Cancer Treatment

Cancer Treatment

1. Cancer Treatment

2. Cancer Treatment   Cancer can be treated by:-  S urgery Chemotherapy   Radiation therapy   Hormonal therapy Targeted therapy (including immunotherapy such as monoclonal antibody therapy ) S ynthetic lethality The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient (performance status).

3. 1.Surgery:- In theory, non-hematological cancers can be cured if entirely removed by surgery, but this is not always possible . When the cancer has metastasized to other sites in the body prior to surgery, complete surgical excision is usually impossible. In the  Halstedian model of cancer progression, tumors grow locally, then spread to the lymph nodes, then to the rest of the body. This has given rise to the popularity of local-only treatments such as surgery for small cancers . Even small localized tumors are increasingly recognized as possessing metastatic potential .

4. Examples:- Examples of surgical procedures for cancer include  for non-small cell lung cancer:- Such as- mastectomy  for breast cancer , prostatectomy  for prostate cancer, lung cancer surgery. The goal of the surgery can be either the removal of only the tumor, or the entire organ .  A single cancer cell is invisible to the naked eye but can regrow into a new tumor, a process called recurrence. 

5. 2.Chemotherapy :- It is one of the most common treatments for cancer. It uses certain drugs to kill cancer cells or to stop them from growing and spreading to other parts of your body. Your doctor might prescribe chemo by itself or with surgery or  radiation therapy. Why You Need Chemotherapy ? Even after surgery to remove a tumor, your body might still have cancer cells. These cells can grow new tumors or spread the cancer to other parts of your body Chemotherapy drugs help destroy, shrink, or control those cells. It might also treat symptoms the cancer causes, like pain. You might also get chemo to shrink a tumor before your doctor removes it in surgery. How It Works Chemotherapy drugs work in a few different ways. They can: Kill both cancerous and healthy cells Fight only cancer cells Keep tumors from growing blood vessels, which help them thrive Attack the cancer cells’ genes so the cells die and can’t grow into new tumors

6. Common Chemotherapy Drugs chemo drug interferes with the normal metabolism of cells, which makes them stop growing. These drugs are called antimetabolites. Doctors often use them to treat leukemia and cancer in the breasts, ovaries, and intestines . Drugs in this group include 5-fluorouracil,6-mercaptopurine ,  cytarabine , gemcitabine, and  methotrexate Anthracycline chemotherapy attacks the enzymes inside cancer cells’ DNA that help them divide and grow. They work for many types of cancer. Some of these drugs are actinomycin -D,  bleomycin ,  daunorubicin , and  doxorubicin .

7. 3.Radiation therapy:- Radiation therapy  (also called radiotherapy, X-ray therapy, or irradiation) is the use of ionizing radiation to kill cancer cells and shrink tumors . . Radiation therapy can be administered externally via external beam radiotherapy (EBRT) or internally via  brachytherapy. How Does It Work? Cells in your body are always dividing and making new copies. When you have  cancer , though, some cells start to divide way too fast. That's where radiation therapy can help. It uses high-energy particles to make tiny breaks in the DNA of cancer cells to destroy or damage them, so they can no longer make new copies. The aim is to treat your cancer by slowing or stopping tumor growth. Your doctor may sometimes suggest you get radiation therapy to shrink a tumor before you get surgery. Or he may recommend it after surgery to keep a tumor from coming back. If cancer cells have spread to other parts of your body, radiation therapy can kill them before they grow into new tumors. If you have a cancer that can't be cured, your doctor may still suggest you use "palliative" radiation therapy. The goal is to shrink tumors and ease symptoms of your disease.

8. Types of Radiation Therapy:- The kind of radiation therapy you get depends on things like: Type of cancer you have How big your tumors are Where your tumors are How close your tumors are to other tissues Your general health Other treatments you're getting The two main types of radiation therapy for cancer are : - External beam radiation therapy Internal radiation therapy In another option, called brachytherapy- Brachytherapy usually treats head, neck,  breast ,  cervix , endometrial,  prostate , and  eye  cancers .

