Cancer starts spreading from the cells to the tissues and then finally to the organs. Regular cells grow, divide, and degenerate over a period of time. If these cells are produced constantly and do not die, there is excessive cell accumulation. This causes unnecessary growth or tumors which can either be benign or malignant. Cancer can start anywhere in the body and then spread to the bones, organs, and lymph nodes which is also known as metastatic/ advanced/ Stage IV cancer. Cancer usually moves from Stage 1 to Stage 4 with different grades and scores.
Many treatment options are available for treating cancer. The treatment depends on the type of cancer and the extent of the cancer spread. Some may need one treatment while others may need a combination of treatments – such as chemotherapy and surgery. You should talk to your doctor about the various options you have at hand.
Getting diagnosed with cancer
Get the specific details on your cancer – stage of cancer and also the grade. Talk to your doctor and choose healthcare options that will suit your needs. In certain cases, if the cancer is indolent such as being non-reactive, or is a slow-growing tumor then immediate treatment may not be required. Active surveillance may be sufficient to track and screen the progress of the disease. Staying positive is extremely important because many people who have been diagnosed with cancer at an early stage have been able to beat it.
There is a primary treatment which can be surgery and the goal is to eradicate cancer or kill it. In adjuvant treatment, any cancer cells that remain after primary treatment is treated to stop their recurrence. These include chemotherapy, radiation, and hormone therapy.
Using biomarker tests in treatment selection
By understanding our body’s genes, proteins and tumor markers (also known as markers) doctors can gather information about the type of cancer. Each cancer-affected person has a unique set of biomarkers. Taking a biomarker test is available for those affected by cancer. It can be useful in testing tumors, tumor genetic testing, genome profiling, molecular testing, etc. There are certain targeted therapies or immunotherapy treatments that work for people with certain biomarkers. Targeted therapy works by targeting proteins that control the growth, division, and spread of cancer cells.
The idea of precision medicine or personalized treatments is relatively new. Using biomarkers provides a better medical approach to preventing diseases, diagnosis, or treatment based on the genetic make-up, protein type, and other factors. There are many kinds of biomarker tests and it is usually conducted through collecting samples of cancer cells through biopsy. For those detected with blood cancer, a liquid biopsy will be conducted. The results will show cancer with certain biomarkers that can be targeted through a specific therapy.
In cases where tumors are more consolidated and limited to a single area, surgery may work better. It is not useful in treating blood cancer or leukemia which has spread to many parts through the bloodstream. Although surgery could be open or minimally invasive, it may be more painful; requiring time to heal. There are other surgery options. These include cryosurgery -which involves passing extremely cold gases like nitrogen and argon to destroy abnormal tissues. It may be used to treat early-stage cancers on the skin and cervix. Lasers may also be used to cut through accurately small areas or to shrink tumors that may turn cancerous. They may be used to treat surface tumors or the lining of internal organs.
An emerging technique in the field of surgery is the robot-assisted one. The robotic arm is found to be more precise than a surgeon’s arm and can reach any part of the body. It can also reduce blood loss to the patient and is guided through precision tools and cameras. They can be used in surgeries related to the bladder, prostate, uterus, throat, etc.
It could be used to cure cancer, stop its growth or recurrence. Chemotherapy can also ease cancer symptoms by shrinking tumors. This stops cancer from growing or slows its pace down as well. Chemotherapy is used to treat different types of cancer and may be accompanied by other treatment options. It is particularly useful to shrink the tumor size before surgery or radiation. When used as a post-operative method, it can destroy any remaining cancer cells. It can also kill cancer cells that have returned or spread to other parts of the body. There are many ways to receive chemotherapy:
- As pills, capsules, or oral treatment.
- Injection, Intravenous, between tissue layers, in the peritoneal cavity, or even in the intra-arterial form.
- It may even come in the form of a topical cream that can be rubbed onto the skin.
If you develop side effects from chemotherapy, it will be monitored by your doctor or nurse. It is not advisable to miss any treatment. Chemotherapy is usually given in cycles followed by a period of rest to rejuvenate and build new cells in the body.
Also known as endocrine therapy it slows and stops the growth of hormones that cause the cancer cells to grow. It is used to treat prostate and breast cancer that use hormones to propagate. Hormone therapy is often used as a combination with other treatments. The type of cancer, its stage, its grade, and spread are important determinants of using hormone therapy.
Sometimes it can cause side effects as it interferes with hormone production or may block certain hormones. Depending on the kind of therapy you are receiving and how your body reacts, there may be different effects. Some men receiving hormone therapy for prostate cancer may find a difference in their testosterone levels, it may cause nausea, fatigue, or sexual health issues. For women going through breast cancer treatment with hormone therapy, it could cause mood swings, vaginal dryness, and loss of sex drive as well.
