CANCER (2): AVAILABLE TREATMENTS

The available cancer treatments consist of various treatment options related to a variety of factors, such as the type and stage of cancer, the general health situation, and the patient’s own preferences.

The oncologist can be consulted about the benefits and risks of each cancer treatment option to determine the best and most effective cancer treatment for each case.

CANCER TREATMENT GOALS

The cancer treatment aims at:

  1. killing or removing cancer cells (basic treatment)
  2. destroying remaining cancer cells (adjuvant therapy)
  3.  treating the side effects of previous cancer treatment (supportive treatment).

TREATMENTS AVAILABLE FOR CANCER 

Doctors today have a variety of tools designed to treat cancer. These treatments include:

1. Surgery

In theory, solid cancers can be cured by surgery, but this is not what actually happens. When cancer spreads and moves to other parts of the body before surgery, the chances of removing the cancer are zero. The Halstedian Model explains the progression of solid cancer. This led to the search for topical treatments for solid cancers before they spread, including surgical treatment.

 Surgeries such as mastectomy or prostatectomy in which the cancerous part is removed or the entire organ may be removed. A single microscopic cancer cell is enough to produce new cancer, which is called a relapse. Therefore, when the surgery is performed, the surgeon sends a sample from the edge of the removed part to the surgical pathologist to make sure it is free of any infected cells, to reduce the chances of relapse. 

As surgery is important to remove cancer. it is most important to identify the stage of cancer and explore if lymph nodes are invaded by cancer cells. And this information has a significant impact on the choice of appropriate treatment and predicts the therapeutic effect.

 Sometimes surgery is required to control and relieve symptoms of cancer such as pressure on the spinal cord or intestinal obstruction called Palliative Treatment.

 2. Chemotherapy

Patient undergoing chemotherapy

Chemotherapy is the treatment of cancers with chemical drugs (Anticancer Drugs) capable of destroying cancer cells. The term chemotherapy is currently used to express cytotoxic drugs that affect all cells characterized by rapid division. In contrast, there is treatment with targeted drugs. Chemotherapy interferes with cell division in various areas, such as when DNA duplication is duplicated or when chromosomes are formed. Cytotoxic drugs target fast-dividing cells and are therefore non-target. They may target both cancerous and healthy cells. But healthy cells are able to repair any DNA damage that results from treatment. One of the tissues that are affected by chemotherapy is the constantly changing tissues such as the intestinal lining that repair themselves after chemotherapy

Sometimes providing two types of medication to a patient is better than a single drug. This is called a combination of chemotherapy.

Some treatments of leukemia or lymphoma require high doses of chemotherapy to remove the entire bone marrow, giving the body a chance to produce a new bone marrow and then give new blood cells. For this reason, the bone marrow or blood stem cells are kept before treatment in case the body is unable to produce a new marrow. This is called repetitive stem cell transplantation. In contrast, Hematopoietic Stem Cells can be transplanted from another matching donor.

3. Targeted Therapy

This treatment uses fine drugs that target proteins that appear in cancer cells. These drugs are antibodies in the form of small molecules that block/ inhibit Tyrosine Kinase proteins from mutating and reproducing in cancer cells. An example of these antibodies is  Trastuzumab.

4. Hematopoietic stem-cell transplantation (HSCT)

 This method is used in hematology, tumors, blood and bone marrow diseases. This bone marrow transplantation is the process of injecting blood-forming stem cells into your body to replace damaged or sick bone marrow. You may need a bone marrow transplant if the bone marrow stops working or no longer produces enough healthy blood cells. Bone marrow transplants may use cells from your body (self-transplantation), or cells from a donor (a khifi transplant).

5.  Biological therapy

Biotherapy for cancer is a form of treatment that uses the body’s immune system to kill cancer cells. Biotherapy for cancer is used to treat many types of cancer to prevent or slow tumor growth and to prevent the spread of cancer. It often causes fewer toxic side effects than other cancer treatments

6. Drug therapy

 Because surgery and radiation therapy can cause inflammation within the organ, like tumors themselves, doctors sometimes prescribe corticosteroids to relieve swelling, both after surgery and during radiation therapy. Although corticosteroids relieve inflammation, they are used for certain periods of time to avoid serious side effects, such as muscle weakness, osteoporosis, high blood pressure, diabetes, and increased susceptibility to infection.

