Treatment

Treatment options for cancer can include:

Leksell Gamma Knife In addition to the treatments listed above, cancer also may be treated by adjuvant therapy and prophylactic or preventive treatment. Adjuvant therapy combines two or more treatments. Prophylactic or preventive treatment is given even when the cancer has not appeared, or all the cancer is thought to have been removed, if there is a significant statistical risk that the cancer will reappear later.

Specific treatment for cancer will be determined by your physician(s) based on:

  • your overall health and medical history
  • extent of the disease -- type, grade, stage, and location
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The four goals of treatment are:

  • successful treatment
  • prevention of cancer recurrences
  • prolonged life
  • palliation

Palliation is treatment for a symptom of the cancer, such as pain. It is not a treatment for the cancer itself. The goal of palliation treatment is to improve the quality of life, not longevity.

Chemotherapy

Chemotherapy (also referred to as cyto-toxic therapy) is the use of anti-cancer drugs to treat cancerous cells. Chemotherapy reaches all part of the body, not just the cancer cells. The oncologist will recommend a treatment plan for each individual. Specific treatment will be based on:

  • your overall health and medical history
  • the type and stage of the cancer
  • your tolerance for specific medications and procedures
  • expectations for the course of the disease
  • your opinion or preference

The oncologist will also determine how long and how often you will have chemotherapy treatments. Chemotherapy can be administered intravenously (in the vein) or by pill, and is usually a combination of drugs. Chemotherapy treatments are often given in cycles; a treatment for a period of time, followed by a recovery period, then another treatment. Chemotherapy may be given in a variety of settings including your home, a hospital outpatient facility, a physician's office or clinic, or in a hospital.

Hormone Therapy

Some types of cancer thrive and grow because of hormones (estrogen and progesterone) that naturally occur in the body, while other types of cancer growth is slowed or suppressed by these same types of hormones. Hormone therapy as cancer treatment may involve:

  • removing the organ(s) that is the source of the hormone (such as the ovaries)
  • taking drugs that slow the growth of the endometrial cancer cells, such as a progesterone

Researchers are continually studying the risks and benefits of hormone therapy for the treatment of gynecological cancers, breast cancer, and prostate cancer.

Immunotherapy

Immunotherapy (also called biological therapy, biological response modifier therapy, or biotherapy) uses the body's immune system to fight cancer.

The cells, antibodies, and organs of the immune system work to protect or defend the body against foreign invaders, such as bacteria or viruses. Physicians and researchers found that the immune system may also be able to determine the difference between healthy cells and cancer cells in the body. It might then be used to eliminate the cancer cells.

Immune system cells that fight cancer include:


 

Lymphocytes

White blood cells, including B cells, T cells, and NK cells.

    • B cells - become plasma cells that make antibodies or immunoglobulins
    • T cells - produce cytokines, which control immune response
    • NK cells - produce chemical substances that bind to and kill foreign invaders in the body
Monocytes

White blood cells that move into tissues and develop into macrophages, which, when needed, play a role in phagocytosis. Phagocytosis is a process in which some cells "eat" other cells or foreign invaders.


 

Biological Response Modifier (BRM) Therapy

Biological Response Modifiers or BRM's are substances that occur naturally in the body, such as cytokines or antibodies. They assist the body in fighting disease. BRMs can also be made in the laboratory. These created BRMs directly inhibit tumor cell growth, as well as assist the healthy cells in controlling the cancer. They have been successfully used in combination with each other and with other treatments. Some BRMs include:

  • interferons (IFNs)
  • interleukins (ILs)
  • tumor necrosis factors (TNFs)
  • colony-stimulating factors (CSFs)
  • monoclonal antibodies (MAOBs)
  • cancer vaccines

Radiation Therapy

Therapeutic radiology (also called radiation oncology) is the treatment of cancer and other diseases with radiation. High energy x-rays are used to kill the cancer cells by preventing them from multiplying. Therapeutic radiology may be used to cure or control cancer, or to alleviate some of the symptoms associated with cancer.

