Cancer: Different Types of Treatments

Surgery: The First Treatment?

Surgery is performed for many reasons. Some types of surgery are minor and may be called procedures, while others are major operations.

Here are the most common types of cancer surgery:

• Preventive or Prophylactic Surgery: Preventive or prophylactic surgery is used to remove body tissues that have the potential to develop into cancer, even if there are no signs of cancer at the time of the operation. For example, precancerous polyps can be removed from the colon during a colonoscopy;
• Diagnostic Surgery: Surgery is often performed to help diagnose cancer. In most cases, the only way to know if a person has cancer and to determine the type of cancer is to perform a biopsy. The diagnosis is made by examining the cells in the sample under a microscope or by other laboratory tests performed on the sample;
• Curative Surgery: Curative cancer surgery is generally performed when the cancer is confined to a single part of the body and it is likely that the cancer can be completely removed. In this case, the surgical operation removes cancer cells and is the only treatment needed. It can be used alone or in combination with other treatments, such as chemotherapy or radiotherapy, which may be administered before or after the operation;
• Cytoreductive Surgery: Cytoreductive surgery removes part (but not all) of the cancer. It is sometimes performed when removing the entire tumor would cause too much damage to surrounding organs or tissues. In these cases, the doctor can remove as much of the tumor as possible, then treat what remains with radiation therapy, chemotherapy, or other treatments;
• Palliative Surgery: This type of surgery is performed to treat complications caused by advanced cancer. It can be used to correct a problem that causes discomfort or disability. Palliative surgery can also be used to treat pain when it is difficult to control by other means. Palliative surgery relieves problems caused by cancer and helps people feel better, but it is not used to treat or cure the cancer itself;

Chemotherapy: Acting with Medications

When thinking about cancer treatment, chemotherapy is often the first method that comes to mind. Chemotherapy involves administering drugs to destroy cancer cells and prevent them from multiplying in the body. The most common methods for receiving chemotherapy are infusion or tablets to be taken at home (oral chemotherapy).

Chemotherapy causes side effects in some patients, but not all. Most of these side effects can be controlled. Serious side effects are rare.

Doctors and nurses will talk to you about possible side effects before starting treatment. And once you've started, they will help you manage them. It is important that you keep a diary of your symptoms and report them to your doctors and nurses during your visits.

Targeted Therapies: Personalized Medicine

These are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules (molecular targets) involved in the progression of the disease. Targeted therapies are often cytostatic (they block the proliferation of tumor cells).

Targeted therapies are at the heart of precision medicine, which uses information from a person's genes and proteins to prevent, diagnose, and treat diseases.

To formulate targeted therapies, it is necessary to identify targets that play a key role in the growth of cancer cells. One way to do this is to compare the amount of individual proteins in cancer cells and normal cells. Proteins present in cancer cells but not in normal cells would be possible targets.

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Radiation Therapy: Exposure to Rays

Radiation therapy consists of drugs containing radioactive materials that are used in the administration of systemic radiation therapy. They can be taken orally or injected, travel through the body via the blood, and accumulate at the cancer site to emit their radiation and fight cancer cells.

Hormone Therapy: Indirect Action

Hormone therapy involves administering drugs that block the activity of estrogen hormones. Hormone therapy is often used in the treatment of breast cancer.

Certain neoplastic forms are positively affected by hormone deprivation. The most suitable forms, if they present appropriate histological expression of receptors, are neoplasms of the breast, prostate, and ovaries.

Hormone therapy works in two ways:

• It prevents the tumor cell from using estrogen hormones;
• It inhibits the production of estrogen hormones;

Hormone therapy is generally performed after chemotherapy. Hormone therapy treatment is reserved for non-advanced breast pathologies with adequate receptor expression as adjuvant treatment or for advanced forms in sequential association with chemotherapy and/or radiotherapy.

Similarly, in clinical practice, prostate neoplasms are treated with hormone therapy to achieve better disease control in both the adjuvant phase (prevention of recurrence after surgical treatment or radiotherapy) and advanced disease (metastatic disease).

It has been verified that ovarian neoplasms can also express estrogen receptors and may therefore benefit from suppressive hormone treatment.

Immunotherapy

This is a type of biological therapy that helps the immune system (the system that helps the body fight infections and other diseases) to cope with cancer. Some immunotherapies strengthen the immune system to make it more effective against cancer, while others can "mark" cancer cells so that the immune system can find and destroy them.

There are different methods of administering immunotherapy: intravenous, oral, topical, or intravesical (directly into the bladder).

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