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Peritoneal Mesothelioma Asbestos Symptoms<br><br>The digestive system is frequently affected by the symptoms of mesothelioma of the peritoneal region. This is because asbestos fibers get inhaled and then become a part of the lining of the stomach known as the peritoneum.<br><br>As time passes the fibers trigger mutations in healthy peritoneal cells. Cancerous tumors develop in the peritoneum as a result of.<br><br>The diagnosis of mesothelioma can be difficult. The early signs can be similar to symptoms of other diseases, such as hernia or IBS.<br><br>Signs and symptoms<br><br>When asbestos fibers are inhaled, they can enter the lungs and then travel throughout the body. The fibers can then get trapped in the linings the abdomen and other organs. This can cause inflammation and irritation that results in the development of tumors. The process can take years to develop, and many victims are unaware of their asbestos exposure until it is too late.<br><br>Malignant peritoneal mesothelioma is a condition that occurs asbestos fibers get trapped in the tissues that line the abdominal cavity and other organs. It is the second most prevalent mesothelioma. However, it can be difficult to identify because the initial symptoms are not specific and similar to those of digestive diseases. Patients suffering from peritoneal cancer typically experience fatigue, stomach pain and gastrointestinal problems.<br><br>After a physical examination followed by reviewing medical history, and a series of tests in the laboratory, mesothelioma patients are diagnosed with peritoneal cancer. A X-ray and a CT scan can assist doctors to identify any lumps or other indications of illness. In some cases mesothelioma specialists may also order a biopsy to obtain an precise diagnosis.<br><br>Peritoneal mesothelioma symptoms generally begin in the abdomen and can result in severe abdominal pain and bloating, weight loss, stomach fluid accumulation nausea, vomiting, and other digestive problems. The symptoms can also include chest pain, swelling and fatigue. If symptoms like these occur it is essential that victims seek medical attention since they may be caused by other ailments.<br><br>Despite the difficulty of diagnosing peritoneal cancer, patients are often able to receive the right treatment to extend their lives. In most cases, this requires surgery and heated chemotherapy.<br><br>If you or a loved one have been diagnosed with peritoneal mesothelioma, call our [http://ywhhg.com/home.php?mod=space&uid=1079545 mesothelioma attorneys] to learn how we can help. We can connect you to mesothelioma specialists near you who can assist you in bringing a suit against the asbestos companies that are responsible for your exposure. We can also help you get the financial compensation you deserve. Start the process by filling in our free online form. We can assist you in obtaining the best possible outcome working with top [http://delphi.larsbo.org/user/baconattic3 mesothelioma attorneys].<br><br>Diagnosis<br><br>The first step in identifying mesothelioma peritoneal is to obtain an exact medical history. Doctors will inquire about the person's exposure to asbestos and the time it occurred. They also conduct a physical examination. Initial work-ups often include X-rays and blood tests and CT scans.<br><br>Peritoneal mesothelioma is a difficult cancer to identify due to its long period of latency. Patients may be afflicted by symptoms like nausea, abdominal pain and fever that are similar to those of other conditions. These symptoms that are not specific can confuse doctors. Mesothelioma is a rare cancer, and it can take years for symptoms to appear after exposure to asbestos.<br><br>Inhaling or eating asbestos fibers move into the stomach lining, called the peritoneum. When they reach the peritoneum, the asbestos fibers are sharp and can cause irritation to the mesothelium. In time this irritation can cause inflammation and scar tissue formation. This leads to abnormal cell growth and tumors.<br><br>Researchers are working to develop ways to detect the disease at its earliest stages. The stage of mesothelioma determines the treatment options.<br><br>A mesothelioma expert can perform a paracentesis procedure or percutaneous needle biopsy to collect mesothelioma tumours for laboratory testing. These tests will reveal if the cancerous cells are epithelioid (epithelioid), the sarcomatoid (sarcomatoid) or biphasic within the tumor. This information aids doctors to develop a treatment plan.<br><br>Specialists in mesothelioma can also determine the stage of a patient. Staging determines which treatments might be most effective and also helps mesothelioma lawyers determine which asbestos companies to pursue in [http://www.underworldralinwood.ca/forums/member.php?action=profile&uid=282920 mesothelioma lawsuits].