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Peritoneal Mesothelioma Asbestos Symptoms<br><br>The digestive system is often affected by the symptoms of peritoneal mesothelioma. This is due to asbestos fibers being consumed and then absorbed within the lining of your stomach, known as the peritoneum.<br><br>Over time, these fibres cause mutations to healthy peritoneal cells. In the end, cancerous tumors form in the peritoneum.<br><br>The diagnosis of mesothelioma can be a bit difficult. The initial signs may resemble symptoms of other conditions like hernia, or irritable bowel syndrome.<br><br>Symptoms<br><br>Asbestos fibers can move through the body when breathed. The fibers may then become trapped in the linings of the abdomen and other organs. This can cause inflammation and irritation that can lead to the development of tumors. The process can take years to develop, and a lot of sufferers are unaware that they are exposed to asbestos until it is too late.<br><br>Malignant peritoneal [http://yd.yichang.cc/home.php?mod=space&uid=1018833 mesothelioma lawsuit] is a condition that occurs asbestos fibers get trapped in the tissues that line the abdominal cavity as well as other organs. It is the second most frequent type of [http://gtrade.cc/home.php?mod=space&uid=621469 Mesothelioma lawsuit], but it is difficult to recognize because the early symptoms are nonspecific and similar to symptoms of gastrointestinal diseases. Patients with peritoneal cancer frequently suffer from stomach pain, fatigue and gastrointestinal problems.<br><br>Mesothelioma sufferers are usually diagnosed with peritoneal cancer after undergoing a physical examination, a medical history review and an array of laboratory tests. A X-ray and a CT scan can help doctors identify any lumps or other signs of disease. In some instances, mesothelioma doctors will also request a biopsy for an accurate diagnosis.<br><br>Peritoneal mesothelioma symptoms typically begin in the abdomen and can lead to severe abdominal pain as well as bloating, weight loss, swelling of the belly nausea, vomiting, and other digestive issues. Other symptoms include chest pain, fatigue and swelling. When these symptoms occur it is essential that patients seek medical attention since they may be caused by other conditions.<br><br>Despite the difficulty in diagnosing peritoneal msothelioma patients, they can often receive the right treatment to prolong their lives. In the majority of cases, this requires surgery and heated chemotherapy.<br><br>If you or a loved one have been diagnosed with peritoneal mesothelioma, call our mesothelioma lawyers to learn what we can do to help. We can connect you to a mesothelioma specialist near you, who can assist you in filing a lawsuit against the asbestos companies responsible for your exposure. We can also assist you in ensuring that you receive the financial compensation that you deserve. Fill out our online form to start the process. We have a strong relationship with mesothelioma lawyers and can help you secure the best possible outcome.<br><br>Diagnosis<br><br>To determine if you have peritoneal msothelioma it is crucial to have a a complete medical history. Doctors will ask about the person's exposure asbestos and the time it occurred. They may also conduct a physical exam. Blood tests, X-rays, and CT scans are commonly utilized in the initial check-up.<br><br>Due to the lengthy latency period, peritoneal mesothelioma is often difficult to identify. Patients may experience symptoms like abdominal discomfort, nausea, and fever that are similar to other conditions. These nonspecific symptoms can cause confusion for doctors. Mesothelioma is a rare cancer that can take years to show symptoms after asbestos exposure, is a rare condition.<br><br>Asbestos fibers inhaled or consumed move into the stomach lining known as the peritoneum. Once in the peritoneum, the sharp asbestos fibers cause irritation to the mesothelium. Over time the irritation causes inflammation and scar tissue growth. Eventually, this leads to abnormal cell growth and tumors forming.<br><br>There are no FDA-approved screening tests for mesothelioma of the peritoneum, however, researchers are finding ways to detect the disease in its early stages. The process of identifying mesothelioma's stage is crucial as it will determine the treatment options.<br><br>A mesothelioma specialist can perform a paracentesis procedure or percutaneous needle biopsy to take a sample of mesothelioma tumors to be tested in the lab. These tests can reveal the kind of cancer cells (epithelioid, sarcomatoid or biphasic) within the tumor and help doctors come up with an appropriate treatment strategy.<br><br>Mesothelioma specialists also evaluate a patient's stage of mesothelioma. It determines which treatment options will be most effective and also helps [http://freeok.cn/home.php?mod=space&uid=6399230 mesothelioma attorneys] know which asbestos-related companies to sue in [https://nativ.media:443/wiki/index.php?vaultatm6 mesothelioma lawsuits].