Cancer Treatment

Cancer Treatment

Reviewed By:
Carol Kornmehl, MD, F.A.C.R.O
Martin E. Liebling, M.D., FACP

Summary

There are several different methods used to treat cancer. The goals of treatment may include curing the cancer, controlling the cancer or treating symptoms and complications caused by the disease. Cancer treatment is usually coordinated by  members of the patient’s cancer care team, a group of healthcare professionals responsible for finding cancer, treating cancer and caring for people who have cancer. The team is often headed up by a primary care physician and/or medical oncologist.

In order to choose the best course of treatment, physicians consider the location and type of cancer and the stage (extent of the cancer). It is essential to identify the exact type of cancer because treatment may vary depending on the type. Identifying the stage or how far the cancer has spread is also important because early stage cancers respond differently to treatment and require different options than advanced cancers. In addition, a number of other factors, including the patient’s age, overall health, and personal preferences are considered in the treatment plan.

This guide focuses on the treatments and therapies used in fighting cancers.

About cancer surgery

Surgery is the oldest form of cancer treatment. It may be performed to cure the disease, to treat complications of the disease or to support other types of treatment. Most cancer patients will undergo some type of surgery during their illness.

There are four main goals for cancer surgeries:

  • Curative. The goal of curative surgery is to totally remove all of the cancer in the body by removing a tumor that appears to be confined to one area. Curative surgery may be used alone or in combination with chemotherapy or radiation therapy. Two terms commonly used to describe a cancer’s potential to be cured with surgery are:
    • Resectable. Cancer that can be completely removed with surgery. This type of cancer is primarily in an early stage.

    • Unresectable. Cancer that cannot be completely removed with surgery. This type of cancer may have spread too far from the original tumor, or may be positioned so that it cannot be entirely removed with surgery.

  • Debulking. When a tumor cannot be completely removed (unresectable), debulking surgery may be used in some cancers to remove as much of the tumor as possible without causing damage to surrounding organs. Chemotherapy or radiation therapy may be ordered after the surgery to destroy the remaining areas of the tumor.

  • Palliative. The goal of palliative surgery is not to treat the disease. Instead, it is used to treat the complications of advanced cancer. In a patient with pancreatic cancer, for example, palliative surgery may be used to prevent or treat certain complications such as blockage of the bile ducts or the intestines.

  • Supportive. The goal of supportive surgery is to help with other types of treatment. For example, surgery may be used to place a catheter port into a vein. Following the surgery, the catheter can be used to deliver chemotherapy treatments or draw blood for testing.

In addition, some cancer patients may receive prophylactic surgery to prevent cancer. Prophylactic surgery may be performed on women with cancer in one breast, who have a prophylactic mastectomy to avoid the potential for cancer to develop in the other breast. Some women with certain genetic mutations are at greater risk of developing breast cancer and ovarian cancer. they may choose to have a prophylactic mastectomy or oophorectomy (ovary removal).

Non-surgical cancer therapies

There are a number of non-surgical methods used to treat cancer. The treatment method chosen depends on the type and stage of cancer, as well as certain additional factors including the patient’s age and general health. Some patients may receive a combination of therapies, while others may only receive one. The main types of non-surgical cancer treatment options include:

  • Chemotherapy. Powerful drug therapy used to destroy cancer cells. The drugs are typically taken orally or by injection, but may be provided in other methods, such as a patch. The drugs are used to treat cancers that have metastasized (spread) because they are able to travel throughout the body in the bloodstream. Chemotherapy may be used to cure cancer, prevent cancer from spreading, slow the growth of cancer, destroy cancer cells that may have spread to other areas of the body, or relieve symptoms caused by cancer. A combination of chemotherapy drugs is commonly used.

  • Radiation therapy. High-energy specialized x-rays that destroy or shrink cancer cells. This treatment targets dividing cancer cells and disrupts or destroys their genetic material, preventing the cells from continuing to grow and spread throughout the body. Radiation may be delivered from a machine outside the body (external radiation therapy) or a source of radiation may be inserted directly into the body (brachytherapy). In some cases, radiation may be delivered during surgery to remove a tumor. Some types of radiation are so precise that they may be referred to as radiosurgery.

  • Biological therapy (or immunotherapy). Uses substances naturally produced by the immune system to kill cancer cells, slow the growth of the cancer cells or activate the patient’s immune system to more successfully fight the disease. It may also be used to lessen the side of effects of other cancer treatments. There are several different types of biological therapy. More than one type may be used in treatment, or it may be used in combination with chemotherapy or radiation therapy.