<br><br>A mesothelioma specialist examines the results of a biopsy they prepare an a pathology report which contains details about the type of mesothelioma. The report may also include the staging system which outlines how far the cancer has spread within the body. The more advanced the stage, the less likely it will respond to treatment. Lawyers can explain the significance of this in a client's situation.<br><br>Treatment<br><br>When swallowed or inhaled asbestos fibers get encased in the tissue that lines the abdomen and other organs. The fibers cause irritation to cells and damage DNA. As time passes, this leads to the formation of tumors in the lining. Typically, peritoneal cancer is found in the lining of the abdomen. Peritoneal Mesothelioma is more prevalent in women than pleural Mesothelioma however, it is less prevalent.<br><br>Symptoms of peritoneal mesothelioma are similar to those of gastrointestinal conditions such as irritable bowel syndrome and Crohn's disease, making it difficult for doctors to diagnose the condition. Because of this, early symptoms are mistaken for normal ailments, and can last for months or even years before a patient is given the mesothelioma diagnosis.<br><br>A doctor may also perform imaging and blood tests to rule out other diseases or conditions that could cause mesothelioma-like symptoms. These tests can be used to determine the most suitable treatment options.<br><br>A biopsy is performed by a doctor to confirm the diagnosis. This is due to the fact that peritoneal msothelioma can in the abdominal lining. A biopsy is the process of removing small portions of the affected area for examination by pathologists. Biopsies can identify cancerous cells, and can identify the type of Mesothelioma.<br><br>After a peritoneal msothelioma is confirmed, doctors will discuss the treatment options with patients. The goal of any treatment plan is usually to reduce the size and number of tumors. Surgery is usually the first option, however patients can also look into chemotherapy and immunotherapy.<br><br>Contrary to chest-based treatments for pleural mesothelioma, which are administered through the lungs, peritoneal mesothelioma treatments are administered either intravenously or orally. Injections of chemotherapies, like heated intraperitoneal chemotherapy (HIPEC) have helped to prolong the life of many patients. HIPEC is a procedure innovated by mesothelioma pioneer Paul Sugarbaker.<br><br>Patients diagnosed with peritoneal mesothelioma may qualify to file an asbestos lawsuit against negligent companies. A [https://www.mazafakas.com/user/profile/4867008 mesothelioma lawyer] with experience will evaluate a patient's situation and suggest legal options. Contact us today to get started. It is free, confidential and there is no commitment. We offer nationwide representation.<br><br>Prognosis<br><br>Mesothelioma cancer is rare. Because doctors aren't experienced with the disease, many patients are misdiagnosed with other diseases. A mesothelioma expert can assist patients to diagnose the disease and ensure they receive the right treatment.<br><br>Asbestos exposure is the only known cause of peritoneal cancer. Asbestos fibers can cause irritation of the abdominal tissues and cell changes when inhaled or consumed. Over time, this can lead to tumors that form mesothelioma in the peritoneum.<br><br>The exposure to asbestos typically starts with work in construction or manufacturing. These industries can utilize asbestos-containing materials, such as fireproofing and insulation. Asbestos is also found in household products, such as flooring and roof tiles. Even low levels of exposure to asbestos can put someone at risk of developing mesothelioma. Because of the lengthy latency period of the disease the victims could be diagnosed with peritoneal mesothelioma for a long time after their first exposure.<br><br>Peritoneal mesothelioma symptoms could resemble those of other conditions and be mistaken for hernias, digestive issues such as Crohn's disease or colitis, or other forms of abdominal cancer. A lot of patients do not declare their asbestos exposure and do not seek medical care. When mesothelioma is detected experts may suggest the procedure of a biopsy to make an precise diagnosis. A biopsy is the removal of a small piece of tissue to be examined. This procedure can reveal the stage of mesothelioma, and whether it is epithelioid biphasic or sarcomatoid.<br><br>If the mesothelioma is at an early stage doctors can remove all of the tumors and provide an effective treatment. The doctor can also determine whether the cancer has spread to the abdomen. They may then recommend palliative care for the patient, such as paracentesis that drains abdominal fluid.<br><br>If a mesothelioma has advanced, the prognosis becomes poorer. This is because the tumors can become resistant to certain treatments and may be recurred. The doctor may recommend a combination of surgery and chemotherapy. The surgical options include cytoreduction surgery combined with hyperthermic intraperitoneal chemotherapy. This combination is more likely than chemotherapy by itself to improve the outlook of a patient.
