Original Medicare (Parts A & B): Chemotherapy
Chemotherapy (chemo) is drug treatment that uses powerful chemicals to kill fast-growing cancer cells for both curative and life-extending care.
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Medicare covers chemotherapy in a provider's office, freestanding clinic, or hospital outpatient setting under Part B. Chemotherapy in an inpatient hospital setting is covered under Part A (Inpatient Hospital Care).
Chemotherapy (chemo) provides variably effective treatment for the majority of forms of human cancer and curative treatment for many categories of cancer.
Curative chemotherapy
Curative chemotherapy is administered with the goal of achieving complete remission and preventing the recurrence of cancer. This also includes adjuvant chemotherapy following surgery for localized cancers (breast, colon, lung).
Adjuvant chemotherapy is applied after initial treatment for cancer, especially to suppress secondary tumor formation.
Palliative chemotherapy
Palliative care, or palliation, is the relief of symptoms and suffering from cancer or other life-threatening disease.
In contrast to curative, oncologists typically use the term palliative chemotherapy to refer to any chemotherapy administration that is not curative. It is therefore defined by what it isn't (curative) rather than specifying the palliative intention. Palliative chemotherapy is given without curative intent and does not increase survival, but is used simply to decrease tumor load and tumor-related symptoms, as well as increase life expectancy.
Today, many oncologists object to the term "palliative chemotherapy" because the intended outcome is not palliation. As well, because the term palliative care has errantly become synonymous with end-of-life, it may unnecessarily alarm people who are not near death to hear it. Likewise, its use for people who truly are at the end of life gets misapplied because it is not necessarily prescribed for palliation.
Life-extending chemotherapy
Cancer outcomes have improved, in some cases dramatically. For many metastatic tumors, even if incurable, survival with chemotherapy and best practice treatments is now well over a year and frequently much more. If chemotherapy is offered with the goal of prolonging life, but not preventing recurrence (not curative), it has been suggested that the term "palliative chemotherapy" be dropped in favor of the term "life‐extending chemotherapy."
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