TREATMENTS &
RESEARCH
latest
treatment
information
here.
Dr. Huntley's
Diagnosis
Checklist
See what questions
a doctor would ask.
Treatments for Cancer
Treatment list for Cancer:
The list of treatments mentioned in various sources for Cancer includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
- Treatments depend on the specific type of cancer but some types of treatments are common
- Chemotherapy
- Radiation therapy
- Surgery
- Biological therapy (immunotherapy)
- Hormone therapy
- Combination therapy - different cancers respond to different combinations of the various treatments.
- Adjuvant therapy - getting additional chemotherapy, hormone, or other therapy after surgery or radiation.
- Neoadjuvant therapy - additional chemotherapy, hormone, or other therapy before surgery or radiation.
Treatments of Cancer: Online Medical Books
16 MEDICAL BOOKS ONLINE! Review the full text of medical books online, free, without registration, for more information about the treatments of Cancer.
Breast cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Much controversy exists over breast cancer treatments. In choosing therapy, the patient and physician should take into consideration the stage of the disease, the woman's age and menopausal status, and the disfiguring effects of the surgery. Treatment of breast cancer may include one or any combination of the following:
❑Surgery involves either mastectomy or lumpectomy. A lumpectomy may be done on an outpatient basis and may be the only surgery needed, especially if the tumor is small and there's no evidence of axillary node involvement. In many cases, radiation therapy is combined with this surgery.
A two-stage procedure, in which the surgeon removes the lump and confirms that it's malignant and then discusses treatment options with the patient, is desirable because it allows the patient to participate in her plan of treatment. Sometimes, if the tumor is diagnosed as clinically malignant, such planning can be done before surgery. In lumpectomy and dissection of the axillary lymph nodes, the tumor and the axillary lymph nodes are removed, leaving the breast intact. A simple mastectomy removes the breast but not the lymph nodes or pectoral muscles. Modified radical mastectomy removes the breast and the axillary lymph nodes. Radical mastectomy, the performance of which has declined, removes the breast, pectoralis major and minor, and the axillary lymph nodes.
The spread of breast cancer to regional lymph nodes is considered a vital prognostic indicator. Sentinel lymph-node biopsy, a reliable and minimally invasive procedure, is used to identify and sample the sentinel lymph node closest to the breast tumor. During the patient's surgery, the axillary node is injected with dye to help with identification and then sent to the pathologist to assess for cancer spread. If the node is negative, the patient can be spared an axillary node dissection, which carries its own risks and the potential for long-term complications .
Reconstructive breast surgery can be performed at the same time as mastectomy or it can be planned for a later date. Several options are available for breast reconstruction, including the insertion of breast implants or a transverse rectus abdominis musculocutaneous flap.
❑Chemotherapy, involving various cytotoxic drug combinations, is used as either adjuvant or primary therapy, depending on several factors, including the TNM staging and estrogen receptor status. The most commonly used antineoplastic drugs are cyclophosphamide, fluorouracil, methotrexate, doxorubicin, vincristine, and paclitaxel. A common drug combination used in both premenopausal and postmenopausal women is cyclophosphamide, doxorubicin, and paclitaxel.
Tamoxifen, an estrogen antagonist, is the adjuvant treatment of choice for postmenopausal patients with positive estrogen receptor status. It's also been found to reduce the risk of breast cancer in women at high risk.
❑ Peripheral stem cell therapy is an option, but it's rarely used for advanced breast cancer.
❑ Primary radiation therapy before or after tumor removal is effective for small tumors in early stages with no evidence of distant metastasis; it's also used to prevent or treat local recurrence. Presurgical radiation to the breast in inflammatory breast cancer helps make tumors more surgically manageable.
❑ Estrogen, progesterone, androgen, or antiandrogen aminoglutethimide therapy may also be given to breast cancer patients. The success of these drug therapies — along with growing evidence that breast cancer is a systemic, not local, disease — has led to a decline in ablative surgery.
Malignant spinal neoplasms:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of spinal cord tumors generally includes decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it isn't usually indicated for metastatic tumors. If the tumor is slowly progressive or if it's treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and his outlook is ominous. If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy with dexamethasone minimizes cord edema and temporarily relieves symptoms until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time. Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy. Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to opioid analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers. Chemotherapy generally hasn't proven effective against most spinal tumors, but may be recommended in some cases.
Bladder cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Superficial bladder tumors are removed by transurethral (cystoscopic) resection and fulguration (electrical destruction). This procedure is adequate when the tumor hasn't invaded the muscle.
Intravesicular chemotherapy is also used for superficial tumors (especially those that occur in many sites) and to prevent tumor recurrence. This treatment involves washing the bladder directly with antineoplastic drugs — most commonly, thiotepa, doxorubicin, mitomycin, or Bacillus Calmette-Guérin immunotherapy.
If additional tumors develop, fulguration may have to be repeated every 3 months for years. However, if the tumors penetrate the muscle layer or recur frequently, cystoscopy with fulguration is no longer appropriate.
Tumors too large to be treated through a cystoscope require segmental bladder resection to remove a full-thickness section of the bladder. This procedure is feasible only if the tumor isn't near the bladder neck or ureteral orifices. Bladder instillation of thiotepa, mitomycin-C, or doxorubicin after transurethral resection may also help control such tumors.
For infiltrating bladder tumors, radical cystectomy is the treatment of choice. The week before cystectomy, treatment may include external beam therapy to the bladder. Surgery involves removal of the bladder with perivesical fat, lymph nodes, urethra, the prostate and seminal vesicles (in males), and the uterus and adnexa (in females). The surgeon forms a urinary diversion, usually an ileal conduit. The patient must then wear an external pouch continuously. Other diversions include ureterostomy, nephrostomy, vesicostomy, ileal bladder, ileal loop, and sigmoid conduit.
Males are impotent following radical cystectomy and urethrectomy because these procedures damage the sympathetic and parasympathetic nerves that control erection and ejaculation. At a later date, the patient may desire a penile implant to make sexual intercourse (without ejaculation) possible.
Treatment of patients with advanced bladder cancer includes cystectomy to remove the tumor, radiation therapy, and systemic chemotherapy with such drugs as doxorubicin, methotrexate, vinblastine, and cisplatin. This combination sometimes is successful in arresting bladder cancer. Cisplatin is the most effective single agent.
Investigational treatments include photodynamic therapy and intravesicular administration of interferon-alfa and tumor necrosis factor. Photodynamic therapy involves I.V. injection of a photosensitizing agent such as hematoporphyrin ether, which malignant cells readily absorb. Then a cystoscopic laser device introduces laser energy into the bladder, exposing the malignant cells to laser light, which kills them. Because this treatment also produces photosensitivity in normal cells, the patient must totally avoid sunlight for about 30 days.
Cancer of the vulva:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Depending on the stage of the disease, cancer of the vulva usually calls for radical or simple vulvectomy (or laser therapy, for some small lesions). Radical vulvectomy requires bilateral dissection of superficial and deep inguinal lymph nodes. Depending on the extent of metastasis, resection may include the urethra, vagina, and bowel, leaving an open perineal wound until healing — about 2 to 3 months. Plastic surgery, including mucocutaneous graft to reconstruct pelvic structures, may be done later.
