TREATMENT CANCER



TREATMENT
Oncologists select from a number of options when treating cancer, depending on the type and stage of the tumor involved. The major treatments currently available are surgery, radiation therapy, chemotherapy, hormone therapy, and immunotherapy. Often, targeting cancerous tumors requires the artful combination of more than one type of cancer therapy.


Surgery

Surgery is the most effective and fastest treatment for tumors that are caught early and have not metastasized. It is the only option ensuring that the entire visible tumor is eliminated. However, there is no guarantee that all microscopic extensions of a tumor have been removed. For this reason, surgeons may also remove a large portion of healthy tissue that surrounds the tumor. This may not be possible if the tumor lies near or within a vital tissue, such as a major nerve or organ.

Often, cancer surgery requires general anesthesia, in which the patient loses consciousness, and a hospital stay of several days. For example, women with breast cancer may have a lumpectomy or mastectomy, surgical removal of part (or all) of the breast. Depending on the stage of the tumor, doctors may also remove the nearby lymph nodes and muscle tissue. As with any major surgery, mastectomies and other major surgical cancer treatments involve some risk, and doctors must consider the overall health of the patient, as well as the stage of the tumor.
Some cancers can be treated surgically with less-invasive techniques, such as laser surgery. Laser surgery uses a powerful beam of high-energy light to vaporize certain tumors of the cervix, larynx, and skin. Physicians perform laser surgery with an endoscope inserted through a small incision in the skin. Laser surgery and other less-invasive surgical procedures may require only local anesthesia, in which a patient loses feeling in one particular area of the body but never loses consciousness.

Sometimes oncologists recommend surgery to improve a patient’s quality of life, even if it is not likely to rid the body of cancer. Surgery of this type aims to correct a problem that is causing discomfort or disability. For example, some cancers may spread to the spine, pressing on the spinal cord or nearby nerves. This pressure may cause severe pain, and in some instances, paralysis. Surgical removal of all or part of the tumor near the spine may alleviate these symptoms.

Radiation Therapy

Radiation Treatment
Here, a patient undergoes radiation treatment for cancer of the spine. In this procedure the radioisotope cobalt 60 is used as the source of gamma radiation. A high dose of gamma radiation is guided by laser targeting to a localized area of treatment.
Therapeutic radiology uses high-energy particles or waves, such as X rays or gamma rays, to focus damaging radiation on the region of a tumor, inflicting genetic damage that kills cancerous cells. Radiation therapy damages rapidly dividing cells, mostly cancer cells but also healthy cells that reproduce quickly. This leads to side effects such as fatigue, skin changes, and loss of appetite. Other side effects usually are related to the treatment of specific areas, such as hair loss following radiation treatment to the head. Radiation therapy can also cause a decrease in the number of white blood cells, cells that help protect the body against infection. Most side effects are short-lived, as healthy tissues recover from radiation much better than cancer cells because healthy cells repair damaged DNA more efficiently.
Many short doses of radiation therapy, instead of fewer heavier doses, can minimize side effects. The total dose and the number of treatments depend on the size, location, and type of cancer and the patient’s general health. Patients usually receive radiation therapy five days a week for five to eight weeks. Weekend rest breaks allow normal cells to recover.

Unlike surgery, radiation can destroy microscopic cancer cells that have moved into surrounding tissues. Radiation is also a safer option for older patients or those weakened from other diseases, who may not recover well from surgery. Oncologists may use radiation to shrink the tumor, making surgery feasible. For other tumors, radiation may be used following surgery. However, radiation does not always eliminate all tumor cells, and it cannot treat widespread metastases. Like surgery, radiation therapy may be used to relieve pain and discomfort, even when a cure is not likely

Chemotherapy

Chemotherapy uses powerful anticancer drugs that travel through the bloodstream, making it potentially useful for cancers that have spread. Oncologists use about 50 different chemotherapeutic drugs to combat cancer, generally administering more than one drug at a time because these drugs are more powerful when combined. Taken orally or injected into the bloodstream, chemotherapeutic drugs interfere with cancer cells’ ability to make new DNA or divide properly. In some cases, the drugs cause programmed cell death. Many leukemias and lymphomas and cancer of the testicles are successfully treated with chemotherapy. Breast, lung, colorectal, and prostate cancer are not currently curable with chemotherapy alone, so chemotherapy is often used in combination with other therapies. In fact, the most common combination of cancer treatments is surgery or radiation therapy followed by chemotherapy.
Chemotherapy often causes severe side effects, particularly reduced resistance to infection, internal bleeding, diarrhea, nausea, vomiting, hair loss, and insufficient oxygen in the blood, known as anemia. Some tumors develop resistance to many drugs after exposure to just one drug, a condition called multidrug resistance. When this happens, there may be no drugs that are effective against the tumor.

Hormone Therapy

Some types of cancer, such as breast and prostate cancer, depend on sex hormones to grow. Hormone therapy prevents cancer cells from receiving or using the hormones they need. Hormone therapy may include surgery to remove organs in the endocrine system that make hormones. In other cases, hormone therapy relies on drugs to stop hormone production or change the way hormones work. Antiestrogen drugs, such as tamoxifen and raloxifene, given to women with breast cancer block estrogen and inhibit its ability to stimulate cell growth. Sometimes called designer estrogens, these drugs cause only mild side effects because treatment is limited to tissues affected by hormones. Androgen blockers are given to men with prostate cancer to block the production of testosterone and other male hormones that may contribute to cancer growth.
Contributed By:Karen R. Peterson

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