Peritoneal Mesothelioma Asbestos Symptoms<br><br>The digestive system is often affected by the symptoms of mesothelioma peritoneal. This is because asbestos fibers get consumed and are absorbed into the lining of the stomach and peritoneum.<br><br>Over time, these fibers cause changes in healthy peritoneal cells. Cancerous tumors develop in the peritoneum as a result of.<br><br>The diagnosis of mesothelioma can be a challenge. The early signs can be similar to symptoms of other conditions like hernia or IBS.<br><br>Signs and symptoms<br><br>Asbestos fibers can travel through the body when inhaled. They can then get trapped in the lining of the abdomen or other organs, causing inflammation and irritation that can lead to the growth of tumors. This process can take decades to develop, and most sufferers are unaware the fact that they've been exposed to asbestos until it is too late.<br><br>Asbestos fibers may get caught in the tissue that lines the abdominal cavity or other organs, causing malignant peritoneal melanomas. It is the second most common form of mesothelioma. However it can be difficult for doctors to diagnose because the early symptoms are not specific. It is also possible that they are similar to gastrointestinal disorders. Patients with peritoneal mesothelioma frequently have stomach pain, fatigue, and digestive problems.<br><br>Mesothelioma patients are usually diagnosed with peritoneal cancer after having a physical exam, a medical history review and several laboratory tests. A CT scan or X-ray can aid in identifying lumps, or other indications of illness. In some instances, mesothelioma doctors will also require a biopsy to get a more precise diagnosis.<br><br>Peritoneal Mesothelioma symptoms typically begin in the abdomen and can cause extreme abdominal discomfort, bloating and weight loss. They may also cause nausea, vomiting, and other digestive issues. Other symptoms include chest pain, fatigue and swelling. When these symptoms occur, it is important that patients seek medical attention since they may be caused by other conditions.<br><br>Despite the difficulty in diagnosing peritoneal mesothelioma, victims can often receive the proper treatment to prolong their lives. In the majority of cases, this is done through surgical treatment and heated chemotherapy.<br><br>If you or a loved one have been diagnosed with peritoneal cancer, contact our mesothelioma lawyers to find out how we can assist. We can help you locate a [https://brockca.com/home.php?mod=space&uid=596940 mesothelioma attorneys] expert near you who can assist you in filing a lawsuit against asbestos companies responsible for your exposure. We can also ensure you receive the financial settlement you deserve. Complete our online form to start the process. We can assist you to get the best possible outcome working with the best mesothelioma lawyers.<br><br>Diagnosis<br><br>To determine if you have peritoneal msothelioma it is important to have an extensive medical history. Doctors will ask the patient about their exposure to asbestos and when it happened. A physical exam will be conducted. Blood tests, X-rays, and CT scans are commonly utilized in the initial check-up.<br><br>Due to the lengthy period of latency, peritoneal mesothelioma can be difficult to diagnose. Patients may experience symptoms such as abdominal pain, nausea and fever that are similar to other illnesses. These symptoms that are not specific could confuse doctors. Mesothelioma, a rare cancer that can take years to show symptoms following exposure to asbestos, is a rare condition.<br><br>Inhaling or eating asbestos fibers move to the stomach lining known as the peritoneum. Asbestos fibers that are sharp can irritate mesothelium when they reach the peritoneum. This irritation can cause scar tissue and inflammation over time. Then, it leads to abnormal cell growth and tumors forming.<br><br>There are no FDA-approved screening tests for mesothelioma of the peritoneum, but researchers are working on finding ways to detect the disease in its earliest stages. The process of identifying mesothelioma's stage is crucial as it determines treatment options.<br><br>A mesothelioma doctor can perform a paracentesis procedure or percutaneous needle biopsy to take a sample of mesothelioma tumours for laboratory testing. These tests can reveal whether the cancerous cells are epithelioid (epithelioid), Sarcomatoid (sarcomatoid) or biphasic within the tumor. This information helps doctors create the treatment plan.<br><br>Mesothelioma specialists also evaluate a patient's stage of mesothelioma. The stage determines the most effective treatments and helps [http://mariskamast.net:/smf/index.php?action=profile;area=forumprofile;u=3518622 mesothelioma attorney] lawyers; [https://ask.xn--mgbg7b3bdcu.net/user/gramrain66 hop over to here], know which asbestos-related companies are responsible in mesothelioma cases.<br><br>When a mesothelioma expert reviews the results of the biopsy and creates a pathology record that contains information on the mesothelioma type. The report may also include a staging scale that indicates how far the cancer has spread across the body. The higher the stage, the less likely it is to respond to treatment. Lawyers can explain the implications of this to a particular client's case.