Cancer Management

By Dr Ananya Mandal, MD

Since there are numerous types of cancer affecting several organs, treatment also differs. Some of the treatment modalities like surgery, radiation therapy, chemotherapy with anticancer drugs are common for nearly all types of cancers.

Some of the types of therapy for cancers include:

Surgery

Surgery is used for initial diagnosis of cancer as well. Sometimes a solid lump or tumor is removed surgically and tissues are examined under the microscope for cancer. This is both a diagnostic and therapeutic use of surgery. Most people with cancer will have some type of surgery. If the cancer has not spread to other organs and tissues, surgery usually helps increase chances of survival to a great extent.

Chemotherapy

Chemotherapy is also called chemo. Despite most diseases being treated by chemicals or drugs, it is cancer therapy with drugs that is termed chemotherapy.

These anticancer drugs are cyto-toxic. This means they kill all rapidly growing cells of the body including cancer cells. This also means that chemotherapeutic drugs affect healthy fast growing cells like bone marrow cells, cells that line the gastrointestinal tract and hair follicle cells. When this happens there is bone marrow suppression and decrease in production of red blood cells, white blood cells and platelets in blood. This may lead to anemia, propensity to catch life threatening infections and bleeding tendencies respectively.

When chemo drugs affect the cells of the gastrointestinal tract there may be mouth sores, diarrhea, nausea and vomiting. Due to suppression of hair follicle cells there may be loss of hair or alopecia.

Not all anticancer drugs cause these side effects. Some may be fairly selective for cancer cells alone.

Radiation Therapy

After surgery, sometimes radiation therapy is advised. In this therapeutic modality high energy radiation beams are projected on cancerous regions. This kills the cancer cells.

Radiation may be external when the patient needs to visit the hospital for radiation sessions that may last from 10 to 30 minutes.

Radiation therapy may also be given internally when small pellets of seeds that emit radiation are implanted in the body of the patient. The seeds emit small amounts of radiation.

Radiation therapy has several side effects including skin burns, changes, fatigue, hoarseness of voice and risk of secondary cancers (this is seen in patients who have had chest radiation who may be at a higher risk of developing breast cancer later in life).

Targeted Therapy

Some types of cancers have specific targeted therapy that affects only the cancer cells and spares the healthy cells. These have significantly lower side effects compared to generalized anti-cancer drugs.

Immunotherapy

This includes therapy with molecules called monoclonal antibodies that target the cancer specifically and spare healthy cells.

Hormonal therapy

Some cancers like breast cancer and prostate cancer are responsive to certain female hormones like estrogen and male hormones like testosterone. Drugs that modulate levels of these hormones are used in therapy of these cancers.

Biological therapy

This includes monoclonal antibodies as well as use of gene therapy and certain vaccines in treatment of cancers.

Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants)

There are several methods of bone marrow transplants that may benefit patients with leukaemia and lymphomas.

Photodynamic Therapy

This therapy involves use of special drugs that are called photosensitizing agents and these are used along with laser light to kill cancer cells. The drugs only work after they have been activated with light.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Mar 13, 2013

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