Refractory cancer is a cancer that is not responding to treatments. Individuals with cases of refractory cancer can be provided with supportive care to help them feel more comfortable, but their treatment options have been exhausted. Since new treatments are often in development, patients with this diagnosis may be able to find a clinical trial or apply for compassionate use of medications to try another treatment option that would not otherwise be available. Care for such patients is supervised by an oncologist, a medical specialist who focuses on cancer care.
For some refractory cancers, the cancer resists treatment from the start. Various treatment protocols may be tried, but the cancer is resistant to all of them. These cancers will not shrink or break up in response to chemotherapy and radiation, and either cannot be operated on or return after surgery. A diagnosis of refractory cancer can be made by examining medical imaging studies to see if the cancer is shrinking or changing shape in response to the treatments.
In other cases, a cancer responds to treatment initially, but stops responding partway through treatment. Patients with this form of refractory cancer may initially improve before the cancer returns and stubbornly resists treatments. In these patients, scans from various stages of treatment can be compared to see how the cancer is responding and to identify the point when the cancer stopped being susceptible to treatment.
If a patient has a cancer that is unresponsive to treatment and all traditional treatment avenues have been pursued, an oncologist may recommend the patient for clinical trials. Clinical trials provide access to medications in development and may offer opportunities to the patient. Certain trials actively seek out patients with refractory cancer. Patients can also look up clinical trial databases to see if there are any ongoing trials they can enroll in.
Treatment is also provided to manage symptoms. Cancer can be painful and a patient with refractory cancer will be provided with pain medication to increase comfort. Other medications and treatments can address symptoms like loss of appetite, anxiety, nausea, difficulty breathing, and organ failure. Some patients prefer to receive supportive treatments at home with the assistance of a home care nurse while others may prefer to be hospitalized or housed in a hospice facility. As new treatment options arise, patients can be presented with them to determine if they are interested in pursuing new treatments for their cancers.