<br><br>Treatment<br><br>Asbestos fibers are inhaled or eaten and then absorbed in the tissues lining the abdomen and other organs. These fibers damage DNA and cause irritation to cells. Over time, this leads to the development of tumors in the lining. Typically, peritoneal cancer develops in the lining of the abdomen. Peritoneal mesothelioma is less common than pleural mesothelioma and usually affects women more.<br><br>Symptoms of peritoneal mesothelioma are similar to those of gastrointestinal conditions like irritable bowel disorder and Crohn's disease. This makes it difficult for doctors to diagnose the condition. Because of this, early symptoms can be mistaken as normal ailments, and can last for months or even years before a patient is given a mesothelioma diagnosis.<br><br>In addition to a thorough medical history, a doctor will run imaging and blood tests to rule out other diseases and conditions that could cause the same symptoms as mesothelioma. These tests can be used to determine the most effective treatment options.<br><br>A biopsy is carried out by a physician to confirm the diagnosis. This is because peritoneal msothelioma occurs in the abdominal liner. A biopsy is the process of removing small samples from the affected area to be examined by pathologists. Biopsies may reveal cancerous cells and identify the type of mesothelioma.<br><br>If a diagnosis of peritoneal cancer is confirmed doctors will discuss the options for treatment with the patient. The aim of any treatment plan is typically to decrease the size and number of tumors. Surgery is usually the first line of defense however, patients must also consider the possibility of immunotherapy and chemotherapy.<br><br>Contrary to chest-based treatments for pleural mesothelioma that are administered via the lung, the peritoneal mesothelioma treatment are injected orally or intravenously. Chemotherapies like injections, such as heated intraperitoneal chemotherapy (HIPEC), have helped to prolong the life of many patients. HIPEC was invented by mesothelioma expert Paul Sugarbaker.<br><br>Individuals with peritoneal asbestosis may be able to sue negligent asbestos companies. An experienced [http://bx02.com/home.php?mod=space&uid=393790 mesothelioma lawyer] can review a patient's case and suggest legal options. Contact us today to begin. Contact us today. It's completely free, confidential, and there's no obligation. We offer nationwide representation.<br><br>Prognosis<br><br>Mesothelioma cancer is rare. Because doctors aren't experienced, many patients are misdiagnosed with other illnesses. A mesothelioma expert can help patients with the diagnosis and ensure they receive the appropriate treatment.<br><br>Asbestos exposure is only the one known cause of peritoneal cancer. When asbestos fibers are breathed in or ingested, they can irritate abdominal tissues and cause cells to mutate. This may cause tumors to develop mesothelioma within the peritoneum over time.<br><br>Manufacturing or construction is often the first location where asbestos exposure begins. These industries could use products that contain asbestos, such as insulation and fireproofing. Asbestos may also be found in household products like roofing tiles and flooring. Even the smallest amount of asbestos exposure could cause a person to be at risk of mesothelioma. Because of the lengthy period of latency, victims may be diagnosed with peritoneal mesothelioma many decades after their initial exposure.<br><br>Peritoneal mesothelioma symptoms could be similar to those of other conditions and can be mistaken for a hernia gastrointestinal issues like colitis or Crohn's disease, or other forms of abdominal cancer. Many patients don't disclose their asbestos exposure, and do not seek medical care. If mesothelioma has been identified doctors may recommend a biopsy for a more precise diagnosis. A biopsy is the process of removing just a small portion of affected tissue for testing. This procedure can reveal the stage of mesothelioma as well as if it is epithelioid, biphasic or sarcomatoid.<br><br>If mesothelioma does not have spread and the doctors are able to remove the tumors. They will also offer a curative treatment. The doctor will also be able to determine whether the cancer has been able to spread to the abdomen. They will then recommend palliative treatments for the patient. For instance paracentesis, which is a procedure to drain fluid from the abdomen.<br><br>The outlook for patients is worse when a mesothelioma has progressed. The reason for this is that the tumors can become resistant to certain treatments and may recur. The doctor might suggest a combination of chemotherapy and surgery. Surgical options include cytoreduction surgery with hyperthermic intraperitoneal chemotherapy. This combination is more likely to improve a patient's outlook than chemotherapy alone.

