TREATMENT
We provide each patient with an individualized treatment plan, carefully factoring in the all the specific variables; including the type of cancer, the age and overall condition of the patient and the overall goal of treatment. This complex approach has a profound impact on outcome.
Cancer treatment involves different modalities (surgery, radiation therapy and medical management) directed at destroying cancer cells in different parts of the body. One or more modalities may be used together (concurrently) or in sequence to achieve the desired goal. This is referred to as multi-modality approach to cancer. The medical management is usually complex and involves several different substances, each interfering with the growth and spread of the cancer at various biological levels.
Preparing for treatment is important, and can even help minimize the harshness of side effects. Learn how to prepare for treatment here »
Variables considered for personal treatment plans:
- Type and characteristics of the cancer: Different types (lung, breast, colon, etc) of cancers respond to different drugs. Therefore, different combinations of drugs may be used for different types of cancers. The specific characteristics of the cancer allow clinicians to make a better assessment of its behavior and its likely response to specific types of treatments. For example, the expression of certain proteins on the surface of cancer cells, such as hormone receptors or certain antigens, may allow the incorporation of drugs specifically designed to interact with and affect these proteins' ability to control cancer growth. Other drugs interfere with a specific cellular growth pathway or immune modulatory pathway making the cancer cells more susceptible to self-destruct. Factoring these characteristics into the treatment plan has the promise of improved clinical outcomes.
- Patient's age and overall condition: Adequate function of the liver and kidney are important for the safe administration of most chemotherapeutic agents. Therefore, treatment choices are made based on the health profile of the patient.
- Goal of treatment: Depending upon individual situations, the goal of treatment may vary from cure, to keeping the cancer from spreading to relieving symptoms. These goals may change with time, clinical assessment and especially through discussions with the patient and their family. Cancer treatment must be regarded as a partnership between patient and medical professionals. Therefore it is of utmost importance that information is adequately and appropriately shared with the patient and their caretakers as to allow them to make the best decision for their medical care.
Chemotherapy
Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Some people may receive chemotherapy in their doctor's office; others may go to the hospital. A chemotherapy regimen usually consists of a specific number of cycles given over a period of time. Some drugs are given continuously over several days; some are given several times a week.
Side effects of chemotherapy
Chemotherapy can damage healthy cells along with cancer cells, which may cause side effects, including nausea, vomiting, and fatigue. Depending on the drug, some people may also experience tingling or numbness in the arms and legs, hair loss, and mouth sores. Because some drugs can damage blood cells, a person may experience anemia (low red blood cell counts) and/or an increased risk of infection (low white blood cell counts). Side effects can usually be treated and go away once treatment is finished. The occurrence of side effects is not related to whether the cancer drug is working or not.
During chemotherapy, a person may lose his or her appetite or develop an aversion to the taste or smell of food. Consider talking to a registered dietitian who can give suggestions about meal planning and managing side effects through simple diet changes.
Many people are concerned about the side effects of chemotherapy, and children and young adults should ask about long-term side effects of chemotherapy. Fortunately, many new drugs do not cause the same, severe side effects as some older chemotherapy drugs. And, there are many effective medications that help reduce side effects, caused by chemotherapy.
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Radiation
Radiation therapy uses high-energy x-rays to destroy cancer cells. Radiation therapy is considered a local treatment, as it only affects one part of the body. The goals of radiation therapy include shrinking the tumor before surgery, keeping the tumor from returning after surgery, eliminating cancer cells in other parts of the body, and relieving pain (palliation).
Radiation therapy can be given two ways: externally and internally. With external-beam radiation therapy, a machine directs the radiation at the tumor from outside the body. With internal radiation therapy, also called brachytherapy, small tubes or implants (also called seeds) containing radioactive materials are placed in the body near the tumor. With internal radiation therapy, the person does not need to come to the hospital every day to be treated, and the doctor can use a higher dose of radiation. However, internal radiation therapy can only be used if the tumor is in a location where the doctor can place the implant.
Before beginning external-beam radiation therapy, the doctor will plan where to aim the radiation. The goal is to hit as much of the tumor as possible, while minimizing the exposure of healthy tissue. A person's skin may be marked to show where the radiation will be directed. New computerized techniques help pinpoint the best place to give the radiation.
Side effects of radiation treatment
Like chemotherapy, radiation therapy can also damage normal cells, causing side effects. These include tiredness (fatigue), swelling, redness or irritation of the skin, hair loss, cough or shortness of breath (if the radiation is given to the neck or chest area), mouth sores (if the radiation is given to the head), and digestive problems (if the radiation is given to the abdominal area). These side effects go away once treatment is finished. Internal radiation therapy may cause bleeding, infection, or irritation after the implant is removed. Radiation treatment does not make a person radioactive. Read more about Managing Side Effects.