<br><br>A mesothelioma specialist examines the results of a biopsy, they produce an a pathology report which contains details about the type of mesothelioma. The report may also include an assessment system that outlines how far the cancer has spread within the body. The more advanced the stage is, the less likely it is to respond to treatment. Lawyers can explain the significance of this in a client's situation.<br><br>Treatment<br><br>When inhaled or swallowed asbestos fibers are embedded in the tissues that line the abdomen and other organs. These fibers damage DNA and irritate cells. This can lead to the development of tumors. Typically, peritoneal cancer develops in the lining that covers the abdomen. Peritoneal Mesothelioma affects more women than pleural Mesothelioma however, it is less prevalent.<br><br>The symptoms of peritoneal cancer are similar to those associated with digestive disorders like Crohn's and irritable bowel disease which makes it difficult for doctors to recognize. Because of this, early symptoms can be mistaken as normal ailments and may last for months or years before a patient is diagnosed with a mesothelioma diagnosis.<br><br>In addition to a thorough medical history, a doctor will conduct bloodwork and imaging tests to rule out other diseases and conditions that may cause the same symptoms as mesothelioma. These tests can help to determine the best treatment options.<br><br>A biopsy is carried out by a doctor to confirm the diagnosis. This is because peritoneal msothelioma occurs in the abdominal lining. A biopsy involves the removal of small amounts of tissue from the affected area to be examined by pathologists. Biopsies can reveal cancerous cells, and can determine the type of Mesothelioma.<br><br>Once a peritoneal mesothelioma diagnosis has been established doctors will discuss options for treatment with the patient. The purpose of any treatment plan is typically to decrease the size and the number of tumors. Surgery is usually the first line of defense, however, patients should also talk about the possibility of immunotherapy and chemotherapy.<br><br>Unlike the chest-based treatments for pleural mesothelioma that are administered via the lung, peritoneal mesothelioma treatments are administered either intravenously or orally. Chemotherapies like injections, such as heated intraperitoneal chemotherapy (HIPEC) have helped to prolong the life of many patients. HIPEC is a method that was invented by mesothelioma pioneer Paul Sugarbaker.<br><br>Individuals suffering from peritoneal cancer could 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 get started. It's completely no cost, it's confidential and there is no commitment. We offer nationwide representation.<br><br>Prognosis<br><br>Mesothelioma cancer is rare. Because doctors lack experience with the disease, many patients are misdiagnosed with other diseases. A mesothelioma expert can assist patients to diagnose the disease and ensure they receive appropriate treatment.<br><br>Asbestos exposure is the only known cause of peritoneal mesthelioma. Asbestos fibers can cause irritation of abdominal tissues and cell mutations when consumed or inhaled. As time passes, this could result in tumors that develop into a mesothelioma of the peritoneum.<br><br>The exposure to asbestos usually starts with working in manufacturing or construction. These industries can utilize asbestos-containing materials, such as fireproofing and insulation. Asbestos is also found in household products, such as roof tiles and flooring. Even very low levels of exposure can put someone at risk for mesothelioma. Due to the long latency period of the disease patients may be diagnosed with peritoneal mesothelioma several decades after their initial exposure.<br><br>Peritoneal mesothelioma symptoms can resemble those of other diseases and could be mistaken for a hernia digestive problems such as colitis or Crohn's disease, or other forms of abdominal cancer. A lot of patients do not disclose their asbestos exposure, and do not seek medical care. When mesothelioma is detected experts may suggest a biopsy for a more accurate diagnosis. A biopsy involves removing just a small portion of affected tissue for testing. This procedure will reveal the stage of mesothelioma and whether it is epithelioid biphasic, or sarcomatoid.<br><br>If mesothelioma has reached an early stage, doctors can remove all the tumors and provide an effective treatment. The doctor will also be able to determine whether the cancer has been able to spread to the abdomen. They can then prescribe palliative treatments for the patient. For example paracentesis, which is a procedure to drain fluid from the abdomen.<br><br>The prognosis is worsened when a mesothelioma has advanced. The reason for this is that the tumors can become resistant to certain treatments, and they may be recurred. The doctor might suggest a combination of surgery and chemotherapy. Surgery options include cytoreduction with hyperthermic intraperitoneal chemotherapy. This combination is more likely than chemotherapy alone to improve the prognosis for a patient.