Latest revision as of 13:05, 27 January 2025

Peritoneal Mesothelioma Asbestos Symptoms

The digestive system is often affected by the symptoms of mesothelioma peritoneal. This is because asbestos fibers get consumed and are absorbed into the lining of the stomach and peritoneum.

Over time, these fibers cause changes in healthy peritoneal cells. Cancerous tumors develop in the peritoneum as a result of.

The diagnosis of mesothelioma can be a challenge. The early signs can be similar to symptoms of other conditions like hernia or IBS.

Signs and symptoms

Asbestos fibers can travel through the body when inhaled. They can then get trapped in the lining of the abdomen or other organs, causing inflammation and irritation that can lead to the growth of tumors. This process can take decades to develop, and most sufferers are unaware the fact that they've been exposed to asbestos until it is too late.

Asbestos fibers may get caught in the tissue that lines the abdominal cavity or other organs, causing malignant peritoneal melanomas. It is the second most common form of mesothelioma. However it can be difficult for doctors to diagnose because the early symptoms are not specific. It is also possible that they are similar to gastrointestinal disorders. Patients with peritoneal mesothelioma frequently have stomach pain, fatigue, and digestive problems.

Mesothelioma patients are usually diagnosed with peritoneal cancer after having a physical exam, a medical history review and several laboratory tests. A CT scan or X-ray can aid in identifying lumps, or other indications of illness. In some instances, mesothelioma doctors will also require a biopsy to get a more precise diagnosis.

Peritoneal Mesothelioma symptoms typically begin in the abdomen and can cause extreme abdominal discomfort, bloating and weight loss. They may also cause nausea, vomiting, and other digestive issues. Other symptoms include chest pain, fatigue and swelling. When these symptoms occur, it is important that patients seek medical attention since they may be caused by other conditions.

Despite the difficulty in diagnosing peritoneal mesothelioma, victims can often receive the proper treatment to prolong their lives. In the majority of cases, this is done through surgical treatment and heated chemotherapy.

If you or a loved one have been diagnosed with peritoneal cancer, contact our mesothelioma lawyers to find out how we can assist. We can help you locate a mesothelioma attorneys expert near you who can assist you in filing a lawsuit against asbestos companies responsible for your exposure. We can also ensure you receive the financial settlement you deserve. Complete our online form to start the process. We can assist you to get the best possible outcome working with the best mesothelioma lawyers.

Diagnosis

To determine if you have peritoneal msothelioma it is important to have an extensive medical history. Doctors will ask the patient about their exposure to asbestos and when it happened. A physical exam will be conducted. Blood tests, X-rays, and CT scans are commonly utilized in the initial check-up.

Due to the lengthy period of latency, peritoneal mesothelioma can be difficult to diagnose. Patients may experience symptoms such as abdominal pain, nausea and fever that are similar to other illnesses. These symptoms that are not specific could confuse doctors. Mesothelioma, a rare cancer that can take years to show symptoms following exposure to asbestos, is a rare condition.

Inhaling or eating asbestos fibers move to the stomach lining known as the peritoneum. Asbestos fibers that are sharp can irritate mesothelium when they reach the peritoneum. This irritation can cause scar tissue and inflammation over time. Then, it leads to abnormal cell growth and tumors forming.

There are no FDA-approved screening tests for mesothelioma of the peritoneum, but researchers are working on finding ways to detect the disease in its earliest stages. The process of identifying mesothelioma's stage is crucial as it determines treatment options.

A mesothelioma doctor can perform a paracentesis procedure or percutaneous needle biopsy to take a sample of mesothelioma tumours for laboratory testing. These tests can reveal whether the cancerous cells are epithelioid (epithelioid), Sarcomatoid (sarcomatoid) or biphasic within the tumor. This information helps doctors create the treatment plan.

Mesothelioma specialists also evaluate a patient's stage of mesothelioma. The stage determines the most effective treatments and helps mesothelioma attorney lawyers; hop over to here, know which asbestos-related companies are responsible in mesothelioma cases.