External-beam radiation therapy may have long-term side effects that can affect a person for many years. For this reason, children and young adults who receive radiation therapy should keep a record of their radiation treatment schedule (including the dose and location of the radiation) and report it as part of their medical history. Long-term side effects can include the risk of a second cancer, the inability to have children (infertility), heart problems (from radiation to the chest), gastrointestinal problems (from radiation to the abdominal area), lung fibrosis (scarring or thickening of the lung tissue), neurological problems, thyroid problems, or osteoporosis. Also, people who have had previous radiation to the chest should be aware that they are at higher risk of developing breast and lung cancers. Today, most people who receive radiation therapy now receive smaller doses than what was given in years past. Each individual considering radiation therapy should discuss the risks versus benefits of the treatment with his or her doctor.
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Surgery
Surgery involves the removal of cancerous tissue from the body. It is the primary treatment for many types of cancer, and some cancers can be cured with surgery. Surgery can also confirm a diagnosis (biopsy), determine how far a person's cancer has advanced (staging), relieve side effects (such as an obstruction), or ease pain (palliative surgery).
Some types of surgery can be performed in a clinic or doctor's office instead of the hospital. This is called outpatient surgery. Most cancer surgeries, though, will be performed in a hospital. Before surgery, consider preparing a list of questions for the surgeon. Carefully review with your doctor any preparation you may need before surgery.
The side effects of surgery depend on the type of surgery and the health of the person before surgery. One of the more common side effects is pain, which can be successfully treated in most people. Refer to individual Cancer Type sections for more information about surgical procedures for specific cancers.
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Hormonal Therapy
Several types of cancer, including some breast and prostate cancers, can only grow and spread in the presence of natural chemicals in the body called hormones. Hormone therapy fights cancer by changing the amounts of hormones in the body, and is used to treat cancers of the prostate, breast, and reproductive system. For example, tamoxifen (Nolvadex) is an anti-estrogen drug used to treat some hormone-responsive breast cancers.
Hormone therapy does have potential side effects, but most side effects go away once treatment is finished. The side effects depend on the drug and affect men and women differently. Refer to individual Cancer Type sections for more information about hormone therapy and specific side effects. ertility), heart problems (from radiation to the chest), gastrointestinal problems (from radiation to the abdominal area), lung fibrosis (scarring or thickening of the lung tissue), neurologic problems, thyroid problems, or osteoporosis. Also, people who have had previous radiation to the chest should be aware that they are at higher risk of developing breast and lung cancers. Today, most people who receive radiation therapy now receive smaller doses than what was given in years past. Each individual considering radiation therapy should discuss the risks versus benefits of the treatment with his or her doctor.
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Target Therapy
This general term describes drugs that "target" various proteins that can contribute to cancer. Unlike chemotherapy drugs that kill both healthy and cancerous cells, these drugs selectively kill cancer cells, which helps to reduce side effects. For example, imatinib mesylate (Gleevec) selectively blocks a protein that helps cancer cells grow. Other targeted treatments include gefitinib (Iressa) and erlotinib (Tarceva). Most targeted treatments are still experimental and are used along with other types of therapy. The benefits of these drugs can vary depending on a person's response to previous treatment and overall health. Generally, targeted treatments do not have the same side effects as traditional chemotherapy. Depending on the drug and the dosage, a person may experience nausea, vomiting, muscle cramps, rash, and/or diarrhea.
Anti-angiogenesis drugs: The formation of new blood vessels that feed tumors is known as angiogenesis. Some scientists think that by cutting off a tumor's blood supply, it may be possible to starve the tumor, and prevent it from growing and spreading. Anti-angiogenesis drugs are considered experimental at this time.
Antisense therapy: This therapy utilizes small, chemically-modified strands of DNA that block gene expression by binding to messenger RNA before it can produce a protein. Essentially, the technology acts to selectively "knock out" the production of a single protein.
Gene therapy: This therapy is used to repair or replace damaged genetic material or add new genetic material.
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Complementary & Alternative (CAM)
Complementary and alternative medicine (CAM) is a term used to describe a diverse group of treatments, techniques, and products that are not considered to be conventional or standard medicine. Conventional/standard treatments are those that have been scientifically tested, found to be safe and effective, and approved by the U.S. Food and Drug Administration (FDA).
Complementary medicine is used in addition to conventional treatments. Alternative medicine includes unproven therapies and products used instead of conventional treatments.
People with cancer who are considering complementary or alternative therapies should first discuss them with their doctor, just as they would any other treatment approach, because some CAM therapies may interfere with conventional therapies.
Questions to Ask When Considering CAM: When considering CAM, it is important to first discuss all treatment options with your doctor. This list of questions may help gather the necessary information on the potential benefits and risks of a therapy.
About Complementary Medicine: Complementary therapies are used in combination with standard/conventional therapies; this approach is often called integrative medicine. Find out more about the many therapies that can be safely used to manage side effects of conventional treatment or improve a patient's physical or emotional well-being.
About Alternative Medicine: Alternative therapies are those treatments used in place of standard/conventional treatments. Patients considering alternative therapies are strongly encouraged to learn about the risks involved with this approach.
PREPARING FOR TREATMENT »
