Once your cancer diagnosis has been confirmed, it is important that you and your doctor are well prepared for future possibilities. This can involve understanding the standard treatment for your cancer type, why this has been recommended, as well as what the other options are if this fails. It can also involve ensuring that you and your doctor take a tissue biopsy that can be used again, just in case you pursue molecular profiling.
What is a ‘standard of care treatment’ for cancer?
‘Standard of care treatment’ for many cancers will typically be started by your oncologist once your cancer diagnosis has been confirmed. The term ‘standard of care treatment’ describes the broadly agreed treatment for a particular type of cancer, based primarily on its location in the body (e.g. lung, breast, prostate). The National Comprehensive Cancer Network (NCCN) is a not-for-profit alliance of the leading cancer centres around the world which coordinates the documentation for treatment standards.1 Other factors, such as disease history or tumour progression, can also affect which ‘standard treatment’ will be recommended.
When standard treatment fails
The ‘one treatment fits all’ approach taken with standard treatments doesn’t work with everyone. Some patients will ultimately end up exhausting all of the standard treatment options because their cancers do not respond to any of them. On some occasions, particularly with aggressive cancers, standard treatment options may work for a short period, but eventually prove to be ineffective over time.2 In the case of some rare cancers, there may not even be a recognised standard treatment pathway for patients to follow.3
This is where precision medicine comes in. Advances in the ability to identify predictive biomarkers in each patient’s cancer can provide oncologists with important information about potentially beneficial treatments – some of which may not have been considered previously.4
When to profile
Your doctor will likely propose molecular profiling:5
- If first-line standard treatments have failed;
- If there has been a recurrence of your cancer;
- If your cancer is rare or particularly aggressive;
- To help find the most appropriate option if there are several recommended treatments available.
A biopsy is the main way doctors diagnose most types of cancers.6 It is a procedure in which a small sample of tissue or cells are taken from the body to be examined under a microscope. When your doctor takes a biopsy, it is important to be prepared and plan for the future. Good quality specimens may be stored (over many months) and subsequently reused if sufficient tissue is taken. This means that it may not be necessary to have another biopsy if you decide to have your tumour profiled, which may save you important time later. The situation may also arise where it may no longer be suitable to have another biopsy, such as when there is an increased risk of a complication.
We have clear instructions about the minimum specimen size to ensure appropriate and accurate analysis, as well as how to prepare the tissue in order to keep it preserved for as long as possible. We recommend that you and your doctor read through these instructions so that you can plan ahead.
- What is standard treatment? NCCN guidelines and the future of cancer therapy [online]. Caris Life Sciences; 2018 [cited 27 March 2018]. Available from [URL link]
- Is standard treatment right for me? [online]. Caris Life Sciences; 2018 [cited 27 March 2018]. Available from [URL link]
- What is rare or aggressive cancer? [online]. Caris Life Sciences; 2018 [cited 27 March 2018]. Available from [URL link]
- Ussia G, Leonard R, Janssens J. Multi-platform tumour profiling delivers the highest clinical utility and improves patient outcomes in today’s routine clinical practice. Int J Surg Surgical Proced. 2016; 1:107. [PDF]
- When to profile: Is it time to profile my tumor? [online]. Caris Life Sciences; 2018 [cited 27 March 2018]. Available from [URL link]
- Biopsy [online]. American Society of Clinical Oncology; 2018 [cited 27 March 2018]. Available from [URL link]