Small, confined lesions with no lymph node involvement may require a simple vulvectomy or hemivulvectomy (without pelvic node dissection). Personal considerations (young age of patient, active sexual life) may also mandate such conservative management. However, a simple vulvectomy requires careful postoperative surveillance because it leaves the patient at higher risk for developing a new lesion.
Chemotherapy alone or in combination with radiation therapy can be used in advanced cases of vulvar cancer. Cisplatin, fluorouracil, bleomycin, and doxorubicin have shown some effectiveness as a palliative treatment option.
If extensive metastasis, advanced age, or fragile health rules out surgery, irradiation of the primary lesion can offer palliative treatment.
Cervical cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Appropriate treatment depends on accurate clinical staging. Preinvasive lesions may be treated with total excisional biopsy, cryosurgery, laser destruction, conization (and frequent Pap smear follow-up) or, rarely, hysterectomy. Therapy for invasive squamous cell cancer may include radical hysterectomy and radiation therapy (internal, external, or both). Chemotherapy may be used alone or in combination with radiation therapy in treating cervical cancer. Cisplatin and fluorouracil are the agents used.
Colorectal cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The most effective treatment of colorectal cancer is surgery to remove the malignant tumor and adjacent tissues and any lymph nodes that may contain cancer cells. The type of surgery depends on the location of the tumor:
❑Cecum and ascending colon — right hemicolectomy (for advanced disease) may include resection of the terminal segment of the ileum, cecum, ascending colon, and right half of the transverse colon with corresponding mesentery
❑ Proximal and middle transverse colon — right colectomy to include transverse colon and mesentery corresponding to midcolic vessels, or segmental resection of transverse colon and associated midcolic vessels
❑ Sigmoid colon — surgery is usually limited to sigmoid colon and mesentery
❑ Upper rectum — anterior or low anterior resection (newer method, using a stapler, allows for resections much lower than were previously possible)
❑ Lower rectum — abdominoperineal resection and permanent sigmoid colostomy.
Chemotherapy is indicated for patients with metastasis, residual disease, or a recurrent inoperable tumor. Drugs used in such treatment commonly include fluorouracil with leucovorin, irinotecan, and oxaliplatin.
Radiation therapy induces tumor regression and may be used before or after surgery or combined with chemotherapy, especially fluorouracil.
Esophageal cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Multimodal therapy is usually indicated. Whenever possible, treatment includes resection to maintain a passageway for food. This may require such radical surgery as esophagogastrectomy with jejunal or colonic bypass grafts. Palliative surgery may include a feeding gastrostomy. Chemotherapy with 5-fluorouracil or cisplatin may be used. Insertion of prosthetic tubes to bridge the tumor alleviates dysphagia. Other treatments to improve the patient's ability to swallow include endoscopic dilation of the esophagus (sometimes with placement of a stent) and photodynamic therapy.
Treatment complications may be severe. Surgery may precipitate an anastomotic leak, a fistula, pneumonia, and empyema. Rarely, radiation may cause esophageal perforation, pneumonitis and pulmonary fibrosis, or myelitis of the spinal cord. Prosthetic tubes may dislodge and perforate the mediastinum or erode the tumor.
Fallopian tube cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of fallopian tube cancer consists of total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy; chemotherapy with progestogens, cyclophosphamide, and cisplatin; and external radiation for 5 to 6 weeks. All patients should receive some form of adjunctive therapy (radiation or chemotherapy), even when surgery has removed all evidence of the disease.
Gallbladder and bile duct cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Surgical treatment of gallbladder cancer is essentially palliative and includes various procedures, such as cholecystectomy, common bile duct exploration, T-tube drain-age, and wedge excision of hepatic tissue.
If the cancer invades gallbladder musculature, the survival rate is less than 5%, even with massive resection. Although some cases of long-term survival (4 to 5 years) have been reported, few patients survive longer than 6 months after surgery for gallbladder cancer.
Surgery is normally indicated to relieve obstruction and jaundice that result from extrahepatic bile duct cancer. The procedure used to relieve obstruction depends on the cancer site. Such procedures may include cholecystoduodenostomy or T-tube drainage of the common duct.
Other palliative measures for both kinds of cancer include radiation, radiation implants (mostly used for local and incisional recurrences), and chemotherapy (with combinations of fluorouracil, irinotecan, and gemcitabine). All of these treatment measures have limited effects.
Gastric cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
In many cases, surgery is the treatment of choice. Excision of the lesion with appropriate margins is possible in over one-third of patients. Even in patients whose disease isn't considered surgically curable, resection offers palliation and improves potential benefits from chemotherapy and radiation.
The nature and extent of the lesion determine what kind of surgery is most appropriate. Common surgical procedures include subtotal gastric resection (subtotal gastrectomy) and total gastric resection (total gastrectomy). When carcinoma involves the pylorus and antrum, gastric resection removes the lower stomach and duodenum (gastrojejunostomy or Billroth II). If metastasis has occurred, the omentum and spleen may also have to be removed.
If gastric cancer has spread to the liver, peritoneum, or lymph glands, palliative surgery may include gastrostomy, jejunostomy, or a gastric or partial gastric resection. Such surgery may temporarily relieve vomiting, nausea, pain, and dysphagia, while allowing enteral nutrition to continue.
Chemotherapy for GI cancers may help to control symptoms and prolong survival. Adenocarcinoma of the stomach has responded to several agents, including fluorouracil, paclitaxel, doxorubicin, cisplatin, methotrexate, and mitomycin. Antiemetics can control nausea, which increases as the cancer advances. In the more advanced stages, sedatives and tranquilizers may be necessary to control overwhelming anxiety. Opioids are commonly necessary to relieve severe and unremitting pain.
Radiation has been particularly useful when combined with chemotherapy in patients who have unresectable or partially resectable disease. It should be given on an empty stomach and shouldn't be used preoperatively because it may damage viscera and impede healing.
Treatment with antispasmodics and antacids may help relieve GI distress.
Kidney cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Radical nephrectomy, with or without regional lymph node dissection, offers the only chance of cure. Because the disease is radiation resistant, radiation is used only if the cancer spreads to the perinephric region or the lymph nodes or if the primary tumor or metastatic sites can't be fully excised. In these cases, high radiation doses are used.
Chemotherapy has been only erratically effective against kidney cancer. Fluorouracil, cyclophosphamide, vinblastine, vincristine, cisplatin, tamoxifen, teniposide, interferons, and hormones such as medroxyprogesterone and testosterone have been used, usually with poor results. Biotherapy (interferon and interleukins), commonly used in advanced disease, has produced few durable remissions.
Laryngeal cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Early lesions are treated with surgery or radiation; advanced lesions with surgery, radiation, and chemotherapy. In early stages, laser surgery can excise precancerous lesions; in advanced stages it can help relieve obstruction caused by tumor growth. Surgical procedures vary with tumor size and can include cordectomy, partial or total laryngectomy, supraglottic laryngectomy, or total laryngectomy with laryngoplasty. The treatment goal is to eliminate the cancer and preserve speech. If speech preservation isn't possible, speech rehabilitation may include esophageal speech or prosthetic devices; surgical techniques to construct a new voice box are still experimental.