Peritoneal Mesothelioma Asbestos Symptoms<br><br>Peritoneal mesothelioma asbestos symptoms often affect the digestive system. This is due to asbestos fibers being inhaled and then become a part of the lining of the stomach, called the peritoneum.<br><br>Over time the fibers cause mutations in healthy peritoneal cells. In the end tumors that are cancerous develop in the peritoneum.<br><br>Mesothelioma is a challenging condition to identify. Early signs can be confused with symptoms of other conditions like hernias, or irritable Bowel syndrome.<br><br>Signs and symptoms<br><br>When asbestos fibers are inhaled they can enter the lungs and travel throughout the body. The fibers may then become trapped in the linings the abdomen and other organs. This can cause inflammation and irritation that leads to tumor development. The process can take years to develop and many patients are unaware of their asbestos exposure until it's too late.<br><br>Malignant peritoneal mesothelioma is a condition that occurs asbestos fibers get trapped in the tissues that line the abdominal cavity as well as other organs. It is the second most frequent mesothelioma type, however it can be difficult to identify because the initial symptoms aren't specific and are similar to those of gastrointestinal conditions. Patients suffering from peritoneal mesothelioma typically have stomach pain, fatigue and gastrointestinal issues.<br><br>After a physical examination followed by reviewing medical history, and a series of laboratory tests, [http://www.nzdao.cn/home.php?mod=space&uid=468430 mesothelioma lawyer] patients are diagnosed with peritoneal cancer. A CT scan and an X-ray may help doctors identify lumps or other signs of disease. In some instances mesothelioma specialists may also order a biopsy to obtain an accurate diagnosis.<br><br>Peritoneal mesothelioma symptoms typically start in the abdominal region and can cause severe abdominal discomfort and weight loss, bloating, stomach fluid accumulation nausea, vomiting, and other digestive problems. Other symptoms include fatigue, chest pain and swelling. If symptoms like these occur it is essential to seek medical attention because they may be caused by other ailments.<br><br>Despite the difficulty in diagnosing peritoneal msothelioma patients can often receive the right treatment to prolong their lives. In the majority of cases, treatment involves surgery and chemo treatment that is heated.<br><br>Contact our mesothelioma lawyers today to learn more about how we can help you if a family member has been diagnosed with peritoneal mesothelioma. We can assist you in finding an expert in mesothelioma near you who can assist you in filing an asbestos lawsuit against asbestos-related companies responsible for your exposure. We can also help ensure that you receive the financial settlement you're entitled to. Complete our online form to begin the process. We can assist you to get the best possible outcome by working with the top mesothelioma lawyers.<br><br>Diagnosis<br><br>The first step in diagnosing mesothelioma of the peritoneal region is to collect an accurate medical history. Doctors will ask about the person's exposure asbestos and when it happened. A physical examination will be conducted. X-rays, blood tests and CT scans are typically used in the initial work-up.<br><br>Because of the long period of latency, peritoneal mesothelioma is often difficult to identify. Patients may experience symptoms such as abdominal pain, nausea and fever that are similar to other conditions. These nonspecific symptoms may cause confusion for doctors. Mesothelioma is a rare cancer, and it can take years before symptoms show up after asbestos exposure.<br><br>Asbestos fibers inhaled, or consumed are transported to the stomach lining, known as the peritoneum. Asbestos fibers are sharp and irritate mesothelium once they reach the peritoneum. This irritation can cause scar tissue and inflammation over time. This leads to abnormal cell growth and tumors.<br><br>Researchers are working to develop 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 specialist can perform a paracentesis procedure or percutaneous needle biopsy to collect a sample of mesothelioma tumors for lab testing. These tests can identify the type of cancer cells (epithelioid or sarcomatoid) within the tumor and help doctors develop the best treatment plan.<br><br>Mesothelioma specialists also evaluate the mesothelioma stage of a patient. It determines which treatment options will be most effective and helps mesothelioma lawyers know which asbestos-related companies to sue in mesothelioma lawsuits.