When Would Combination Therapy be Recommended?
Often, it is not a case of using radiotherapy or surgery, but radiotherapy and surgery.
Depending on the type and stage of the cancer, it may be recommended that a patient undergoes combination therapy consisting of both MR-linac radiotherapy and surgery. In this case, the question will be, in what order they are used. Usually, when the cancer has metastasized, surgery will not be the primary treatment but may take place before the patient undergoes radiotherapy.
In the case that the cancer is still localised, but the tumour is of a manageable size, a patient may undergo a course of MR-linac radiotherapy treatment before surgery to reduce the size of the tumour, therefore making it easier for surgeons to remove it. This is called debulking. This is more common for patients with lung, oesophageal or bladder cancer where the tumour cannot be removed completely by surgery alone.
Combination therapy may also be used not as a means of treating/removing the cancer completely but to manage symptoms and prolong life. This will be when the cancer has reached an advanced stage and is considered terminal. At this point, the aim is to offer a best-case scenario which is to manage symptoms and treat the cancer so the patient can enjoy a good quality of life for as long as possible.