Liver cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Because liver cancer is commonly in an advanced stage at diagnosis, few hepatic tumors are resectable. A resectable tumor must be a single tumor in one lobe, without cirrhosis, jaundice, or ascites. Resection is done by lobectomy or partial hepatectomy.
Radiation therapy for unresectable tumors is usually palliative. Because of the liver's low tolerance for radiation, external beam radiation hasn't increased survival. However, radiolabeled antibodies have been used to selectively target cancer tissue; when used concurrently with chemotherapy, patients can convert from nonresectable to resectable.
Another method of treatment is chemotherapy with I.V. fluorouracil, mitomycin, or doxorubicin, or with regional infusion of fluorouracil or floxuridine (catheters are placed directly into the hepatic artery or left brachial artery for continuous infusion for 7 to 21 days, or permanent implantable pumps are used on an outpatient basis for long-term infusion).
Appropriate treatment for liver metastasis may include resection by lobectomy or chemotherapy with mitomycin or fludarabine (results similar to those in hepatoma). Liver transplantation is now an alternative for a small subset of patients.
Lung cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Recent treatment, which consists of combinations of surgery, radiation, and chemo-therapy, may improve the prognosis and prolong survival. Nevertheless, because treatment usually begins at an advanced stage, it's largely palliative.
Surgery is the primary treatment for stage I, stage II, or selected stage III squamous cell cancer; adenocarcinoma; and large cell carcinoma, unless the tumor is nonresectable or other conditions rule out surgery.
Surgery may include partial removal of a lung (wedge resection, segmental resection, lobectomy, or radical lobectomy) or total removal (pneumonectomy or radical pneumonectomy).
Preoperative radiation therapy may reduce tumor bulk to allow for surgical resection. Preradiation chemotherapy helps improve response rates. Radiation therapy is ordinarily recommended for stage I and stage II lesions, if surgery is contraindicated, and for stage III lesions when the disease is confined to the involved hemithorax and the ipsilateral supraclavicular lymph nodes.
Generally, radiation therapy is delayed until one month after surgery, to allow the wound to heal, and is then directed to the part of the chest most likely to develop metastasis. High-dose radiation therapy or radiation implants may also be used.
Research has shown that chemotherapy combinations of paclitaxel, gemcitabine, docetaxel, irinotecan, and vinorelbine are more active and better tolerated when combined with cisplatin or carboplatin. Many of these drugs are also being utilized as single agents for the treatment of small-cell and non–small-cell lung cancers.
In laser therapy, laser energy is directed through a bronchoscope to destroy local tumors.
Breast cancer:
Treatment
(Handbook of Diseases)
Much controversy exists over breast cancer treatments. In choosing therapy, the patient and physician should consider the stage of the disease, the woman’s age and menopausal status, and the disfiguring effects of the surgery. Treatment for breast cancer may include one or any combination of the following.
Surgery
With breast cancer, surgery involves either lumpectomy or mastectomy. A lumpectomy may be done on an outpatient basis and may be the only surgery needed, especially if the tumor is small and there’s no evidence of axillary node involvement. Radiation therapy is often combined with this surgery.
A two-stage procedure, in which the surgeon removes the lump, confirms that it’s malignant, and discusses treatment options with the patient, is desirable because it allows the patient to participate in her treatment plan. Sometimes, if the tumor is diagnosed as malignant, such planning can be done before surgery. In lumpectomy and dissection of the axillary lymph nodes, the tumor and the axillary lymph nodes are removed, leaving the breast intact.
A simple mastectomy removes the breast but not the lymph nodes or pectoral muscles. A modified radical mastectomy removes the breast and the axillary lymph nodes. A radical mastectomy, the performance of which has declined, removes the breast, the pectoralis major and minor, and the axillary lymph nodes.
After a mastectomy, reconstructive surgery can create a breast mound if the patient desires it and doesn’t have evidence of advanced disease.
Chemotherapy, tamoxifen, and peripheral
stem cell therapy
Various cytotoxic drug combinations are used as either adjuvant or primary therapy, depending on several factors, including staging and estrogen receptor status. The most commonly used antineoplastics are cyclophosphamide, fluorouracil, methotrexate, doxorubicin, vincristine, paclitaxel, and prednisone. A common drug combination used in both premenopausal and postmenopausal women is cyclophosphamide, methotrexate, and fluorouracil.
Tamoxifen, an estrogen antagonist, is the adjuvant treatment of choice for postmenopausal patients with positive estrogen receptor status.
Peripheral stem cell therapy may be used for patients with advanced breast cancer.
Primary radiation therapy
Used before or after tumor removal, primary radiation therapy is effective for small tumors in early stages with no evidence of distant metastasis; it’s also used to prevent or treat local recurrence. Presurgical radiation to the breast in patients with inflammatory breast cancer helps make tumors more surgically manageable.
Other drug therapy
Breast cancer patients may also receive estrogen, progesterone, androgen, or antiandrogen aminoglutethimide therapy. The success of these drug therapies with growing evidence that breast cancer is a systemic, not local, disease has led to a decline in ablative surgery.
Spinal neoplasms:
Treatment
(Handbook of Diseases)
Spinal cord tumors usually require decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it’s not usually indicated for metastatic tumors.
If the tumor is slowly progressive, or if it’s treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and the outlook is ominous.
If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy minimizes cord edema until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time.
Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy.
Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to narcotic analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers.
Bladder cancer:
Treatment
(Handbook of Diseases)
Appropriate treatment for bladder cancer varies.
Superficial bladder tumors
Superficial bladder tumors are removed by transurethral (cystoscopic) resection and fulguration (electrical destruction). This procedure is adequate when the tumor hasn’t invaded the muscle.
Intravesicular chemotherapy is used for superficial tumors (especially those that occur in many sites) and to prevent tumor recurrence. This treatment involves washing the bladder directly with an antineoplastic — most commonly, thiotepa, doxorubicin, mitomycin, or bacille Calmette-Guérin (BCG).
If additional tumors develop, fulguration may have to be repeated every 3 months for years. However, if the tumors penetrate the muscle layer or recur frequently, cystoscopy with fulguration is no longer appropriate.
Tumors too large to be treated through a cystoscope require segmental bladder resection to remove a full-thickness section of the bladder. This procedure is feasible only if the tumor isn’t near the bladder neck or ureteral orifices. Bladder instillations of thiotepa after transurethral resection may also help control such tumors.
Under study Immunotherapy may be used to fight cancer. BCG is an immunomodulating agent commonly used in the treatment of superficial bladder cancer following surgery to remove the tumor. Biologic response modifiers — such as interferons, interleukins, colony-stimulating factors, monoclonal antibodies, and vaccines — may also be used to alter the interaction between the body’s immune defenses and the cancer cells. The goal is to boost, direct, or restore the body’s ability to fight the disease.
Infiltrating bladder tumors
Radical cystectomy is the treatment of choice for infiltrating bladder tumors. The week before cystectomy, treatment may include external beam therapy to the bladder. Surgery involves removal of the bladder with perivesical fat, lymph nodes, urethra, the prostate and seminal vesicles (in males), and the uterus and adnexa (in females). The surgeon forms a urinary diversion, usually an ileal conduit. The patient must then continuously wear an external pouch. (See Caring for a urinary stoma.) Other diversions include ureterostomy, nephrostomy, vesicostomy, ileal bladder, ileal loop, and sigmoid conduit.