<br><br>When a mesothelioma expert analyzes the results of a biopsy, he or she creates a pathology record that contains information on the type mesothelioma. The report could also include the staging scale, which indicates how far the cancer has spread across the body. The higher the stage of cancer is, the less likely the patient is to respond to treatment. Lawyers can explain the significance of this for the client's case.<br><br>Treatment<br><br>Asbestos fibers are inhaled or ingested and become embedded in the tissue lining the abdomen and other organs. They damage DNA and irritate cells. This can lead to the development of tumors. Typically, peritoneal mesothelioma forms in the abdomen's lining known as the peritoneum. Peritoneal mesothelioma is less common than pleural mesothelioma, and typically affects women more.<br><br>The symptoms of peritoneal cancer are similar to symptoms of gastrointestinal diseases like irritable bowel syndrome and Crohn's disease, which makes it difficult for doctors to identify the condition. Early symptoms can be mistaken for other ailments and can last for months or even years before mesothelioma is identified.<br><br>In addition to an extensive medical history, a physician will perform imaging and blood tests to rule out other diseases and conditions that may cause the same symptoms as mesothelioma. These tests will help to determine the best treatment options.<br><br>A biopsy is conducted by a doctor to confirm the diagnosis. This is because peritoneal Msothelioma can be found in the abdominal lining. A biopsy involves the removal of small amounts of the affected area for examination by pathologists. Biopsies may reveal cancerous cells and identify the type of mesothelioma.<br><br>If a peritoneal msothelioma has been confirmed doctors will discuss treatment options with patients. The goal of any treatment plan is typically to decrease the size and quantity of tumors. Surgery is often the first option, but patients may also consider chemotherapy and immunotherapy.<br><br>In contrast to chest-based therapies for pleural [https://lamm-cooper.hubstack.net/attorney-for-mesothelioma-tips-from-the-top-in-the-business/ Mesothelioma Lawsuit], which are administered through the lungs, peritoneal mesothelioma treatments are injected orally or intravenously. Injections of chemotherapy, such as heated intraperitoneal therapy (HIPEC), helped extend survival for many patients. HIPEC is a technique that was developed by mesothelioma pioneer Paul Sugarbaker.<br><br>Individuals with peritoneal asbestosis may be able to bring a lawsuit against negligent asbestos companies. A [https://infozillon.com/user/porchflute9/ mesothelioma attorney] can review the case of a patient and suggest legal options. Contact us today to get started. 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 with the disease, many patients are misdiagnosed as having other illnesses. Fortunately [https://tawassol.univ-tebessa.dz/index.php?qa=user&qa_1=kenyadragon4 mesothelioma lawsuit] specialists can help with the diagnostic process and help patients receive the right treatment.<br><br>Asbestos exposure is the sole known cause of peritoneal mesothelioma. Asbestos fibers can cause irritation to abdominal tissues as well as cell mutations when inhaled or consumed. This may cause tumors to form mesothelioma in the peritoneum in time.<br><br>The exposure to asbestos usually starts with jobs in manufacturing or construction. These industries may use asbestos-containing materials like fireproofing and insulation. Asbestos is also found in household products, such as roof tiles and flooring. Even low levels of exposure to asbestos can cause a person to be at risk of mesothelioma. Because the disease has an extended latency period patients may be diagnosed with peritoneal mesothelioma years after their initial exposure.<br><br>Peritoneal mesothelioma symptoms can be similar to those of other diseases and could be mistaken for a hernia, digestive problems such as colitis or Crohn's disease, or other types of abdominal cancer. This is why many patients don't report their exposure to asbestos, and they don't seek medical care. A biopsy may be recommended by a specialist to confirm a diagnosis of mesothelioma. A biopsy involves the removal of only a small amount of affected tissue for testing. This test can determine whether the mesothelioma has epithelioid (epidermoid) or the sarcomatoid (sarcomatoid) or biphasic.<br><br>If the mesothelioma is at an early stage, doctors can remove all of the tumors and provide the best treatment. The specialist can also determine whether the cancer has expanded to the abdomen. They may then recommend palliative treatment for the patient, such as paracentesis to drain the fluid from the abdomen.<br><br>If mesothelioma progresses the chances of survival are less. The tumors could become resistant to certain treatments and then recur. The doctor might suggest a combination of chemotherapy and surgery. Options for surgery include cytoreduction and hyperthermic intraperitoneal chemo. This combination is more likely to improve a patient's outlook than chemotherapy alone.