When a mesothelioma expert reviews the results of the biopsy and creates a pathology record that contains information on the mesothelioma type. The report may also include a staging scale that indicates how far the cancer has spread across the body. The higher the stage, the less likely it is to respond to treatment. Lawyers can explain the implications of this to a particular client's case.

Treatment

Asbestos fibers are inhaled or eaten and then absorbed in the tissues lining the abdomen and other organs. These fibers damage DNA and cause irritation to cells. Over time, this leads to the development of tumors in the lining. Typically, peritoneal cancer develops in the lining of the abdomen. Peritoneal mesothelioma is less common than pleural mesothelioma and usually affects women more.

Symptoms of peritoneal mesothelioma are similar to those of gastrointestinal conditions like irritable bowel disorder and Crohn's disease. This makes it difficult for doctors to diagnose the condition. Because of this, early symptoms can be mistaken as normal ailments, and can last for months or even years before a patient is given a mesothelioma diagnosis.

In addition to a thorough medical history, a doctor will run imaging and blood tests to rule out other diseases and conditions that could cause the same symptoms as mesothelioma. These tests can be used to determine the most effective treatment options.

A biopsy is carried out by a physician to confirm the diagnosis. This is because peritoneal msothelioma occurs in the abdominal liner. A biopsy is the process of removing small samples from the affected area to be examined by pathologists. Biopsies may reveal cancerous cells and identify the type of mesothelioma.

If a diagnosis of peritoneal cancer is confirmed doctors will discuss the options for treatment with the patient. The aim of any treatment plan is typically to decrease the size and number of tumors. Surgery is usually the first line of defense however, patients must also consider the possibility of immunotherapy and chemotherapy.

Contrary to chest-based treatments for pleural mesothelioma that are administered via the lung, the peritoneal mesothelioma treatment are injected orally or intravenously. Chemotherapies like injections, such as heated intraperitoneal chemotherapy (HIPEC), have helped to prolong the life of many patients. HIPEC was invented by mesothelioma expert Paul Sugarbaker.

Individuals with peritoneal asbestosis may be able to sue negligent asbestos companies. An experienced mesothelioma lawyer can review a patient's case and suggest legal options. Contact us today to begin. Contact us today. It's completely free, confidential, and there's no obligation. We offer nationwide representation.

Prognosis

Mesothelioma cancer is rare. Because doctors aren't experienced, many patients are misdiagnosed with other illnesses. A mesothelioma expert can help patients with the diagnosis and ensure they receive the appropriate treatment.

Asbestos exposure is only the one known cause of peritoneal cancer. When asbestos fibers are breathed in or ingested, they can irritate abdominal tissues and cause cells to mutate. This may cause tumors to develop mesothelioma within the peritoneum over time.

Manufacturing or construction is often the first location where asbestos exposure begins. These industries could use products that contain asbestos, such as insulation and fireproofing. Asbestos may also be found in household products like roofing tiles and flooring. Even the smallest amount of asbestos exposure could cause a person to be at risk of mesothelioma. Because of the lengthy period of latency, victims may be diagnosed with peritoneal mesothelioma many decades after their initial exposure.

Peritoneal mesothelioma symptoms could be similar to those of other conditions and can be mistaken for a hernia gastrointestinal issues like colitis or Crohn's disease, or other forms of abdominal cancer. Many patients don't disclose their asbestos exposure, and do not seek medical care. If mesothelioma has been identified doctors may recommend a biopsy for a more precise diagnosis. A biopsy is the process of removing just a small portion of affected tissue for testing. This procedure can reveal the stage of mesothelioma as well as if it is epithelioid, biphasic or sarcomatoid.

If mesothelioma does not have spread and the doctors are able to remove the tumors. They will also offer a curative treatment. The doctor will also be able to determine whether the cancer has been able to spread to the abdomen. They will then recommend palliative treatments for the patient. For instance paracentesis, which is a procedure to drain fluid from the abdomen.

The outlook for patients is worse when a mesothelioma has progressed. The reason for this is that the tumors can become resistant to certain treatments and may recur. The doctor might suggest a combination of chemotherapy and surgery. Surgical options include cytoreduction surgery with hyperthermic intraperitoneal chemotherapy. This combination is more likely to improve a patient's outlook than chemotherapy alone.