Males are impotent following radical cystectomy and urethrectomy because these procedures damage the sympathetic and parasympathetic nerves that control erection and ejaculation. At a later date, the patient may desire a penile implant to make sexual intercourse (without ejaculation) possible.
Advanced bladder cancer
For patients with advanced bladder cancer, treatment includes cystectomy to remove the tumor, radiation therapy, and systemic chemotherapy with such drugs as cyclophosphamide, fluorouracil, doxorubicin, and cisplatin. This combination sometimes is successful in arresting bladder cancer.
Cisplatin is the single most effective agent.
Investigational treatments
Such treatments include photodynamic therapy and intravesicular administration of interferon alfa and tumor necrosis factor. Photodynamic therapy involves I.V. injection of a photosensitizing agent such as hematoporphyrin ether, which malignant cells readily ab
sorb. Then a cystoscopic laser device introduces laser energy into the bladder, exposing the malignant cells to laser light, which kills them. Because this treatment also produces photosensitivity in normal cells, the patient must totally avoid sunlight for about 30 days.
Cervical cancer:
Treatment
(Handbook of Diseases)
Appropriate treatment depends on accurate staging. Preinvasive lesions may be treated with a loop electrosurgical examination procedure, cryosurgery, laser destruction, conization (and frequent Pap test follow-up) or, rarely, hysterectomy. Therapy for invasive squamous cell carcinoma may include radical hysterectomy and radiation therapy (internal, external, or both). Radiation is effective for all stages, but surgery is preferable for some premenopausal women.
Colorectal cancer:
Treatment
(Handbook of Diseases)
The most effective treatment for colorectal cancer is surgery to remove the malignant tumor and adjacent tissues as well as any lymph nodes that may contain cancer cells. The type of surgery depends on the location of the tumor:
❑ Cecum and ascending colon: A right hemicolectomy (for advanced disease) is performed. It may include resection of the terminal segment of the ileum, cecum, ascending colon, and the right half of the transverse colon with corresponding mesentery.
❑ Proximal and middle transverse colon: A right colectomy is performed that includes the transverse colon and mesentery corresponding to midcolic vessels or segmental resection of the transverse colon and associated midcolic vessels.
❑ Sigmoid colon: Surgery is typically limited to the sigmoid colon and mesentery.
❑ Upper rectum: Anterior or low anterior resection is performed. A newer method, using a stapler, allows for resections much lower than were previously possible.
❑ Lower rectum: Abdominoperineal resection and permanent sigmoid colostomy is performed.
Chemotherapy is indicated for patients with metastasis, residual disease, or a recurrent inoperable tumor. Drugs used in such treatment commonly include fluorouracil with levamisole, leucovorin, methotrexate, or streptozocin. Patients whose tumor has extended to regional lymph nodes may receive fluorouracil and levamisole for 1 year postoperatively.
Radiation therapy induces tumor regression and may be used before or after surgery or combined with chemotherapy, especially fluorouracil.
Esophageal cancer:
Treatment
(Handbook of Diseases)
Whenever possible, treatment includes resection to maintain a passageway for food. This may require such radical surgery as esophagogastrectomy with jejunal or colonic bypass grafts. Palliative surgery may include a feeding gastrostomy. Lash palliation decreases tumor size. Other therapies consist of radiation, chemotherapy with cisplatin, and the insertion of prosthetic tubes to bridge the tumor and alleviate dysphagia.
Treatment complications
Complications of treatment may be severe. Surgery may precipitate an anastomotic leak, a fistula, pneumonia, and empyema. Rarely, radiation may cause esophageal perforation, pneumonitis and pulmonary fibrosis, or myelitis of the spinal cord. Prosthetic tubes may dislodge and perforate the mediastinum or erode the tumor.
Gallbladder and bile duct cancers:
Treatment
(Handbook of Diseases)
Surgical treatment of gallbladder cancer is essentially palliative and includes various procedures, such as cholecystectomy, common bile duct exploration, T-tube drainage, and wedge excision of hepatic tissue.
If the cancer invades gallbladder musculature, the survival rate is less than 5%, even with massive resection. Although some cases of long-term survival (4 to 5 years) have been reported, few patients survive longer than 6 months after surgery for gallbladder cancer.
Surgery is normally indicated to relieve the obstruction and jaundice that result from extrahepatic bile duct cancer. The type of procedure used to relieve obstruction depends on the site of the cancer. Such procedures may include cholecystoduodenostomy and T-tube drainage of the common duct.
Clinical tip Other palliative measures for both kinds of cancer include radiation therapy, radiation implants (used mostly for local and incisional recurrences), and chemotherapy (with combinations of fluorouracil, doxorubicin, and lomustine). All these treatment measures have limited effects.
Gastric cancer:
Treatment
(Handbook of Diseases)
Surgery is commonly the treatment of choice. Excision of the lesion with appropriate margins is possible in more than one-third of patients. Even in patients whose disease isn’t considered surgically curable, resection offers palliation and improves potential benefits from chemotherapy and radiation therapy.
Surgery
The nature and extent of the lesion determine what kind of surgery is most appropriate. Common surgical procedures include subtotal gastrectomy and total gastrectomy.
When cancer involves the pylorus and antrum, gastrectomy removes the lower stomach and duodenum (gastrojejunostomy or Billroth II). If metastasis has occurred, the omentum and spleen may also have to be removed.
If gastric cancer has spread to the liver, peritoneum, or lymph glands, palliative surgery may include gastro-stomy, jejunostomy, or a total or subtotal gastrectomy. Such surgery may temporarily relieve vomiting, nausea, pain, and dysphagia while allowing enteral nutrition to continue.
Other treatments
Chemotherapy for GI cancers may help to control symptoms and prolong survival. Adenocarcinoma of the stomach has responded to several agents, including fluorouracil, carmustine, doxorubicin, cisplatin, methotrexate, and mitomycin.
Antiemetics can control nausea, which increases as the cancer advances. In the more advanced stages, sedatives and tranquilizers may be necessary to control overwhelming anxiety. Narcotics are necessary in many cases to relieve severe and unremitting pain.
Radiation therapy has been particularly useful when combined with chemotherapy in patients who have unresectable or partially resectable disease. It should be given on an empty stomach and shouldn’t be used preoperatively because it may damage viscera and impede healing.
Treatment with antispasmodics and antacids may help relieve GI distress.
Kidney cancer:
Treatment
(Handbook of Diseases)
Radical nephrectomy, with or without regional lymph node dissection, offers the only chance of cure. Because the disease is radiation-resistant, radiation is used only if the cancer spreads to the perinephric region or the lymph nodes or if the primary tumor or metastatic sites can’t be fully excised. In such cases, high doses of radiation are used.
Chemotherapy has been only erratically effective against kidney cancer and includes various drugs. Interferons and hormones, such as medroxyprogesterone and testosterone, have also been used. Biotherapy (lymphokine-activated killer cells with recombinant interleukin-2) shows promise, but causes adverse reactions. Interferon is somewhat effective in advanced disease. Hormone therapy may be tried in advanced cases.
