Therapy

Therapy (often abbreviated tx or Tx) is the attempted remediation of a health problem, usually following a diagnosis. In the medical field, it is synonymous with treatment (also abbreviated tx). Among psychologists and other mental health professionals including psychiatrists, psychiatric nurse practitioners, and clinical social workers, the term may refer specifically to psychotherapy or talking therapies. The English word therapy comes via Latin therapīa from Greek: θεραπεία and literally means "curing" or "healing".

As a rule, each therapy has indications and contraindications.

Types of therapies

By therapy composition

Treatments can be classified according to the method of treatment:

by matter

• by drug: pharmacotherapy, chemotherapy, mesotherapy
• by medical device
• by gene: gene therapy
• by gold: chrysotherapy (aurotherapy)
• by hormone: hormone therapy
• by organism: biotherapy
  • by virus: virotherapy
  • by bacteriophage: phage therapy
  • by maggot: maggot therapy
• by ozone: ozonotherapy
• by salt: speleotherapy
• by serum: serotherapy
• by smell: aromatherapy
• by water: hydrotherapy
• by plants: phytotherapy

by energy

• by electric energy
  • by electricity: electrotherapy
  • by electromagnetic radiation: electromagnetic therapy
  • by magnetic energy: magnet therapy
• by light: phototherapy
• by mechanical: manual therapy as massotherapy and therapy by exercise as in physiotherapy
  • by sound: cymatic therapy, music therapy
• by radiation: radiotherapy
• by temperature
  • by heat: thermotherapy
  • by cold: cryotherapy

by human interaction

• by counseling, such as psychotherapy
• by education
  • by psychoeducation
  • by information therapy
• by physical therapy/occupational therapy, massage therapy, or acupuncture
• by lifestyle modifications, such as avoiding unhealthy food or maintaining a predictable sleep schedule
• by coaching

by animal interaction

• by fish: ichthyotherapy
• by horse: equine therapy, hippotherapy

by meditation

meditative therapy, mindfulness

by reading

• by bibliotherapy

By chronology or priority (lines of therapy)

Treatment decisions often follow formal or informal algorithmic guidelines. Treatment options can often be ranked or prioritized into lines of therapy: first-line therapy, second-line therapy, third-line therapy, and so on. First-line therapy (sometimes called induction therapy, primary therapy, or front-line therapy) is the first therapy that will be tried. Its priority over other options is usually either (1) formally recommended on the basis of clinical trial evidence for its best-available combination of efficacy, safety, and tolerability or (2) chosen based on the clinical experience of the physician. If a first-line therapy either fails to resolve the issue or produces intolerable side effects, additional (second-line) therapies may be substituted or added to the treatment regimen, followed by third-line therapies, and so on.

An example of a context in which the formalization of treatment algorithms and the ranking of lines of therapy is very extensive is chemotherapy regimens. Because of the great difficulty in successfully treating some forms of cancer, one line after another may be tried. In oncology the count of therapy lines may reach 10 or even 20.

Often multiple therapies may be tried simultaneously (combination therapy or polytherapy). Thus combination chemotherapy is also called polychemotherapy, whereas chemotherapy with one agent at a time is called single-agent therapy or monotherapy.

By treatment intent

• A preventive therapy or prophylactic therapy is a treatment that is intended to prevent a medical condition from occurring. For example, many vaccines prevent infectious diseases.
• An abortive therapy is a treatment that is intended to stop a medical condition from progressing any further. A medication taken at the earliest signs of a disease, such as at the very symptoms of a migraine headache, is an abortive therapy.
• A consolidation therapy is one given to consolidate the gains from induction therapy. In cancer, this means chasing after any malignant cells that may be left.
• A maintenance therapy is one taken during disease remission to prevent relapse.
• A supportive therapy (such as supportive psychotherapy) is one that does not treat or improve the underlying condition, but instead increases the patient's comfort. Supportive therapy may be palliative therapy (palliative care). Therapy may be categorized as having curative intent (when it is possible to eliminate the disease) or palliative intent (when eliminating the disease is impossible and the focus shifts to minimizing the distress that it causes).
• A salvage therapy is a therapy tried after others have failed; it may be a "last-line" therapy.
• An investigational therapy is an experimental one. Use of experimental therapies must be ethically justified, because by definition they raise the question of standard of care. Physicians have autonomy to provide empirical care (such as off-label care) according to their experience and clinical judgment, but the autonomy has limits that preclude quackery. Thus it may be necessary to design a clinical trial around the new therapy and to use the therapy only per a formal protocol. Sometimes shorthand phrases such as "treated on protocol" imply not just "treated according to a plan" but specifically "treated with investigational therapy".