The most common types of cancer treatment include surgery, radiation therapy, and chemotherapy. These therapies may be used either alone or in combination with other therapies. More recent treatment options include hormonal therapy, biological therapy or stem cell transplant which may be used for some types of cancer. Cancer treatment is given by cancer specialists (oncologists). Some specialize in surgery, some in radiation therapy and others in chemotherapy (drugs). These doctors work with the patient to decide on a treatment plan. The cancer treatment options for a patient depend on the type and stage of cancer, possible side effects, and the patient's preferences and overall health. The first treatment that a patient is given is called first-line therapy or the main treatment or primary treatment. Adjuvant therapy is treatment that is given after the first treatment (such as chemotherapy after surgery.) Neoadjuvant therapy is treatment that is given before the primary treatment (such as hormone therapy before surgery.) Most experimental therapies are tested in clinical trials.
Treatment Goals
Cancer treatment may be given for a number of reasons. Sometimes, the goal of treatment can change over time.
Prevention (Prophylaxis)– Treatment is given to prevent the growth of cancer cells or to remove precancerous tissue that could turn into cancer. Cure– Treatment is given to cure the cancer. Control– Treatment is given to control the tumour and stop cancer from growing and spreading. It also reduces the risk of the cancer coming back (recurring). Palliation (Palliative)– When cure is not possible, treatment is given to:
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Temporarily shrink tumours
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Reduce symptoms, such as bleeding, pain or pressure
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Treat problems caused by cancer or its treatment
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Improve a person's comfort and quality of life
Types of Treatments
Treatment can be broadly divided into the following types of therapies:
Local Therapy– Local treatments are directed at a specific part of the body and are often used when cancer is limited to that area. Radiation therapy and surgery are both local treatments.
Systemic Therapy– Systemic treatments travel through the bloodstream to reach cancer cells throughout the body. Many chemotherapy drugs are systemic treatments that are absorbed by the body’s cells and tissues. Systemic treatmentsare often used to treat metastatic cancer (the cancer is found in several parts of the body) or to reduce the chance of cancer coming back (as adjuvant treatment).
Targeted Therapy– Targeted treatments directly target the cancer cells while sparing normal cells. Targeted therapy uses a biological agent to zero in on the cancer cell.
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.
Radiation Therapy- Radiation therapy, or radiotherapy, is the use of various forms of radiation to safely and effectively treat cancer and other diseases. Radiation oncologists may use radiation to cure cancer, to control the growth of the cancer or to relieve symptoms, such as pain.
Radiation therapy works by damaging cells. Normal cells are able to repair themselves, whereas cancer cells cannot. New techniques also allow doctors to better target the radiation to protect healthy cells.
The goal of radiation therapy is to get enough radiation into the body to kill the cancer cells while preventing damage to healthy tissue. There are several ways to do this. Depending on the location, size and type of cancer, you may receive one or a combination of techniques. Your treatment team will help you to decide which treatments are best for you.
Radiation therapy can be delivered in two ways, externally and internally. During external beam radiation therapy, the radiation oncology team uses a machine to direct high-energy X-rays at the cancer. Internal radiation therapy, or brachytherapy, involves placing radioactive sources (for example, radioactive seeds) inside your body.
Chemotherapy- Chemotherapy is the use of drugs to destroy cancer cells. Chemotherapy drugs fight cancer by interfering with the growth process of cancer cells, eventually causing the cells to die. Chemotherapy is used to shrink or eliminate the tumor, keep the tumor from spreading, destroy any cancer cells that have spread to other areas in the body, or relieve symptoms. Chemotherapy is called a systemic treatment, because it affects the entire body.
Chemotherapy is given by a medical oncologist, which is 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.
Targeted Therapy- Targeted therapy is a cancer treatment that uses drugs. But it is different from traditional chemotherapy. Targeted therapy works by targeting specific genes or proteins involved in carcinogenesis (the process by which normal cells become cancer cells) and tumor growth. Because scientists call these molecules “molecular targets,” these therapies are sometimes called “molecular-targeted drugs,” “molecularly targeted therapies,” or other similar names. By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies may be more effective than current treatments and less harmful to normal cells.
Gene Therapy- Advances in understanding and manipulating genes have set the stage for scientists to alter a person’s genetic material to fight or prevent disease. Gene therapy is an experimental treatment that involves introducing genetic material (DNA or RNA) into a person’s cells to fight disease. Gene therapy is being studied in clinical trials (research studies with people) for many different types of cancer and for other diseases. It is not currently available outside a clinical trial.