Laryngeal cancer:
Treatment
(Handbook of Diseases)
Early lesions are treated with surgery or radiation; advanced lesions, with surgery, radiation, and chemotherapy. Chemotherapeutic agents may include methotrexate, cisplatin, bleomycin, fluorouracil, and vincristine.
The treatment goal is to eliminate the cancer and preserve speech. If speech preservation is impossible, speech rehabilitation may include esophageal speech or prosthetic devices; surgical techniques to construct a new voice box are still experimental. Surgical procedures vary with tumor size and can include cordectomy, partial or total laryngectomy, supraglottic laryngectomy, or total laryngectomy with laryngoplasty.
Liver cancer:
Treatment
(Handbook of Diseases)
Because liver cancer is usually in an advanced stage at diagnosis, few hepatic tumors are resectable. A resectable tumor must be a single tumor in one lobe, without cirrhosis, jaundice, or ascites. Resection is done by lobectomy or partial hepatectomy.
Radiation therapy for unresectable tumors is usually palliative. However, because of the liver’s low tolerance for radiation, this therapy hasn’t increased survival.
Another treatment method is chemotherapy either I.V. or with regional infusion of a chemotherapeutic drug. (A catheter is placed directly into the hepatic artery or left brachial artery for continuous infusion for 7 to 21 days, or permanent implantable pumps are used on an outpatient basis for long-term infusion.)
Appropriate treatment for liver metastasis may include resection by lobectomy or chemotherapy. (The results are similar to those in hepatoma.) Liver transplantation is an alternative for some patients.
Lung cancer:
Treatment
(Handbook of Diseases)
Various combinations of surgery, radiation, and chemotherapy may improve the prognosis and prolong survival. Nevertheless, because treatment usually begins at an advanced stage, it’s largely palliative.
Surgery
Unless the tumor is nonresectable or other conditions rule out surgery, excision is the primary treatment for stage I, stage II, or selected stage III squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Surgery may include partial removal of a lung (wedge resection, segmental resection, lobectomy, radical lobectomy) or total removal (pneumonectomy, radical pneumonectomy).
Radiation
Preoperative radiation therapy may reduce tumor bulk to allow for surgical resection. Preradiation chemotherapy helps improve response rates. Radiation therapy is ordinarily recommended for stage I and stage II lesions, if surgery is contraindicated, and for stage III lesions when the disease is confined to the involved hemithorax and the ipsilateral supraclavicular lymph nodes.
Generally, radiation therapy is delayed until 1 month after surgery, to allow the wound to heal, and is then directed to the part of the chest most likely to develop metastasis. High-dose radiation therapy or radiation implants may also be used.
Chemotherapy
Another treatment is chemotherapy, including combinations of drugs, which produce a response rate of about 40%, but have a minimal effect on overall survival. Promising combinations for treating small cell carcinomas include cyclophosphamide with doxorubicin and vincristine; cyclophosphamide with doxorubicin, vincristine, and etoposide; and etoposide with cisplatin, cyclophosphamide, and doxorubicin.
Laser therapy
Some patients may undergo laser therapy, which involves direction of laser energy through a bronchoscope to destroy local tumors.
Ovarian cancer:
Treatment
(Handbook of Diseases)
Depending on the stage of the disease and the patient’s age, treatment of ovarian cancer requires varying combinations of surgery, chemotherapy and, in some cases, radiation. Cytoreductive surgery, in which the tumor nodules are reduced to as small a size as possible, may increase survival time.
Conservative treatment
Occasionally, in girls or young women with a unilateral encapsulated tumor who wish to maintain fertility, the following conservative approach may be appropriate:
❑ resection of the involved ovary
❑ biopsies of the omentum and the uninvolved ovary
❑ peritoneal washings for cytologic examination of pelvic fluid
❑ careful follow-up, including periodic chest X-rays to rule out lung metastasis.
Aggressive treatment
Ovarian cancer usually requires more aggressive treatment, including total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, lymph node biopsies with lymphadenectomy, tissue biopsies, and peritoneal washings.
Complete tumor resection is impossible if the tumor has matted around other organs or if it involves organs that can’t be resected. Bilateral salpingo-oophorectomy in a prepubertal girl necessitates hormone replacement therapy, beginning at puberty, to induce the development of secondary sex characteristics.
Chemotherapy extends survival time in most ovarian cancer patients. Unfortunately, it’s largely palliative in advanced disease, but some patients are achieving prolonged remissions and even cures.
Chemotherapeutic drugs may be used alone; however, they’re usually given in combination. They may be administered intraperitoneally. The preferred first-line regimen is paclitaxel and cisplatin (or carboplatin).
Radiation therapy is generally not used for ovarian cancer because the resulting myelosuppression would limit the effectiveness of chemotherapy. It also has limited efficacy.
Other treatments
Radioisotopes have been used as adjuvant therapy, but they cause small-bowel obstructions and stenosis.
In addition, I.V. administration of biological response modifiers — interleukin-2, interferon, and monoclonal antibodies — may be attempted.
Pancreatic cancer:
Treatment
(Handbook of Diseases)
Treatment of pancreatic cancer is rarely successful because this disease has usually metastasized widely by the time it’s diagnosed.
Therapy consists of surgery and, possibly, radiation and chemotherapy. Small advances have been made in the survival rate with surgery:
❑ Total pancreatectomy may increase survival time.
❑ Cholecystojejunostomy, choledochoduodenostomy, and choledochojejunostomy have partially replaced radical resection to bypass obstructing common bile duct extensions, thus decreasing the incidence of jaundice and pruritus.
❑ Whipple’s operation, or pancreatoduodenectomy, has a high mortality but can produce wide lymphatic clearance, except with tumors located near the portal vein, superior mesenteric vein and artery, and celiac axis. This procedure removes the head of the pancreas, the duodenum, gall bladder, end of the common bile duct, and possibly portions of the body and tail of the pancreas and stomach.
❑ Gastrojejunostomy is performed if radical resection isn’t indicated and duodenal obstruction is expected to develop later.
If the tumor is confined to the pancreas and can’t be removed, a combination of radiation and chemotherapy may be used. If the tumor has metastasized to other organs such as the liver, chemotherapy is usually the lone treatment. Gemcitabine is the standard agent and produces improvement in 50% of patients.
Other medications used in the treatment of pancreatic cancer include:
❑ anticholinergics (particularly propantheline) — to decrease GI tract spasm and motility and reduce pain and secretions
❑ antacids (oral or by nasogastric [NG] tube) — to decrease secretion of pancreatic enzymes and suppress peptic activity, thereby reducing stress-induced damage to gastric mucosa
❑ insulin — to provide adequate exogenous insulin supply after pancreatic resection
❑ narcotics — to relieve pain, but only after analgesics fail because morphine, meperidine, and codeine can lead to biliary tract spasm and increase common bile duct pressure
❑ pancreatic enzymes (average dose is 0.5 to 1 mg with meals) — to assist in the digestion of proteins, carbohydrates, and fats when pancreatic juices are insufficient because of surgery or obstruction.
Prostatic cancer:
Treatment
(Handbook of Diseases)
Management of prostatic cancer depends on clinical assessment, tolerance of therapy, expected life span, and the stage of the disease. Treatment must be chosen carefully because prostatic cancer usually affects older men, who commonly have coexisting disorders, such as hypertension, diabetes, or cardiac disease. If the patient is younger than age 70, a radical prostatectomy is commonly performed. If the patient is age 70 or older, radiation (including implants) or cryosurgery may be performed to ablate the cancer.
