adherence and the need for adjustments, and may include bone density assessment.
Immunotherapy
It does not act directly on the tumor. It acts on the mechanisms that prevent the immune system from recognizing and responding to tumor cells.
When it may be considered
It depends on tumor characteristics identified through testing, including PD-L1 expression and defects in DNA repair mechanisms, known as dMMR and associated with microsatellite instability.
How it differs from chemotherapy
Chemotherapy acts on dividing cells. Immunotherapy acts on the body's immune response. That is why the pattern of side effects is different and calls for its own attention during follow-up.
Possible effects and management
Inflammatory reactions may appear in different organs, such as the thyroid, the bowel, the skin and the liver. Recognizing them early is what guides the course of action, and that is why reporting any new symptom is part of the treatment.
Targeted therapies
Treatments directed at specific alterations identified in the tumor, rather than at dividing cells broadly.
Why testing matters
Pathology, immunohistochemistry and, in selected situations, molecular testing identify the targets present in that tumor. Without an identified target, this type of therapy has nothing to act on.
Most frequently assessed targets
Receptors such as HER2 and alterations in genes such as BRCA are among those assessed in practice. The list changes according to the tumor type and the evolution of scientific evidence.
Good to know
The presence of a molecular alteration does not, in itself, mean targeted therapy is indicated. The decision takes into account the available evidence for that context, the stage of the disease and the clinical condition.
Antibody-drug conjugates
Also known as ADCs, they combine an antibody directed at a target on tumor cells with an anticancer drug linked to it.
How they work
The antibody recognizes the target on the surface of the tumor cell and carries the therapeutic payload there, which allows the drug's effect to be concentrated where it is needed.
When they may be used
It depends on the presence of the target, the type and stage of the tumor and the treatments already carried out. It is one of the areas with the most recent development in oncology.
Possible effects and management
They vary according to the drug attached to the antibody. Follow-up includes periodic tests and attention to symptoms specific to each regimen, with adjustments when needed.
A new assessment can bring more clarity
A second opinion allows the diagnosis, the tests and the proposed treatment plan to be reviewed, without interrupting care that is already underway.
What to bring to the consultation
- Reports and imaging tests
- Biopsy results
- Immunohistochemistry
- Molecular testing, if available
- Medical reports
- Treatments already received
You do not need to understand everything at once
Every question can be discussed during the consultation. You take part in the decisions at every stage of care.
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Areas of Expertise
Breast cancer and ovarian, endometrial, cervical, vulvar and vaginal cancer. Learn the signs that deserve attention and how the assessment works.
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