There may be regular checks for those going through breast cancer treatment. Mammograms and regular examination of the breast and surrounding tissues and nodes will be common. Men will be asked to take PSA tests to check their levels. If the PSA levels still go up then it may be considered that the hormone treatment may not be working well. In both cases, your doctor will advise you on the options you could consider outside of hormone therapy.
These treatments aid your body in boosting the immune system from within. It can help the body attack cancer cells the same way it attacks viruses and bacteria. Monoclonal antibodies are replicas of natural antibodies that attach themselves to antigens. These seek out foreign cells and cancerous cells by sending a signal to the immune cells to attack. This treatment can be sought along with chemotherapy as well.
Body cells contain checkpoints wherein cancer cells can hide easily and your immune system is not able to trigger a reaction. Inhibitors can remove these checkpoints so that the immune system has a way of recognizing and attacking these cancer cells.
Specifically designed to teach your immune system to fight cancer cells, they can either be preventive or prophylactic – which aim to prevent cancer. They could also be therapeutic and aim to strengthen the immune system to fight cancers in the body. mRNA vaccines have ushered in a new era in vaccinology. They have presented themselves as being better than conventional vaccines due to their high potency. It is also found to be effective in protein replacement therapy. mRNA is a non-infectious and non-integrating platform thereby making it safer over DNA-based vaccines. They are more efficient, stable, and highly translatable.
CAR T-cell therapy
A treatment that prepares T cells in the body by changing the genes in them. This will destroy cancer cells when the T cells are reinjected into the body.
Using high beams of energy, cancer cells are destroyed. Newer forms include IMRT which precisely target affected areas sparing the healthy tissues. IGRT uses MRI or CT scans to focus laser beams. There is also SRS which provides a high dose of radiation and is particularly helpful for brain and spine tumors. Proton therapy uses positively charged protons to kill cancer cells.
At the heart of precision medicine is targeted therapy. Targeted therapy works by targeting proteins that control the growth, division and spread of cancer cells. Learning about changes in the DNA and proteins helps medical interventionists control the treatment of cancer better. There are two types of treatments:
- Small molecule drugs: It enters cells easily due to low molecular weight and it can affect proteins, causing cancer cells to die.
- Monoclonal antibodies: A man-made antibody that is synthesized outside the body to mimic immune cells in the body.
Targeted therapies can help in many ways by marking cancer cells helping your immune system fight it naturally. Some can help slow down or stop cancer cells from growing. Angiogenesis inhibitors intervene with the blood supply to keep the tumors from growing. Other targeted therapies can help starve cancer by blocking hormones.
Below are the medications that are effective targeted treatments
Disclaimer – depending on your unique case and medical history your doctor will put you on one of the following or a combination of two or more medications and/or therapies. Do not self-diagnose or decide on treatment without proper medical guidance.
- Trastuzumab: An effective targeted cancer drug which is known by different names. It has been used to treat early as well-advanced breast, stomach, and gastroesophageal cancer. It treats cancer cells with large amounts of human epidermal growth factor receptor 2 (HER2) by attaching itself. As a monoclonal antibody, it stops the cancer cells from growing and dividing. There may be some side effects such as the risk of infection, shortness of breath, bruising, bleeding, allergies, spasms & pain in different parts, diarrhea, etc.
- Afatinib: This is not a generic drug and comes in the form of a tablet that can be consumed orally. It is used for treating non-small cell lung cancer (NSCLC) that is metastatic and has spread to other parts of the body. These drugs fall under the classification of kinase inhibitors that target proteins like EGF receptors within NSCLC cells. Some side effects include diarrhea, skin reactions, breathing issues, tear in the stomach, etc.
- Dabrafenib: This is a small molecule-based drug that is used for treating melanoma with a specific genetic mutation. It Is a selective BRAF inhibitor and has been studied in patients with stage III or IV melanoma. Three BRAF inhibitors have received FDA approval for the treatment of cancer – Dabrafenib, Vemurafenib, and Encorafenib. Dabrafenib is approved for the treatment of advanced melanomas, anaplastic thyroid cancers, non-small cell lung cancers, and for the adjuvant treatment of melanomas harboring the BRAF V600E/K mutation.
There has been tremendous advancement in computer technologies and nanotechnologies, biomedical imaging, and molecular biology. This has made it viable to switch from a population treatment approach to a personalized more precise medical treatment. There are many options available for cancer treatments that are also less invasive, depend on the type of tumor, and can even be taken with minimum side effects.
Clinical trials are ongoing research on various cancer treatments. It may be considered as the final step in bringing out medicine or treatment after all the lab trials are complete. These involve understanding how new treatments can be made safe and effective. Tracking any kind of side effects, as well as improvements in the quality of life of a cancer patient, are extremely important considerations. Taking part in a clinical trial involves many steps including meeting an eligibility criterion. Talk to your doctor about the various tests and treatment options at hand.