OVERVIEW OF CANCER TREATMENT

“ explain the rationale underlying the choice of treatment”

Curative – to completely remove or kill the cancer

Palliative – removal or killing cancerous cells that are causing pain

• Pallative treatments are meant to improve quality of life not length ( by curing )

Four Major Treatment Modalities :

SURGERY :

• Oldest and most commonly used
• Local treatment modality
• Works best with other forms of treatment
• Such as radiation and chemo before and after treatment
• Plays a role in :
• Diagnosis (biopsy)
• Staging
• Primary treatment
• Palliation
• Identification of treatment responses
• Not all patients are surgical candidates
• Surgery is the most successful with small tumors that haven’t spread
• Surgical Palliation – used to relieve symptoms patient may be experiencing

Benefits of Surgery:

• Mostly psychological
• Patient feels that all the bad has been cut out

Disadvantages of Surgery:

•  Loss of function

•  Cosmetic damage

•  Doesn’t effect any metastasis

•  Requires local anesthesia

•  There is a certain percentage of people who do not wake from anesthesia

•  Patients with heart disease or diabetes can come into complications

MEDICAL ONCOLOGY ( Chemotherapy)

Release of mustard gas in the 1940’s started chemotherapy

• Found it lowered the WBC count

• Chemo is a systemic treatment
• Good for leukemia and cancers that spread through the lymph and blood
• Use of cytotic drugs and hormones
• Kills primary tumor cells and those cells circulating throughout the body
• Can be used with other modalities
• Multi drug regimens are often used
• Computer Controlled Models
• Radiosensitizers(w/ radiation therapy)
• Chemicals that increase the effects of the radiation treatments
• Radioprotectors
• Limit the effects of radiation on normal cells
• Side effects may not be seen for many years after treatment

Benefits of Chemotherapy:

• Addresses the spreading of cancer
• Ex. Lymphatic metastasis (breast cancer)
• Can be used prophylaxis – treatment to prevent something from happening
• New chemo drugs are tailored to certain conditions
• Pedrizone – used to help the patients tolerate the strong chemo drugs

Disadvantages of Chemo:

• Effects many parts of the body

BIOTHERAPY ( immunotherapy)

• Systemic treatment
• BCG vaccine - given to reduce the possibility of tuberculosis
• Once you have received BCG vaccine you will show positive for TB on a PPD(reason its not used in the United States)
• Sometimes it is used to treat cancer (some patients show a regression)
• NOONE HAS EVER CURED A PATIENT WITH IMMUNOTHERAPY

RADIATION THERAPY -Radiation therapy is the careful use of high-energy radiation to treat cancer. A radiation oncologist may use radiation to cure cancer or to relieve a cancer patient's pain.

• Local treatment

Advantages of radiation therapy:

• You cant treat primary tumor and surrounding lymphatic's
• No anesthia required

Disadvantages:

• Development of problems years down the road

AIMS OF TREATMENT

Two mutually exclusive goals: