Key takeaways
- Doctors use chemotherapy either as a first-line treatment or in combination with others, such as surgery. If chemotherapy is ineffective, a person may need to consider other options.
- Signs that cancer is not responding to chemotherapy may include new or worsening cancer symptoms, tumor growth, and the spread of cancer to other body parts.
- If cancer does not respond to chemotherapy, doctors may consider other treatment methods, such as radiation therapy, immunotherapy, or targeted therapy.
Chemotherapy is a common treatment option for many cancers. If cancer does not respond to chemo, the alternative treatments vary, depending on the type and stage of cancer.
This article explains signs that chemotherapy is ineffective and explores some other scientifically proven cancer therapies, which can serve as either complementary or primary treatments.
Signs that a person’s cancer is not responding to chemotherapy include:
- a tumor growing or not shrinking
- cancer spreading to other areas of the body (metastasis)
- cancer symptoms returning
- additional symptoms appearing
If any of these issues occur, the doctor may recommend other types of therapy.
A chemotherapy course usually lasts 3 to 6 months, although this can vary.
The timing depends on various factors, including the:
- type and stage of cancer
- person’s overall health
- type of chemotherapy drug that the doctor uses
Doctors will test at intervals to assess the effectiveness of chemotherapy.
If tests show that chemotherapy is not having enough of an impact, the following options may be available.
Radiation therapy
Radiation therapy uses radiation to kill cancer cells and reduce the size of tumors. It can be a primary treatment, but it also works well with other approaches, such as surgery.
According to the American Cancer Society (ACS),
Radiation therapy damages the DNA in cancer cells so that they can no longer repair themselves. These damaged cells stop dividing and eventually die, at which point the body breaks them down and removes them.
There are two types of radiation therapy:
- External beam radiation therapy: This type targets a specific part of the body. To administer it, a healthcare professional uses a large machine to send radiation from several directions to the targeted area.
- Internal beam radiation therapy: To administer this type, doctors implant a permanent or temporary radiation source inside the body near the tumor. This type affects a smaller area of the body than external beam radiation therapy.
Doctors may remove temporary implants after a
The table below outlines some advantages and disadvantages of radiation therapy:
| Advantages of radiation therapy | Disadvantages of radiation therapy |
|---|---|
| • causes only moderate pain, although this can vary from person to person • involves minimal or no hair loss • effectively kills large numbers of cancer cells in a tumor • specifically targets the tumor • most side effects go away within | • a small risk of damage to nearby vital organs • internal beam radiation therapy causes a person to be radioactive for a short period • may not kill all cancer cells in a large tumor • can be inconvenient and time consuming • can be expensive, though cost depends on the type and amount of treatment • can cause site-specific side effects, including skin soreness |
Immunotherapy
Immunotherapy aims to help the immune system fight cancer in the same way that it fights infections. This treatment either stimulates the immune system in a general way or trains it to attack cancer cells directly.
Methods of delivering immunotherapy
- Monoclonal antibodies: These are synthetic antibodies that bind to specific proteins on cancer cells, marking the cells to help the immune system locate and destroy them.
- Checkpoint inhibitors: These are medications that stimulate the immune system’s T cells, which then identify and attack cancer cells more efficiently.
- Cancer vaccines: Vaccines stimulate the immune system to fight cancer.
Some vaccines , such as that for the human papillomavirus (HPV), can have protective effects, as specific types of HPV are known to cause certain cancers. - Adoptive cell transfer: This involves removing T cells from a tumor and modifying them in a laboratory. After about
2 to 8 weeks , doctors return the T cells to the body. The aim is to enhance the T cells’ ability to detect and destroy cancer cells.
Below are some potential advantages and disadvantages of this treatment:
| Advantages of immunotherapy | Disadvantages of immunotherapy |
|---|---|
| • can be effective against many types of cancer • effective for a long time • can be effective at preventing cancer’s spread and recurrence • | • treatment costs are high • less information about its long term effects • drug resistance can cause immunotherapy to stop working • in some cases, cancer cells can hide from the body’s immune response |
Hormone therapy
Hormone therapy can treat some types of cancer, including prostate cancer and breast cancer, by taking advantage of the disease’s dependence on hormones to grow.
Hormone therapy
Hormone therapy to treat breast cancer, or endocrine therapy, focuses on lowering estrogen levels. If someone has not gone through menopause, doctors
Before that, various medical treatments are available to lower estrogen levels, including aromatase inhibitors, Tamoxifen, fulvestrant (Faslodex), and other treatments
Hormone therapy to treat prostate cancer, or androgen-suppression therapy, lowers testosterone and dihydrotestosterone (DHT) production. Treatments include surgical procedures to remove one or both testicles and medications that prevent the production of testosterone and DHT.
Below are some potential advantages and disadvantages of hormone therapy:
| Advantages of hormone therapy | Disadvantages of hormone therapy |
|---|---|
| • can be effective against tumor growth and cancer spreading • may help stop cancers from recurring | • • can affect bodily functions, including sexual function • only works on cancers that require hormones to grow |
Targeted therapy
This involves using medication that
Unlike chemotherapy, targeted therapy does not affect healthy cells. It targets cancer by identifying particular genetic irregularities in cancer cells.
There are many types of targeted therapy, and they employ different methods. These therapies may fight cancer by:
- blocking or turning off chemical signals that stimulate cancer cell growth
- changing proteins inside cancer cells, causing cell death
- preventing cancer cells from stimulating the growth of new blood vessels
- triggering an immune response to destroy cancer cells
- delivering toxic substances to cancer cells to kill them without affecting other cells
Below are some potential advantages and disadvantages of targeted therapy:
| Advantages of targeted therapy | Disadvantages of targeted therapy |
|---|---|
| • specifically targets cancer cells • is not toxic to healthy cells • wide array of methods, helping doctors tailor effective treatment plans for individuals | • only works for specific genetic mutations • cancer cells can develop resistance to targeted therapies • can cause various side effects, including diarrhea and liver issues |
If tests suggest that chemotherapy is not effective or has stopped working, a person’s healthcare team may recommend other options.
Anyone with concerns that chemotherapy is not working should raise these with their oncologist.
Points to discuss with an oncologist include:
- how well and for how long the first-line treatment worked
- the current status of the cancer
- how a new treatment could affect the overall outlook
- if the cancer has spread
- the success rates of any alternative treatments
- the possible side effects of other treatment options
A person may wish to stop chemotherapy for a while or altogether. This may be because of adverse side effects, because the treatment seems to be ineffective, or for other reasons.
Anyone who is considering stopping
Palliative care
Whether or not cancer responds to treatment, people can receive support from palliative care specialists to ensure their quality of life is addressed throughout their cancer experience.
Palliative care includes:
- pain relief
- help with daily living
- counseling and other forms of mental health support
Also, if treatment is no longer effective or a person has late-stage cancer, they may benefit from hospice care.
A healthcare team will create a plan to help manage all aspects of the person’s care and help them remain comfortable.
Usually, alternative treatments are available if chemotherapy does not work. The range of options depends on the type of cancer and other factors.
After considering the options, some people decline further treatment. In this case, the oncologist focuses on improving the person’s quality of life, and they develop a plan to manage the cancer symptoms.
If chemotherapy stops working, discuss the other options with the oncologist, the rest of the healthcare team, and loved ones, including family members, before making a decision about treatment going forward.