9. Radiation Therapy side effects:- may include  fatigue , temporary  hair loss , sexual and  fertility problems , blurry vision, and  skin  changes . 4. Hormonal therapy :- Hormone therapy is a cancer treatment that slows or stops the growth of cancer that uses  hormones  to grow. Hormone therapy is also called hormonal therapy, hormone treatment, or endocrine therapy . Hormone therapy is used to :- Treat cancer.  Hormone therapy can lessen the chance that cancer will return or stop or slow its growth. Ease cancer  symptoms .  Hormone therapy may be used to reduce or prevent symptoms in men with prostate cancer who are not able to have  surgery  or  radiation therapy . How Hormone Therapy Is Given Hormone therapy may be given in many ways. Some common ways include: Oral.  Hormone therapy comes in pills that you swallow. Injection.  The hormone therapy is given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly. Surgery .  You may have surgery to remove  organs  that produce hormones. In women, the  ovaries  are removed. In men, the  testicles  are removed.

10. 5. Targeted Therapy:- Targeted cancer therapies block specific proteins or genes that help cancers grow and spread. For some types of cancer, they may work better than other treatments like  chemotherapy. The FDA has approved targeted therapies for many types of cancer, including those of the  breast ,  prostate ,  colon , and  lung. Types of Targeted Therapies:_ There are two main types of targeted therapies : small molecule medicines   monoclonal antibodies . 1. Small molecule medicines are small enough to slip inside cancer cells and destroy them. -You can often spot small molecule meds because their  generic name  ends in "-ib." For example,  imatinib  ( Gleevec ) treats  chronic myelogenous leukemia (CML) and other cancers by blocking signals that tell tumor cells to grow.

11. 2. Monoclonal antibodies:- are too big to get into cells. Instead, they attack targets on the outside of cells or right around them. Sometimes they're used to launch chemo and  radiation  straight into tumors. You usually get them through an IV in a vein in your arm at a hospital or clinic. Sometimes they're given as a shot under the  skin . Gene expression modulators.  This type of targeted therapy works to change the proteins that control the way the instructions of genes in cancer cells get carried out, or are expressed, because it's abnormal . Immunotherapies  use your own  immune system  to destroy cancer cells. Some boost your  immune system  so it does a better job of hunting down cancer. Others mark tumor cells so it's easier for your  immune system  to find them . Bortezomib  ( Velcade ) is a drug that does this to  lymphoma  and  multiple myeloma , a  blood cancer . Scientists are also studying plant compounds like  resveratrol  (found in red wine) to see if they, too, might trigger cancer cell death.

12. 6.Synthetic lethality Synthetic lethality  arises when a combination of deficiencies in the expression of two or more genes leads to cell death, whereas a deficiency in only one of these genes does not. The deficiencies can arise through mutations, epigenetic alterations or inhibitors of one or both of the genes . Cancer cells are frequently deficient in a DNA repair gene . This DNA repair defect either may be due to mutation or, often, epigenetic silencing. If this DNA repair defect is in one of seven DNA repair pathways (see  DNA repair pathways ), and a compensating DNA repair pathway is inhibited, then the tumor cells may be killed by synthetic lethality . Ovarian cancer :- Mutations in DNA repair genes  BRCA1  or  BRCA2  (active in  homologous recombinational  repair) are synthetically lethal with inhibition of DNA repair gene  PARP1  (active in the  base excision repair  and in the  microhomology -mediated end joining pathways of DNA repair )

13. Colon cancer:- In colon cancer, epigenetic defects in the  WRN  gene appear to be synthetically lethal with inactivation of  TOP1 . In particular,  irinotecan  inactivation of  TOP1  was synthetically lethal with deficient expression of the DNA repair  WRN  gene in patients with colon cancer. There are five different stages of colon cancer, and these five stages all have treatment. Stage 0, is where the patient is required to undergo surgery to remove the polyp . Stage 1, depending on the location of the cancer in the colon and lymph nodes, the patient undergoes surgery just like Stage 0 Stage 2 patients undergoes removing nearby lymph nodes, but depending on what the doctor says, the patent might have to undergo chemotherapy after surgery Stage 3, is where the cancer has spread all throughout the lymph nodes but not yet to other organs or body parts. When getting to this stage, Surgery is conducted on the colon and lymph nodes, then the doctor orders Chemotherapy to treat the colon cancer in the location needed. The last a patient can get is Stage 4. Stage 4 patients only undergo surgery if it is for the prevention of the cancer, along with pain relief. If the pain continues with these two options, the doctor might recommended radiation therapy. The main treatment strategy is Chemotherapy due to how aggressive the cancer becomes in this stage not only to the colon but to the lymph nodes.

14. Pain medication , such as  morphine  and  oxycodone , and  antiemetics , drugs to suppress nausea and vomiting, are very commonly used in patients with cancer-related symptoms. Improved  antiemetics  such as  ondansetron  and analogues, as well as  aprepitant  have made aggressive treatments much more feasible in cancer patients.