Large medical centers or teaching hospitals may be better equipped to handle unusual or complicated cases, and a patient may visit one institution for diagnosis and staging, another for treatment, and still another for follow-up and rehabilitation. The National Cancer Institute has designated a number of regionally distributed Comprehensive Cancer Centers throughout the United States that carry out investigative cancer treatment and research, and a number of other institutions that are Clinical Cancer Centers or Cancer Research Centers. These centers offer a full range of cancer therapies, including those that are still under investigation. An experimental treatment is not indicated, however, if there is an established therapy that has been proven safe and effective. The severity of chemotherapy's side effects depends on which of the more than 20 commonly used drugs is administered, the individual characteristics of the patient, and the drug dosage.
Most side effects resolve once treatment is completed, and some cease even during continued therapy.
Whereas decreasing the dose may be required in some cases, even small changes in treatment are usually avoided to insure the treatment's effectiveness. Patients who experience these side effects should bring them to the attention of a member of the treatment team a simple coping strategy may be sufficient to alleviate the problem. Surgery to remove the primary tumor and surrounding tissue is necessary to cure most tumors about 25 percent of cancers are curable with surgery alone. Radiation therapy by itself can cure an additional 20 percent of cancers such as lymphoma, cervical cancer, and some forms of testicular cancer. And while most leukemias, multiple myeloma, and certain other cancers are treated with chemotherapy alone, cancer is increasingly being treated with combinations of treatments that produce both a higher cure rate and minimize adverse side effects.