Cancer Treatment Options
Numerous types of treatment are used to target cancer, whether in an attempt to cure it, keep it from metastasizing (spreading), or alleviate the distressing symptoms that it causes. You may not receive all these treatments, or you may receive different combinations of these treatments at different times on your cancer journey.
Every cancer is unique — there’s no one-size-fits-all approach when dealing with this disease, but your cancer team will apply evidence-based and consensus-driven standards when deciding on the best course of action for you.
Chemotherapy is the delivery of drugs specifically designed to kill cancer cells by inhibiting their ability to replicate. It can be given before undertaking a treatment intended to be curative (referred to as neoadjuvant chemotherapy), after such treatment (called adjuvant chemotherapy), or when the cancer has spread to other parts of the body (called chemotherapy for metastatic disease). Regardless of when it’s administered, chemotherapy is a systemic therapy.
Numerous chemotherapeutic agents are available, and they produce their desired effect on cancer cells in a variety of ways. Some damage parts of cancer cells after they’re copied and ready to divide, others damage the part of cancer cells that help them divide, and still others inhibit cancer cells’ ability to duplicate themselves (a process that needs to occur before a cancer cell can divide to create more cancer cells).
Although chemotherapy is commonly administered through intravenous infusion, it can be given in many ways, including orally (through pills, capsules, and liquids), topically (by rubbing creams on the skin), by injection into muscle or directly under the skin, intra-arterially (directly into an artery feeding the tumor), and intraperitoneally (directly into the peritoneal cavity, which is where the intestines are).
Because chemotherapeutic agents target cancer cells in different ways, it’s common for several of these agents to be given together. This strategy increases the potent killing effect of these drugs while reducing the risk that some cells will develop resistance to the drugs.
Radiation kills living cells by damaging their DNA. The successful use of radiation in cancer is based on the ability to direct the radiation dose to the tumor, sparing the surrounding normal tissue. To ensure that the treatments stay focused on their target, various imaging systems, computer software, and body stabilization mechanisms (like molds and masks) may be used.
When radiation is delivered externally, photon or electron beams are typically used. These beams go through the cancer and destroy both healthy and cancerous tissue along the beam’s path. More recently, radiation therapy with proton beams has become available, but only select treatment centers across the country currently offer it.
An advantage of proton beams is that they can be directed to deposit most of their energy at the target site, so they tend to cause less damage to healthy tissue than photon beams. However, technological advances continue to improve the administration of photon beams, reducing their impact on healthy tissue.
A common form of internal radiation therapy is called brachytherapy. When this treatment is used, radioactive seeds, ribbons, or capsules are placed in or near the cancer cells. This enables a high dose of radiation to be delivered directly to the cancer, sparing healthy tissue. This treatment may be used for breast, head and neck, uterine, cervical, prostate, gallbladder, esophageal, eye, and lung cancers.
You can also receive internal radiation in a liquid form (such as radioactive iodine or chemotherapy agents with radioactive materials attached), which may be taken orally or received intravenously. When the liquid form is used, the radiation travels throughout the body to seek out and kill cancer cells. This treatment is often used for thyroid cancer and non-Hodgkin’s lymphoma.
Surgery as a cancer treatment
Surgery is the oldest type of cancer care. This treatment is instrumental in curing most malignant conditions. Surgical removal of cancer may be undertaken in all areas of the body.
And even if a cure isn’t possible, surgery may be used to alleviate distressing symptoms or to avoid complications (for example, placing a rod into the bone of a cancerous lower limb to prevent a fracture and inability to walk), even when survival is unlikely to be improved.
Hormone therapy for cancer patients
Hormone therapy refers to the administration of anti-cancer therapy that favorably impacts growth factors that under normal circumstances control the growth pattern of particular tissues within the body. Hormone therapy may be administered when there is evidence that inhibiting these factors will cause regression of the cancer or prevent its spread.
Hematopoietic stem cell transplantation
Hematopoietic stem cell transplantation is the transplantation of hematopoietic stem cells (blood cells that can develop into any other blood cells) to treat certain blood and bone marrow cancers. The stem cells are usually extracted from the bone marrow, peripheral blood, or umbilical cord blood.
When the stem cells come from your own blood or bone marrow, the transplantation is referred to as autologous; when they come from a donor, it’s referred to as allogeneic. In addition to treating your cancer, hematopoietic stem cell transplantation may be used to enable you to receive higher doses of chemotherapy than your bone marrow could otherwise tolerate.
Biotherapy as a cancer treatment
Biotherapy, also referred to as immunotherapy, is a very broad category of anti-cancer treatment that relies, at least in part, on a patient’s normal immune system to destroy the malignant cells. Biotherapy includes a variety of cancer vaccines, monoclonal antibodies (man-made versions of immune system proteins), and nonspecific immunotherapies (these provide a general boost to the immune system).
Molecularly targeted drugs for cancer treatment
The delivery of molecularly targeted drugs is a truly exciting new approach to cancer management. Every cancer has unique molecular abnormalities. With this therapy, these abnormalities are identified via laboratory assessments; then specific treatments that are known to be active in the presence of these abnormalities are administered.