Revision as of 05:51, 27 December 2024

Peritoneal Mesothelioma Asbestos Symptoms

Peritoneal mesothelioma asbestos symptoms often affect the digestive system. This is due to asbestos fibers being inhaled and then become a part of the lining of the stomach, called the peritoneum.

Over time the fibers cause mutations in healthy peritoneal cells. In the end tumors that are cancerous develop in the peritoneum.

Mesothelioma is a challenging condition to identify. Early signs can be confused with symptoms of other conditions like hernias, or irritable Bowel syndrome.

Signs and symptoms

When asbestos fibers are inhaled they can enter the lungs and travel throughout the body. The fibers may then become trapped in the linings the abdomen and other organs. This can cause inflammation and irritation that leads to tumor development. The process can take years to develop and many patients are unaware of their asbestos exposure until it's too late.

Malignant peritoneal mesothelioma is a condition that occurs asbestos fibers get trapped in the tissues that line the abdominal cavity as well as other organs. It is the second most frequent mesothelioma type, however it can be difficult to identify because the initial symptoms aren't specific and are similar to those of gastrointestinal conditions. Patients suffering from peritoneal mesothelioma typically have stomach pain, fatigue and gastrointestinal issues.

After a physical examination followed by reviewing medical history, and a series of laboratory tests, mesothelioma lawyer patients are diagnosed with peritoneal cancer. A CT scan and an X-ray may help doctors identify lumps or other signs of disease. In some instances mesothelioma specialists may also order a biopsy to obtain an accurate diagnosis.

Peritoneal mesothelioma symptoms typically start in the abdominal region and can cause severe abdominal discomfort and weight loss, bloating, stomach fluid accumulation nausea, vomiting, and other digestive problems. Other symptoms include fatigue, chest pain and swelling. If symptoms like these occur it is essential to seek medical attention because they may be caused by other ailments.

Despite the difficulty in diagnosing peritoneal msothelioma patients can often receive the right treatment to prolong their lives. In the majority of cases, treatment involves surgery and chemo treatment that is heated.

Contact our mesothelioma lawyers today to learn more about how we can help you if a family member has been diagnosed with peritoneal mesothelioma. We can assist you in finding an expert in mesothelioma near you who can assist you in filing an asbestos lawsuit against asbestos-related companies responsible for your exposure. We can also help ensure that you receive the financial settlement you're entitled to. Complete our online form to begin the process. We can assist you to get the best possible outcome by working with the top mesothelioma lawyers.

Diagnosis

The first step in diagnosing mesothelioma of the peritoneal region is to collect an accurate medical history. Doctors will ask about the person's exposure asbestos and when it happened. A physical examination will be conducted. X-rays, blood tests and CT scans are typically used in the initial work-up.

Because of the long period of latency, peritoneal mesothelioma is often difficult to identify. Patients may experience symptoms such as abdominal pain, nausea and fever that are similar to other conditions. These nonspecific symptoms may cause confusion for doctors. Mesothelioma is a rare cancer, and it can take years before symptoms show up after asbestos exposure.

Asbestos fibers inhaled, or consumed are transported to the stomach lining, known as the peritoneum. Asbestos fibers are sharp and irritate mesothelium once they reach the peritoneum. This irritation can cause scar tissue and inflammation over time. This leads to abnormal cell growth and tumors.

Researchers are working to develop 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 specialist can perform a paracentesis procedure or percutaneous needle biopsy to collect a sample of mesothelioma tumors for lab testing. These tests can identify the type of cancer cells (epithelioid or sarcomatoid) within the tumor and help doctors develop the best treatment plan.