The level of radiation will be determined by the radiation oncologist based on the type of cancer, location of the tumor, and sensitivity of the surrounding tissue. Although each hospital may have specific protocols in place, generally, radiation oncology procedures follow this process:


 

Simulation

To help set up the actual treatment, the treatment team first "maps" out the position the patient will be in for each treatment with the aid of molds, headrests, or other devices. Sometimes the area on the body to be treated will be marked to ensure the radiation will be given in the exact area. In addition, special shields may be made to help focus the radiation and protect surrounding tissue.


 

Treatment Plan

Once the simulation has taken place, the radiation oncologist will determine the exact type of treatment.

Examples of types of radiation therapy used to destroy cancerous tissue include:

  • External Beam Therapy
  • Brachytherapy
  • Intensity Modulated Radiation Therapy (IMRT)

Brachytherapy

Brachytherapy is radiation treatment inside the patient, as close to the cancer as possible. The radiation is delivered inside the body with isotopes (chemical elements) such as wires, seeds, or rods.

Brachytherapy is often used in the treatment of cervical, uterine, vaginal, or rectal cancer, as well as eye and certain head and neck cancers. However, the therapy may also used to treat many other cancers.

There are two types of brachytherapy:


 

Intracavitary Treatment

Containers that hold radioactive sources are put in or near the tumor through body cavities such as the vagina, uterus, or windpipe.


 

Interstitial Treatment

The radioactive sources alone are put into the tumor and may stay in the patient permanently.

General anesthesia may be used during the insertion of brachytherapy sources.

Sometimes brachytherapy is done in combination with external beam therapy to help destroy the main mass of tumor cells.

Surgery

According to the American Cancer Society, 60 percent of people with cancer have some type of surgery.

Surgery is used in cancer treatment for several purposes:

 
Preventive

To remove tissue that does not yet contain cancer cells, but has the probability of becoming cancerous in the future. This may also be referred to as prophylactic surgery.

Diagnostic

To remove samples of tissue from a suspicious area for testing and evaluation (in a laboratory by a pathologist) to confirm a diagnosis, identify the type of cancer, or determine the stage of the cancer.

Curative

To remove or destroy cancerous tissue, which may include removal of some tissue around the tumor and nearby lymph nodes.

 

Surgery may also be performed for:

 

Palliative Purposes

To relieve discomfort.

Supportive Purposes

To allow for placement of a device that will aid in the delivery of medications.

Restorative or Reconstructive Purposes

To repair or replace damaged or destroyed areas of the body.

 

Examples of types of surgical procedures used to diagnose or destroy cancerous tissue include:

 

Biopsy

Removal of sample of tissue via a hollow needle or scalpel.

Endoscopy

Use of a very flexible tube with a lens or camera (and a light on the end), which is connected to a computer screen, allowing the physician to see inside the hollow organs, such as the uterus. Biopsy samples can be taken through the tube.

Laparoscopy

Use of a viewing tube with a lens or camera (and a light on the end), which is inserted through a small incision in the abdomen to examine the contents of the abdomen and remove tissue samples.

For some procedures the use of a (da Vinci) Robot Assisted Surgical System, may also be used

Laparotomy

A surgical procedure that involves an incision from the upper to lower abdomen; often used when making a diagnosis by less invasive tests is difficult.

Laser Surgery

Use of a powerful beam of light, which can be directed to specific parts of the body without making a large incision, to destroy abnormal cells.

Cryosurgery

Use of liquid nitrogen, or a probe that is very cold, to freeze and kill cancer cells.

Electrosurgery

Use of high-frequency electrical currents to destroy cancer cells.

Excisional

Cutting away cancerous tissue with a scalpel or other instruments to completely remove it and possibly some surrounding tissue. There are many types of excisional surgeries, each named for the particular area of the body in which they are performed, or the particular purpose for which they are performed.

Nuclear Medicine

Nuclear Medicine is an imaging modality that uses radioactive isotopes that are introduced into the body and allow images to be produced with specialized cameras. Nuclear Medicine focuses on the functional processes of your body to obtain the images, where as other imaging modalities such as CAT scan and MRI focus on the anatomy of the body.

Nuclear Medicine is an imaging modality that uses radioactive isotopes that are introduced into the body and allow images to be produced with specialized cameras.  Nuclear Medicine focuses on the functional processes of your body to obtain the images, where as other imaging modalities such as CAT scan and MRI focus on the anatomy of the body.

 
 
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