7. Clinical trials

 Clinical Trials are a new treatment for patients with cancer. Its goal is to find the best solution to treat patients and help them cope with the disease. Clinical trials test new types of drugs, methods, surgical treatment, radiotherapy, or combination therapies.

Clinical trials are one of the last long and cautious stages of testing the new treatments. The search for new treatments begins in laboratories, where scientists discover or develop the treatment. If the treatment is promising, they try it with animals with cancers to determine its ability to treat and identify its side effects. If this treatment is proven to be effective, it is tested on humans. Of course, not all the proper treatments of animals are appropriate for a person. Each treatment is required to be therapeutic and safe.

Patients are monitored when they receive new treatment by doctors. This is because of the uncertainty of the effects of the tried treatment, and the unknown side effects that may occur.

 8. Radiation therapy

Patient undergoing a type
of radiation therapy

 Radiation therapy or radiotherapy or X-ray therapy is the use of radiation in ionizing cancer cells to kill or shrink their numbers. It is applied to the patient’s body from outside and is called external beam radiotherapy (EBRT) or is applied inside the patient’s body by branchy therapy treatment. The effect of radiation therapy is local and is limited to the area to be treated. Radiation therapy harms and destroys the gene in the cells, affecting the division of those cells. Although this treatment affects cancer cells and healthy ones, most healthy cells can recover from the radiation effect. Radiation therapy aims to destroy most cancer cells while minimizing the impact on healthy cells. Therefore, radiation therapy is divided into several doses, to give healthy cells time to recover between radiation doses.

Radiation therapy is used for all types of solid cancers, and can also be used in leukemia. The radiation dose is determined by the location of cancer and the sensitivity of cancer to radiation if there is a healthy part adjacent to cancer that can be affected by radiation. Its effect on adjacent tissues is the most important side effect of this type of treatment.

9.  Immunotherapy

Immunotherapy differs from Targeted Therapy as it is designed to stimulate the patient’s immune system to eliminate cancer cells. Current methods induce an immune response against cancer, including the use of Bacillus Calmette-Guérin BCG intra-bladder to prevent bladder cancer or the use of interferon or cytokine to stimulate the immune system against the renal cell,l carcinoma, or melanoma. Vaccines, such as the Sipuleucel-T vaccine, are used by taking Dendritic cells – immune-stimulating cells – from the patient’s body loading them with Prostate Acid Phosphatase, and returning them to the body. It stimulates the specific immune system against prostate cancer cells.

10.  Hormone therapy 

Hormonal Therapy may stop the growth of some cancers. Cancer such as breast and prostate cancers may be affected by this type of treatment. Removal or inactivation of estrogen or testosterone is an added benefit of treatment.

11. Gene therapy

Gene therapy is one of the most important new strategies in the fight against cancer. Its importance emerged with the definition of cancers as genetic diseases, tempting researchers to seek the repair of damaged genes. This is done in many ways, including placing the healthy gene in a viral cover, Cataionic Liposomes, or by electrifying cancer cells and forcing them to open their pores to help absorb the healthy gene into the cancer cell, called electroporation. Recently the treatment was intervened by siRNA interlaced RNA to stop the production of cancer proteins.

12. Emotional Influence

Some preliminary studies suggest that family and social relationships, with their psychological and emotional impact/influence on the patient, may reduce the likelihood of the patient dying. Factors such as religion and learning also help the patient to accept his illness or even accept the near-term.

  New sciences, such as psycho-oncology, have emerged to guide doctors and surgeons to better deal with the patient and show understanding and compassion for each case and its impact on the patient’s mental and emotional health. These studies reject the “hit-and-run” principle of defining the patient’s painful truth without incarceration of cancer     

There are organizations that provide much assistance for cancer. It may include counseling, advice, financial assistance, film, or media to identify the disease. These organizations are either governmental or charitable and their work is to help the patient to challenge and overcome cancer. Click here to go to the next part

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