Therapy varies with each stage of the disease and generally includes radiation, prostatectomy, orchiectomy to reduce androgen production, and hormone therapy with synthetic estrogen (diethylstilbestrol [DES]) and antiandrogens, such as cyproterone, meges-trol, and flutamide. Radical prostatectomy is usually effective for localized lesions.
Radiation therapy is used to cure some locally invasive lesions and to relieve pain from metastatic bone involvement. A single injection of the radionuclide strontium-89 is also used to treat pain caused by bone metastasis.
If hormone therapy, surgery, and radiation therapy aren’t feasible or successful, chemotherapy (using combinations of cyclophosphamide, doxorubicin, fluorouracil, cisplatin, etoposide, and vindesine) may be tried. However, current drug therapy offers little benefit. Combining several treatment methods may be most effective.
Medications used to treat Cancer:
Note:You must always seek professional medical advice about any treatment or change in treatment plans.
Some of the different medications used in the treatment of Cancer include:
- Methotrexate - used as part of combination therapy for various cancers
- Abitrexate - used as part of combination therapy for various cancers
- Folex - used as part of combination therapy for various cancers
- Folex PFS - used as part of combination therapy for various cancers
- Mexate - used as part of combination therapy for various cancers
- Mexate AQ - used as part of combination therapy for various cancers
- Rheumatrex Dose Pack - used as part of combination therapy for various cancers
- Trexall - used as part of combination therapy for various cancers
- Gengraf
- Apo-Cyclosporine
- Rhoxal-Cyclosporine
Medical news summaries about treatments for Cancer:
The following medical news items are relevant to treatment of Cancer:
- 40 health professionals fail to diagnose brain tumor
- A little girl undergoes great suffering due to a misdiagnosis
- Abraxan receives FDA approval for breast cancer treatment
- Alimta approved for use against certain cancers in the European Union
- Anti-cancer drug may help acute myeloid leukemia sufferers who can’t tolerate chemotherapy
- Anti-diabetes drugs may be effective against myelomas
- Antidepressants affect tamoxifen activity in some women
- Antioxidants ineffective against cancer
- Approval for human testing sought for novel cancer treatment
- Brain cancer drug shows promising preliminary results
- Breast cancer drug Femara superior to Tamoxifen
- Breast cancer drug reduces tumor size effectively
- Breast cancer triple assessment
- Breast milk may have potential as a cancer therapy
- Cancer development secrets discovered
- Cancer Research UK sponsors new cancer drug trial
- Cancer treatments often too expensive for many
- Cancer vaccine targets only tumor cells
- Cannabis may be able to fight cancer-causing herpes virus
- Celecoxib no longer allowed to be used as a cancer treatment
- Certain form of Vitamin E has anticancer properties
- Cervical cancer vaccine being tested
- Cervical cancer vaccine developed
- Chemotherapy effectiveness may be improved by hearburn medication
- Chip determines liver cancer prognosis following surgery
- Colorectal cancer risk reduced in women through calcium consumption
- Combination drug therapy for treating colorectal cancer challenged
- Combination of Taxotere and Estramustine for prostate cancer therapy
- Compound discovered to rival current antiviral drugs in cancer treatment
- Concerns over Celebrex use mounting
- COX-2 enzyme blockers may be useful in fighting cancer
- Curry ingredient may be effective against cancer
- Diet high in fruit and vegetables may reduce chemo side effects
- Diet supplements need to be governed
- Doubts over the real cause of depression
- Drug combination may increase prostate cancer survival
- Drug company obtains orphan status for its new cancer drug
- Drug company stops marketing plans for new lung cancer drug due to poor trial results
- Drug used to treat prostate enlargement may reduce prostate cancer risk
- Drug which prevents breast cancer recurrence approved for use
- Ecstasy may help terminally ill die easier
- Federal Government promises inquiry into contaminated polio vaccine
- Fertility post cancer therapy
- Gel may reduce need for surgery to treat cervical cancer
- Genetic profile test determines if breast cancer victims need chemotherapy
- Herbal drug, gugulipid, may render some prescription drugs ineffective
- Herbal supplement delivers promise of new hope in prostate cancer treatment
- Herbal supplements prove their worth as a prostate cancer treatment
- Hormone therapy associated with increased risk of ovarian cancer
- How much is really known about the safety of statins
- HRT may help men with prostate cancer without the negative side effects
- Improvement in monitoring prostate cancer
- Isoflavones in soy may inhibit development and spread of breast cancer
- Laparoscopic technique reduces pain and recovery time for hysterectomy patients
- Last resort leukemia drug receives FDA approval
- Low dose antioxidant may reduce cancer risk in men
- Low doses of chemotherapy reduces chances of positive outcome
- Lupus treatment shows promising results
- Lupus treatment shows promising results for SLE sufferers
- Man dies of colorectal cancer after misdiagnosis
- Man receives 192,000 pounds for throat cancer misdiagnosis
- New Advexin tumor shrinking drug developed
- New brain cancer treatment improves prognosis
- New breast cancer drug faces imminent approval
- New breast cancer drug more successful than tamoxifen in postmenopausal women
- New breast cancer treatment offers another option for sufferers
- New drug provides hope for mesothelioma sufferers
- New drug proving effective in reducing cancer cells following chemotherapy
- New drug treatment for Wilson’s disease show’s promise
- New dual therapy for cancer treatment
- New lung cancer drug offers longer survival hope
- New mesothelioma drug shows promising results in mice
- New option for throat cancer surgery helps save voice
- New skull bone tissue grown from fat-derived stem cells
- New weapon being developed against metastatic cancer
- Novel cancer treatment saves man from amputation
- Novel treatment for matastatic prostate cancer being developed
- Nutrition is a vital element in fighting mesothelioma
- Oral estrogen directly increases the risk of ovarian cancer
- Osteoporosis drug had preventative effect against breast cancer
- Ovarian cancer diagnosed in woman a decade after a hysterectomy
- Pancreatic cancer surgery less common in black men
- Prolonged NSAIDs usage implicated in increased cancer risk
- Promising drugs raise dilemma of whether benefits outweigh the risks
- Prostate cancer vaccine improves survival rates
- Prozac may be effective against chemo resistant tumours
- PSA tests are not as “useless” as the inventor claims
- Radio waves to be assessed as a potential cancer therapy
- Recent studies involving contraceptive pill risks may be flawed
- Research examines ginger’s effect on nausea
- Scientists develop synthetic protein that may be capable of killing cancer
- Scientists reveal how protein causes resistance to anti-cancer therapies
- Scientists try to develop methods to avoid toxic side effects of chemotherapy
- Short term use of AST to treat prostate cancer provides survival benefits without significant impact of side effects
- Small clinical trial of phenoxodiol shows it may be very effective in improving survival of prostate cancer patients
- St John’s Wort can have a negative effect on many prescription drugs
- Studies compare hysterectomy techniques
- Study shows oral contraceptives taken before menopause may reduce risk of cancer and heart disease
- Surgeon still operating after botched rectal cancer surgeries
- The effective breast cancer treatment, Femara, only subsidized for those with advanced cases of the disease
- The Oleic acid component of the olive oil used in the Mediterranean diet may be responsible for breast cancer prevention
- Traditional breast cancer pill no longer the best choice
- Traditional herbal remedies being studied provide positive results
- Vegetable compound to be tested for its effect on cervical cancer
- Vitamin C’s newly discovered action may have an anti-cancer role
- Warnings highlight possible risk associated with anemia drug
- Zinc supplementation may prevent some cancers
Discussion of treatments for Cancer:
Cancer: NWHIC (Excerpt)
Cancer is treated with surgery, radiation therapy, chemotherapy, hormone therapy, or biological therapy. The doctor may use one method or a combination of methods. The choice of treatment depends on the type and location of the cancer, whether the disease has spread, the patient’s age and general health, and other factors. Many cancer patients take part in clinical trials (research studies) testing new treatment methods. Such studies are designed to improve cancer treatment. (Source: excerpt from Cancer: NWHIC)
Cancer Facts for People Over 50 - Age Page - Health Information: NIA (Excerpt)
There are a number of cancer treatments, including surgery, radiation therapy, chemo-therapy (anticancer drugs), and biological therapy (treatment that uses the body's natural ability to fight infection and disease). Patients with cancer often are treated by a team of specialists, which may include a medical oncologist (specialist in cancer treatment), a surgeon, a radiation oncologist (specialist in radiation therapy), and others. The doctors may decide to use one type of treatment alone or a combination of treatments. The choice of treatment depends on the type and location of the cancer, the stage of the disease, the patient's general health, and other factors. (Source: excerpt from Cancer Facts for People Over 50 - Age Page - Health Information: NIA)
What You Need To Know About Cancer - An Overview: NCI (Excerpt)
Many people with cancer want to take an active part in decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, the shock and stress that people often feel after a diagnosis of cancer can make it hard for them to think of everything they want to ask the doctor. Often it is helpful to prepare a list of questions in advance. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some people also want to have a family member or friend with them when they talk to the doctor -- to take part in the discussion, to take notes, or just to listen.
