Choice of cancer treatment is
influenced by several factors,
including the specific
characteristics of your cancer; your
overall condition; and whether the
goal of treatment is to cure your
cancer, keep your cancer from
spreading, or to relieve the
symptoms caused by cancer. Depending
on these factors, you may receive
one or more of the following:
- Surgery -
Chemotherapy - Radiation
therapy - Hormonal therapy -
Targeted therapy -
Biological therapy
One or
more treatment modalities may be
used to provide you with the most
effective treatment. Increasingly,
it is common to use several
treatment modalities together
(concurrently) or in sequence with
the goal of preventing recurrence.
This is referred to as
multi-modality treatment of the
cancer.
Surgery
Surgery is used to diagnose
cancer, determine its stage, and to
treat cancer. One common type of
surgery that may be used to help
with diagnosing cancer is a biopsy.
A biopsy involves taking a tissue
sample from the suspected cancer for
examination by a specialist in a
laboratory. A biopsy is often
performed in the physician's office
or in an outpatient surgery center.
A positive biopsy indicates the
presence of cancer; a negative
biopsy may indicate that no cancer
is present in the sample. When
surgery is used for treatment, the
cancer and some tissue adjacent to
the cancer are typically removed. In
addition to providing local
treatment of the cancer, information
gained during surgery is useful in
predicting the likelihood of cancer
recurrence and whether other
treatment modalities will be
necessary.
Chemotherapy
Chemotherapy is any treatment
involving the use of drugs to kill
cancer cells. Cancer chemotherapy
may consist of single drugs or
combinations of drugs, and can be
administered through a vein,
injected into a body cavity, or
delivered orally in the form of a
pill. Chemotherapy is different from
surgery or radiation therapy in that
the cancer-fighting drugs circulate
in the blood to parts of the body
where the cancer may have spread and
can kill or eliminate cancers cells
at sites great distances from the
original cancer. As a result,
chemotherapy is considered a
systemic treatment. More than
half of all people diagnosed with
cancer receive chemotherapy. For
millions of people who have cancers
that respond well to chemotherapy,
this approach helps treat their
cancer effectively, enabling them to
enjoy full, productive lives.
Furthermore, many side effects once
associated with chemotherapy are now
easily prevented or controlled,
allowing many people to work,
travel, and participate in many of
their other normal activities while
receiving chemotherapy.
Radiation Therapy
Radiation therapy, or radiotherapy,
uses high-energy rays to damage or
kill cancer cells by preventing them
from growing and dividing. Similar
to surgery, radiation therapy is a
local treatment used to eliminate or
eradicate visible tumors. Radiation
therapy is not typically useful in
eradicating cancer cells that have
already spread to other parts of the
body. Radiation therapy may be
externally or internally delivered.
External radiation delivers
high-energy rays directly to the
tumor site from a machine outside
the body. Internal radiation, or
brachytherapy, involves the
implantation of a small amount of
radioactive material in or near the
cancer. Radiation may be used to
cure or control cancer, or to ease
some of the symptoms caused by
cancer. Sometimes radiation is used
with other types of cancer
treatment, such as chemotherapy and
surgery, and sometimes it is used
alone.
Hormonal Therapy
Hormones are naturally occurring
substances in the body that
stimulate the growth of hormone
sensitive tissues, such as the
breast or prostate gland. When
cancer arises in breast or prostate
tissue, its growth and spread may be
caused by the body's own hormones.
Therefore, drugs that block hormone
production or change the way
hormones work, and/or removal of
organs that secrete hormones, such
as the ovaries or testicles, are
ways of fighting cancer. Hormone
therapy, similar to chemotherapy, is
a systemic treatment in that it may
affect cancer cells throughout the
body.
Targeted Therapy
A
targeted therapy is one that is
designed to treat only the cancer
cells and minimize damage to normal,
healthy cells. Cancer treatments
that "target" cancer cells may offer
the advantage of reduced
treatment-related side effects and
improved outcomes. Conventional
cancer treatments, such as
chemotherapy and radiation therapy,
cannot distinguish between cancer
cells and healthy cells.
Consequently, healthy cells are
commonly damaged in the process of
treating the cancer, which results
in side effects. Chemotherapy
damages rapidly dividing cells, a
hallmark trait of cancer cells. In
the process, healthy cells that are
also rapidly dividing, such as blood
cells and the cells lining the mouth
and GI tract are also damaged.
Radiation therapy kills some healthy
cells that are in the path of the
radiation or near the cancer being
treated. Newer radiation therapy
techniques can reduce, but not
eliminate this damage.
Treatment-related damage to healthy
cells leads to complications of
treatment, or side effects. These
side effects may be severe, reducing
a patient's quality of life,
compromising their ability to
receive their full, prescribed
treatment, and sometimes, limiting
their chance for an optimal outcome
from treatment.
Biological Therapy
Biological therapy is referred to by
many terms, including immunologic
therapy, immunotherapy, or
biotherapy. Biological therapy is a
type of treatment that uses the
body's immune system to facilitate
the killing of cancer cells. Types
of biological therapy include
interferon, interleukin, monoclonal
antibodies, colony stimulating
factors (cytokines), and vaccines.
Personalized Cancer Care
There is no longer a
"one-size-fits-all" approach to
cancer treatment. Even among
patients with the same type of
cancer, the behavior of the cancer
and its response to treatment can
vary widely. By exploring the
reasons for this variation,
researchers have begun to pave the
way for more personalized cancer
treatment. It is becoming
increasingly clear that specific
characteristics of cancer cells and
cancer patients can have a profound
impact on prognosis and treatment
outcome. Although factoring these
characteristics into treatment
decisions makes cancer care more
complex, it also offers the promise
of improved outcomes.
The
idea of matching a particular
treatment to a particular patient is
not a new one. It has long been
recognized, for example, that
hormonal therapy for breast cancer
is most likely to be effective when
the breast cancer contains receptors
for estrogen and/or progesterone.
Testing for these receptors is part
of the standard clinical work-up of
breast cancer. What is new, however,
is the pace at which researchers are
identifying new tumor markers, new
tests, and new and more targeted
drugs that individualize cancer
treatment. Tests now exist that can
assess the likelihood of cancer
recurrence, the likelihood of
response to particular drugs, and
the presence of specific cancer
targets that can be attacked by new
anti-cancer drugs that directly
target individual cancer cells.
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