A Markov chain model of cancer treatment

This paper develops and analyzes a Markov chain model for the treatment of cancer. Cancer therapy is modeled as the patients Markov Decision Problem, with the objective of maximizing the patients discounted expected quality of life years. Patients choose the number of treatment rounds they wish to administer based on the progression of the disease as well as their own preferences. We obtain a powerful analytic decision tool by which patients may select their preferred treatment strategy. In a second model patients may make choices on the timing of treatment rounds as well. By delaying a round of therapy the patient forgoes the gains of therapy for a time in order to delay its side effects. We obtain an analytic tool that allows numerical approximations of the optimal times of delay.