|
These are some questions a patient may want to ask the doctor before treatment begins:
|
Patients do not need to ask all their questions or remember all the answers at one time. They will have many chances to ask the doctor to explain things and to get more information.
|
|
Methods of Treatment and Their Side Effects
Treatment for cancer can be either local or systemic . Local treatments affect cancer cells in the tumor and the area near it. Systemic treatments travel through the bloodstream, reaching cancer cells all over the body. Surgery and radiation therapy are types of local treatment. Chemotherapy, hormone therapy, and biological therapy are examples of systemic treatment.
It is hard to protect healthy cells from the harmful effects of cancer treatment. Because treatment does damage healthy cells and tissues, it often causes side effects. The side effects of cancer treatment depend mainly on the type and extent of the treatment. Also, the effects may not be the same for each person, and they may change for a person from one treatment to the next. A patient's reaction to treatment is closely monitored by physical exams, blood tests, and other tests. Doctors and nurses can explain the possible side effects of treatment, and they can suggest ways to reduce or eliminate problems that may occur during and after treatment.
Surgery is therapy to remove the cancer; the surgeon may also remove some of the surrounding tissue and lymph nodes near the tumor. Sometimes surgery is done on an outpatient basis, or the patient may have to stay in the hospital. This decision depends mainly on the type of surgery and the type of anesthesia .
The side effects of surgery depend on many factors, including the size and location of the tumor, the type of operation, and the patient's general health. Although patients are often uncomfortable during the first few days after surgery, this pain can be controlled with medicine. Patients should feel free to discuss ways of relieving pain with the doctor or nurse. (More information about pain control is in the "Pain Control " section.) It is also common for patients to feel tired or weak for a while after surgery. The length of time it takes to recover from an operation varies among patients.
Some patients have concerns that cancer will spread during surgery. This subject is discussed in the section on "Biopsy ."
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. For some types of cancer, radiation therapy may be used instead of surgery as the primary treatment. Radiation therapy also may be given before surgery (neoadjuvant therapy ) to shrink a tumor so that it is easier to remove. In other cases, radiation therapy is given after surgery (adjuvant therapy ) to destroy any cancer cells that may remain in the area. Radiation also may be used alone, or along with other types of treatment, to relieve pain or other problems if the tumor cannot be removed.
Radiation therapy can be in either of two forms: external or internal . Some patients receive both.
External radiation comes from a machine that aims the rays at a specific area of the body. Most often, this treatment is given on an outpatient basis in a hospital or clinic. There is no radioactivity left in the body after the treatment.
With internal radiation (also called implant radiation, interstitial radiation, or brachytherapy ), the radiation comes from radioactive material that is sealed in needles, seeds, wires, or catheters and placed directly in or near the tumor. Patients may stay in the hospital while the level of radiation is highest. They may not be able to have visitors during the hospital stay or may have visitors for only a short time. The implant may be permanent or temporary. The amount of radiation in a permanent implant goes down to a safe level before the person leaves the hospital. The doctor will advise the patient if any special precautions should be taken at home. With a temporary implant, there is no radioactivity left in the body after the implant is removed.
The side effects of radiation therapy depend on the treatment dose and the part of the body that is treated. Patients are likely to become extremely tired during radiation therapy, especially in the later weeks of treatment. Extra rest is often necessary, but doctors usually encourage patients to try to stay as active as they can between rest periods.
With external radiation, there may be permanent darkening or "bronzing" of the skin in the treated area. In addition, it is common to have temporary hair loss in the treated area and for the skin to become red, dry, tender, and itchy. Radiation therapy also may cause a decrease in the number of white blood cells , cells that help protect the body against infection.
Although radiation therapy can cause side effects, these can usually be treated or controlled. Most side effects are temporary, but some may be persistent or occur months to years later. The National Cancer Institute booklet Radiation Therapy and You has helpful information about radiation therapy and managing its side effects.
Chemotherapy is the use of drugs to kill cancer cells. The doctor may use one drug or a combination of drugs. Chemotherapy may be the only kind of treatment a patient needs, or it may be combined with other forms of treatment. Neoadjuvant chemotherapy refers to drugs given before surgery to shrink a tumor; adjuvant chemotherapy refers to drugs given after surgery to help prevent the cancer from recurring. Chemotherapy also may be used (alone or along with other forms of treatment) to relieve symptoms of the disease.
Chemotherapy is usually given in cycles: a treatment period (one or more days when treatment is given) followed by a recovery period (several days or weeks), then another treatment period, and so on. Most anticancer drugs are given by injection into a vein (IV ); some are injected into a muscle or under the skin; and some are given by mouth.
Often, patients who need many doses of IV chemotherapy receive the drugs through a catheter (a thin, flexible tube) that stays in place until treatment is over. One end of the catheter is placed in a large vein in the arm or the chest; the other end remains outside the body. Anticancer drugs are given through the catheter. Patients who have catheters avoid the discomfort of having a needle inserted into a vein for each treatment. Patients and their families learn how to care for the catheter and keep it clean.