Mesothelioma specialists also evaluate the mesothelioma stage of a patient. It determines which treatment options will be most effective and helps mesothelioma lawyers know which asbestos-related companies to sue in mesothelioma lawsuits.

When a mesothelioma expert analyzes the results of a biopsy, he or she creates a pathology record that contains information on the type mesothelioma. The report could also include the staging scale, which indicates how far the cancer has spread across the body. The higher the stage of cancer is, the less likely the patient is to respond to treatment. Lawyers can explain the significance of this for the client's case.

Treatment

Asbestos fibers are inhaled or ingested and become embedded in the tissue lining the abdomen and other organs. They damage DNA and irritate cells. This can lead to the development of tumors. Typically, peritoneal mesothelioma forms in the abdomen's lining known as the peritoneum. Peritoneal mesothelioma is less common than pleural mesothelioma, and typically affects women more.

The symptoms of peritoneal cancer are similar to symptoms of gastrointestinal diseases like irritable bowel syndrome and Crohn's disease, which makes it difficult for doctors to identify the condition. Early symptoms can be mistaken for other ailments and can last for months or even years before mesothelioma is identified.

In addition to an extensive medical history, a physician will perform imaging and blood tests to rule out other diseases and conditions that may cause the same symptoms as mesothelioma. These tests will help to determine the best treatment options.

A biopsy is conducted by a doctor to confirm the diagnosis. This is because peritoneal Msothelioma can be found in the abdominal lining. A biopsy involves the removal of small amounts of the affected area for examination by pathologists. Biopsies may reveal cancerous cells and identify the type of mesothelioma.

If a peritoneal msothelioma has been confirmed doctors will discuss treatment options with patients. The goal of any treatment plan is typically to decrease the size and quantity of tumors. Surgery is often the first option, but patients may also consider chemotherapy and immunotherapy.

In contrast to chest-based therapies for pleural Mesothelioma Lawsuit, which are administered through the lungs, peritoneal mesothelioma treatments are injected orally or intravenously. Injections of chemotherapy, such as heated intraperitoneal therapy (HIPEC), helped extend survival for many patients. HIPEC is a technique that was developed by mesothelioma pioneer Paul Sugarbaker.

Individuals with peritoneal asbestosis may be able to bring a lawsuit against negligent asbestos companies. A mesothelioma attorney can review the case of a patient and suggest legal options. Contact us today to get started. 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 with the disease, many patients are misdiagnosed as having other illnesses. Fortunately mesothelioma lawsuit specialists can help with the diagnostic process and help patients receive the right treatment.

Asbestos exposure is the sole known cause of peritoneal mesothelioma. Asbestos fibers can cause irritation to abdominal tissues as well as cell mutations when inhaled or consumed. This may cause tumors to form mesothelioma in the peritoneum in time.

The exposure to asbestos usually starts with jobs in manufacturing or construction. These industries may use asbestos-containing materials like fireproofing and insulation. Asbestos is also found in household products, such as roof tiles and flooring. Even low levels of exposure to asbestos can cause a person to be at risk of mesothelioma. Because the disease has an extended latency period patients may be diagnosed with peritoneal mesothelioma years after their initial exposure.

Peritoneal mesothelioma symptoms can be similar to those of other diseases and could be mistaken for a hernia, digestive problems such as colitis or Crohn's disease, or other types of abdominal cancer. This is why many patients don't report their exposure to asbestos, and they don't seek medical care. A biopsy may be recommended by a specialist to confirm a diagnosis of mesothelioma. A biopsy involves the removal of only a small amount of affected tissue for testing. This test can determine whether the mesothelioma has epithelioid (epidermoid) or the sarcomatoid (sarcomatoid) or biphasic.

If the mesothelioma is at an early stage, doctors can remove all of the tumors and provide the best treatment. The specialist can also determine whether the cancer has expanded to the abdomen. They may then recommend palliative treatment for the patient, such as paracentesis to drain the fluid from the abdomen.

If mesothelioma progresses the chances of survival are less. The tumors could become resistant to certain treatments and then recur. The doctor might suggest a combination of chemotherapy and surgery. Options for surgery include cytoreduction and hyperthermic intraperitoneal chemo. This combination is more likely to improve a patient's outlook than chemotherapy alone.