Other, less common, treatment options include:

  • Bone marrow and peripheral blood stem cell transplantation. Stem cells are cells that can re-populate the bone marrow (which makes all blood cells) after the marrow has been destroyed by treatments with high dose x-ray or chemotherapy. Transplantation of bone marrow stem cells or peripheral blood stem cells may come from a matched donor or from the patients themselves. This is not a direct treatment for cancer, but helps the body to tolerate higher levels of chemotherapy, radiation therapy or a combination of both. In addition to destroying cancer cells, high-dose therapies also destroy normal blood cells in the bone marrow. Patients who undergo transplantation receive an infusion of healthy stem cells through a vein after high-dose therapies. As a result of the infusion, new blood cells begin to develop from the transplanted cells.

  • Anti-angiogenesis therapy. Uses drugs or other substances to block angiogenesis, the formation of new blood vessels. By blocking this process, the treatment prevents blood from reaching the tumor. Without blood, a tumor cannot grow. One anti-angiogenesis drug has been approved for use with chemotherapy to treat colorectal cancer and another is used to treat multiple myeloma (a type of bone marrow cancer). In addition, many other drugs are being studied and some are used in clinical trials for cancer treatment.
  • Blood product donation and transfusion. Temporarily replaces components of the blood (red blood cells and platelets) in people who are unable to produce them on their own, or have lost them from bleeding. People with cancer may need this procedure to replace blood loss due to complications of cancer or to other cancer treatments such as chemotherapy, surgery or radiation therapy.

  • Photodynamic therapy (PDT). Uses a drug known as a photosensitizing agent to destroy cancer cells. The drug is either injected into the bloodstream or applied to the skin. A special light source is then applied to the area being treated. The light causes the drug to react with oxygen, forming a chemical that destroys cancer cells.

  • Hormone therapy. Therapy to either reduce the levels of certain hormones in the body or prevent cancer cells from receiving hormones. Drugs may be used to interfere with the production of hormones or the action of the hormones. In other cases, glands that produce hormones may be surgically removed. This method may be used to destroy cancer cells or slow their growth.

Other therapies are being studied in clinical trials. Gene therapy seeks to treat cancer by transporting healthy genes that contain DNA that is missing or defective in the patient.

In addition to these treatment methods, a variety of complementary and alternative therapies are also available. The American Cancer Society (ACS) defines complementary medicine or methods as treatments that are used along with a patient’s regular medical care. Alternative medicines are defined as treatments that replace a patient’s regular medical care. Complementary and alternative therapies include numerous healthcare practices, systems and products that are not usually part of standard medical treatment. Examples include acupuncture, massage, vitamins, herbs and dietary supplements.

Cancer patients considering the use of complementary and/or alternative therapies are encouraged to first talk to their physician. Using such therapies may cause serious side effects, or worsen the patient’s prognosis (predicted outcome for survival) by replacing, delaying or interfering with regular cancer treatment.

After cancer treatment

There are a number of terms that may be used to describe the status of cancer following treatment. These include:

  • Remission. A period in which a patient’s cancer is under control and undetectable. Following treatment, cancer may be classified as being in remission when the signs and symptoms of the disease have partially or completely disappeared. A remission, however, may not mean the disease is cured. Remissions can last from several weeks to years. When a complete remission continues for many years, the cancer may be considered cured.
  • Recurrence (or relapse). The return of cancer after a period of time in which the patient appeared to be in complete remission. Recurrence may occur locally, regionally or in a distant site.
    • Local recurrence. The cancer occurs at the same site as the original tumor.
    • Regional recurrence. The cancer occurs in the lymph nodes near the original site.
    • Distant recurrence. The cancer occurs in organs or tissues that are farther from the original site than regional lymph nodes. Distant recurrences often occur in the lungs, liver, bone marrow or brain.

When cancer returns, it is often possible to achieve another remission with additional treatment. In some cases, a different course of treatment, such as a different combination of chemotherapy drugs may be used.

Questions for your doctor on cancer treatment

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. You may wish to ask your doctor the following questions about cancer treatment:

  1. What treatment do you recommend for my cancer?
  2. How and where will I receive the treatment?
  3. If this treatment does not work, what are my other options?
  4. What are the benefits and risks of these treatments?
  5. What is the prognosis for each treatment?
  6. Who will coordinate my cancer treatments?
  7. What are the side effects from the treatments?
  8. What tests might be used to monitor my health during treatment?
  9. How will I know if the treatment has been successful?
  10. Can you recommend any other physicians experienced with my type of cancer and treatment?
Scroll to Top