Sometimes the anticancer drugs are given in other ways. For example, in an approach called intraperitoneal chemotherapy , anticancer drugs are placed directly into the abdomen through a catheter. To reach cancer cells in the central nervous system (CNS), the patient may receive intrathecal chemotherapy . In this type of treatment, the anticancer drugs enter the cerebrospinal fluid through a needle placed in the spinal column or a device placed under the scalp.
Usually a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). However, depending on which drugs are given, the dose, how they are given, and the patient's general health, a short hospital stay may be needed.
The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives. As with other types of treatment, side effects vary from person to person. Generally, anticancer drugs affect cells that divide rapidly. In addition to cancer cells, these include blood cells, which fight infection, help the blood to clot, and carry oxygen to all parts of the body. When blood cells are affected, patients are more likely to get infections, may bruise or bleed easily, and may feel unusually weak and very tired. Rapidly dividing cells in hair roots and cells that line the digestive tract may also be affected. As a result, side effects may include loss of hair, poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores.
Hair loss is a major concern for many people with cancer. Some anticancer drugs only cause the hair to thin, while others may result in the loss of all body hair. Patients may cope better if they prepare for hair loss before starting treatment (for example, by buying a wig or hat). Most side effects go away gradually during the recovery periods between treatments, and hair grows back after treatment is over.
Some anticancer drugs can cause long-term side effects such as loss of fertility (the ability to produce children). Loss of fertility may be temporary or permanent, depending on the drugs used and the patient's age and sex. For men, sperm banking before treatment may be an option. Women's menstrual periods may stop, and they may have hot flashes and vaginal dryness. Periods are more likely to return in young women. The National Cancer Institute booklet Chemotherapy and You has helpful information about chemotherapy and coping with side effects.
Hormone therapy is used against certain cancers that depend on hormones for their growth. Hormone therapy keeps cancer cells from getting or using the hormones they need. This treatment may include the use of drugs that stop the production of certain hormones or that change the way they work. Another type of hormone therapy is surgery to remove organs (such as the ovaries or testicles) that make hormones.
Hormone therapy can cause a number of side effects. Patients may feel tired, have fluid retention, weight gain, hot flashes, nausea and vomiting, changes in appetite, and, in some cases, blood clots. In women, hormone therapy may cause interrupted menstrual periods and vaginal dryness. Hormone therapy in women may also cause either a loss of or an increase in fertility; women taking hormone therapy should talk with their doctor about contraception during treatment. In men, hormone therapy may cause impotence , loss of sexual desire, or loss of fertility. Depending on the drug used, these changes may be temporary, long lasting, or permanent. Patients may want to talk with their doctor about these and other side effects.
Biological therapy (also called immunotherapy ) helps the body's natural ability (immune system ) to fight disease or protects the body from some of the side effects of cancer treatment. Monoclonal antibodies , interferon , interleukin-2 , and colony-stimulating factors are some types of biological therapy.
The side effects caused by biological therapy vary with the specific treatment. In general, these treatments tend to cause flu-like symptoms, such as chills, fever, muscle aches, weakness, loss of appetite, nausea, vomiting, and diarrhea. Patients also may bleed or bruise easily, get a skin rash, or have swelling. These problems can be severe, but they go away after the treatment stops.
Bone marrow transplantation (BMT) or peripheral stem cell transplantation (PSCT) may also be used in cancer treatment. The transplant may be autologous (the person's own cells that were saved earlier), allogeneic (cells donated by another person), or syngeneic (cells donated by an identical twin). Both BMT and PSCT provide the patient with healthy stem cells (very immature cells that mature into blood cells). These replace stem cells that have been damaged or destroyed by very high doses of chemotherapy and/or radiation treatment.
Patients who have a BMT or PSCT face an increased risk of infection, bleeding, and other side effects due to the high doses of chemotherapy and/or radiation they receive. The most common side effects associated with the transplant itself are nausea and vomiting during the transplant, and chills and fever during the first day or so. In addition, graft-versus-host disease (GVHD) may occur in patients who receive bone marrow from a donor. In GVHD, the donated marrow (the graft) reacts against the patient's (the host's) tissues (most often the liver, the skin, and the digestive tract). GVHD can be mild or very severe. It can occur any time after the transplant (even years later). Drugs may be given to reduce the risk of GVHD and to treat the problem if it occurs.
|
|
Nutrition During Cancer Treatment
Eating well during cancer treatment means getting enough calories and protein to help prevent weight loss and maintain strength. Eating well often helps people feel better and have more energy.
Some people with cancer find it hard to eat because they lose their appetite. In addition, common side effects of treatment, such as nausea, vomiting, or mouth and lip sores, can make eating difficult. Often, foods taste different. Also, people being treated for cancer may not feel like eating when they are uncomfortable or tired.
Doctors, nurses, and dietitians can offer advice on how to get enough calories and protein during cancer treatment. Patients and their families can find many useful tips in the National Cancer Institute booklet Eating Hints for Cancer Patients.
|
|
Pain Control
Pain is a common problem for people with some types of cancer, especially when the cancer grows and presses against other organs and nerves. Pain may also be a side effect of treatment. However, pain can generally be relieved or reduced with prescription medicines or over-the-counter drugs as recommended by the doctor. Other ways to reduce pain, such as relaxation exercises, may also be useful. It is important for patients to report pain so that steps can be taken to help relieve it.
For additional information about pain control, people with cancer and their families may wish to refer to the materials listed in the "National Cancer Institute Booklets " section.
|
|
Rehabilitation
Rehabilitation is an important part of the overall cancer treatment process. The goal of rehabilitation is to improve a person's quality of life. The medical team, which may include doctors, nurses, a physical therapist, an occupational therapist, or a social worker, develops a rehabilitation plan to meet each patient's physical and emotional needs, helping the patient return to normal activities as soon as possible.
Patients and their families may need to work with an occupational therapist to overcome any difficulty in eating, dressing, bathing, using the toilet, or other activities. Physical therapy may be needed to regain strength in muscles and to prevent stiffness and swelling. Physical therapy may also be necessary if an arm or leg is weak or paralyzed, or if a patient has trouble with balance.
|
|
Followup Care
It is important for people who have had cancer to continue to have examinations regularly after their treatment is over. Followup care ensures that any changes in health are identified, and if the cancer recurs , it can be treated as soon as possible. Checkups may include a careful physical exam, imaging procedures, endoscopy, or lab tests.
Between scheduled appointments, people who have had cancer should report any health problems to their doctor as soon as they appear. (Source: excerpt from What You Need To Know About Cancer - An Overview: NCI)
Find a Therapist or Health Professional
We have linked up with Psychology Today to bring you America's most comprehensive list of Health Professionals throughout the United States and Canada.
Buy Products Related to Treatments for Cancer
» Next page: Doctors and Medical Specialists for Cancer
Medical Tools & Articles:
Next articles:
- Doctors and Medical Specialists for Cancer
- Prevention of Cancer
- Cure Research for Cancer
- Deaths from Cancer
- Death Statistics for Types of Cancer
Tools & Services:
- Bookmark this page
- Take a survey relating to Cancer
- Symptom Search
- Symptom Checker
- Medical Dictionary
- Give your feedback
Medical Articles:
Forums & Message Boards
Major Disease Research
symptoms, treatments,
and misdiagnosis
of major diseases.
Multiple Symptom
Checker
or many
symptoms