Cancer treatment: What are the essential guidelines? 

Cancer treatment guidelines:

In many cases, cancer treatment may mean the complete elimination of cancer from the body, or a cure.  In other cases, cancer treatment aims to retard the growth of the tumors so that an individual may live a longer life.  Sometimes, treatment may even cause more harm than good and the main focus may be to reduce symptoms that would essentially cause pain and suffering, or what is referred to as palliative cancer treatment. 

Most people are aware that the earlier a cancer is found, the more likely it is to be cured.  Advanced cancers and recurrent cancers after initial treatment frequently indicate that the cancer has spread.  Cure then will be much less likely. 

Cancer Treatments:

The main forms of cancer treatment are surgery, radiation and drugs.  Surgery is used when it is possible to completely or partially remove the cancer, so that other therapies may have a higher probability for success.  Also, surgery may be used to stop bleeding or relieve pressure on a particular structure or organ of the body. 
Radiation therapy is usually directed at a tumor to destroy or reduce its size.  However, not all cancers respond to radiation treatment. 

There are several types of drugs that are used in cancer treatment.  Chemotherapy involves drugs that are used to kill cancer cells.  Chemotherapy drugs work through various mechanisms targeting unusual aspects of the cancer cells.  However, chemotherapy drugs also kill normal cells as well, and cause many side effects that make people feel extremely ill.  Other drugs suppress hormones that stimulate cancers to grow and thereby suppress cancer growth.  Some of the newer drugs attack cancerous cells in unusual ways resulting ultimately in their death.  An example of these types of medications is imatinib for chronic mylocytic leukemia.  This drug prevents leukemia cells from functioning through an attachment process which ultimately results in their death. 

Another cancer treatment is referred to as immunotherapy, which stimulates the immune system to attack cancer or uses antibodies that attach themselves to cancer cells.  These antibodies can be combined with chemotherapy drugs or even radioactive agents, so that the drugs may go exactly where they are needed, attacking the cancer cells. 

Cancer and Other Disease:

If an individual has other diseases or conditions, it may complicate their cancer treatment.  Heart failure or impaired kidney function are known to limit the choices in dosages of chemotherapy drugs, which are used to treat certain forms of cancer.  Chronic liver disease may also make the use of chemotherapy drugs more difficult by increasing the toxic side effects of some drugs.  Chronic obstructive pulmonary disease (COPD) can also limit the use of radiation that might otherwise be used to treat lung cancers, because of the harmful side effects of the radiation to lung tissue, which has already been damaged by the COPD.  However, cancer treatment is usually possible in spite of many of these other diseases and conditions.

Early Detection and Treatment:

The optimal cancer treatment is when it is detected early and is able to be removed surgically.  However, sometimes cancers are located in places that make surgery impractical, such as deep in the brain.  Also, some cancers have already spread making removal of the original tumor impossible.  Sometimes, doctors may give additional therapy such as radiation treatment to eliminate cancer cells in nearby lymph nodes, or chemotherapy or hormone therapy to eliminate cancer cells throughout the entire body.  Thus, cancer treatment referred to as adjuvant therapy is frequently used in breast, colon, head and neck cancers. 

People are frequently referred to cancer treatment centers which specialize in the treatment of cancer.  These centers are staffed with doctors and other health-care practitioners who have expertise in treating this specific disease.  These treatment centers often offer drugs and cancer treatment programs that are at the forefront of research into possible new treatment approaches. 

Clinical Trials:

Some people are even offered the opportunity to participate in clinical trials or research studies revealing the effectiveness of new medical treatments.  Although these cancer treatments may be experimental, they are usually carefully monitored by the review boards of universities and hospitals.  The safety measures involved usually require that individuals receive care at hospitals or medical centers while participating in these clinical research trials. 

Alternative Treatments

Sometimes, people seek alternative cancer treatments or a combination of alternative and conventional medicine treatment.  Although some alternative therapies have been found to be helpful, people should not rely on them to the exclusion of proven effective conventional therapies.  You should always discuss this issue with your doctor when pursuing alternative cancer treatments. 

Some older people prefer not to undergo any cancer treatment, other than to relieve pain and suffering.  These decisions are often appropriate when the cancer cannot be cured and the treatment is likely to cause side effects.  A person may choose to participate in enjoyable activities and travel while feeling well, rather than always feeling ill due to the treatments.  These decisions should always be made with full information about the risks and benefits of cancer treatment options, and require careful consultation and discussion with a knowledgeable cancer specialist.

Some information adapted from The Merck Manual of Health of Aging 

Additional information and web page by Paul Susic Ph.D. Licensed Psychologist Ph.D. 

Psych Talk

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