Cancer Cures
Treatment of cancer
Cancer can be treated by surgery, chemotherapy, radiation
therapy, immunotherapy or other methods. 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). A number of experimental cancer treatments
are also under development.
Complete removal of the cancer without damage
to the rest of the body is the goal of treatment. Sometimes
this can be accomplished by surgery, but the propensity of
cancers to invade adjacent tissue or to spread to distant
sites by microscopic metastasis often limits its effectiveness.
The effectiveness of chemotherapy is often limited by toxicity
to other tissues in the body. Radiation can also cause damage
to normal tissue.
Because "cancer" refers to a class of diseases,
it is unlikely that there will ever be a single "cure for
cancer" any more than there will be a single treatment for
all infectious diseases.
Surgery
In theory, 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.
Examples of surgical procedures for cancer include
mastectomy for breast cancer and prostatectomy for prostate
cancer. 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. For this reason, the pathologist
will examine the surgical specimen to determine if a margin
of healthy tissue is present, thus decreasing the chance that
microscopic cancer cells are left in the patient.
In addition to removal of the primary tumor,
surgery is often necessary for staging, e.g. determining the
extent of the disease and whether it has metastasized to regional
lymph nodes. Staging is a major determinant of prognosis and
of the need for adjuvant therapy.
Occasionally, surgery is necessary to control
symptoms, such as spinal cord compression or bowel obstruction.
This is referred to as palliative treatment.
Chemotherapy
Chemotherapy is the treatment of cancer
with drugs ("anticancer drugs") that can destroy cancer cells.
It interferes with cell division in various possible ways,
e.g. with the duplication of DNA or the separation of newly
formed chromosomes. Most forms of chemotherapy target all
rapidly dividing cells and are not specific for cancer cells.
Hence, chemotherapy has the potential to harm healthy tissue,
especially those tissues that have a high replacement rate
(e.g. intestinal lining). These cells usually repair themselves
after chemotherapy.
Because some drugs work better together than
alone, two or more drugs are often given at the same time.
This is called "combination chemotherapy"; most chemotherapy
regimens are given in a combination.
The treatment of some Leukaemias and Lymphomas
requires the use of high-dose chemotherapy, and Total Body
Irradiation. This treatment ablates the bone marrow, and hence
the bodies' ability to recover and repopulate the blood. For
this reason, bone marrow, or peripheral blood stem cell harvesting
is carried out before the ablative part of the therapy, to
enable "rescue" after the treatment has been given. This is
known as autologous transplantation. Alternatively, bone marrow
may be transplanted from a Matched Unrelated Donor.
Immunotherapy
Main article: Cancer immunotherapy Immunotherapy
is the use of immune mechanisms against tumors. These are
used in various forms of cancer, such as breast cancer (trastuzumab/Herceptin®)
and leukemia (gemtuzumab ozogamicin/Mylotarg®). The agents
are monoclonal antibodies directed against proteins that are
characteristic to the cells of the cancer in question, or
cytokines that modulate the immune system's response.
Other, more contemporary methods for generating
non-specific immune response against tumours include intravesical
BCG immunotherapy for superficial bladder cancer, and use
of interferon and interleukin. Vaccines to generate non-specific
immune responses are the subject of intensive research for
a number of tumours, notably malignant melanoma and renal
cell carcinoma.
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. The effects of radiation
therapy are localised and confined to the region being treated.
Radiation therapy injures or destroys cells in the area being
treated (the "target tissue") by damaging their genetic material,
making it impossible for these cells to continue to grow and
divide. In addition, they cut off the blood supply to the
cancer cells causing them to die in a process called necrosis.
Although radiation damages both cancer cells and normal cells,
most normal cells can recover from the effects of radiation
and function properly. The goal of radiation therapy is to
damage as many cancer cells as possible, while limiting harm
to nearby healthy tissue. Hence, it is given in many fractions,
allowing healthy tissue to recover between fractions.
Radiation therapy may be used to treat almost
every type of solid tumor, including cancers of the brain,
breast, cervix, larynx, lung, pancreas, prostate, skin, stomach,
uterus, or soft tissue sarcomas. Radiation is also used to
treat leukemia and lymphoma. Radiation dose to each site depends
on a number of factors, including the radiosensitivity of
each cancer type and whether there are tissues and organs
nearby that may be damaged by radiation. Thus, as with every
form of treatment, radiation therapy is not without its side
effects.
Hormonal suppression
The growth of some cancers can be inhibited
by providing or blocking certain hormones. Common examples
of hormone-sensitive tumors include certain types of breast
and prostate cancers. Removing or blocking oestrogen or testosterone
is often an important additional treatment.
Symptom control
Although the control of the symptoms of
cancer is not typically thought of as a treatment directed
at the cancer, it is an important determinant of the quality
of life of cancer patients, and plays an important role in
the decision whether the patient is able to undergo other
treatments. Although all practicing doctors have the therapeutic
skills to control pain, nausea, vomiting, diarrhea, hemorrhage
and other common problems in cancer patients, the multidisciplinary
specialty of palliative care has arisen specifically in response
to the symptom control needs of this group of patients.
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.
Treatment trials
Clinical trials, also called research studies,
test new treatments in people with cancer. The goal of this
research is to find better ways to treat cancer and help cancer
patients. Clinical trials test many types of treatment such
as new drugs, new approaches to surgery or radiation therapy,
new combinations of treatments, or new methods such as gene
therapy.
A clinical trial is one of the final stages
of a long and careful cancer research process. The search
for new treatments begins in the laboratory, where scientists
first develop and test new ideas. If an approach seems promising,
the next step may be testing a treatment in animals to see
how it affects cancer in a living being and whether it has
harmful effects. Of course, treatments that work well in the
lab or in animals do not always work well in people. Studies
are done with cancer patients to find out whether promising
treatments are safe and effective.
Patients who take part may be helped personally
by the treatment(s) they receive. They get up-to-date care
from cancer experts, and they receive either a new treatment
being tested or the best available standard treatment for
their cancer. Of course, there is no guarantee that a new
treatment being tested or a standard treatment will produce
good results. New treatments also may have unknown risks,
but if a new treatment proves effective or more effective
than standard treatment, study patients who receive it may
be among the first to benefit.
Cancer vaccines
Considerable research effort is now devoted
to the development of vaccines (to prevent infection by oncogenic
infectious agents, as well as to mount an immune response
against cancer-specific epitopes) and to potential venues
for gene therapy for individuals with genetic mutations or
polymorphisms that put them at high risk of cancer.
As of October 2005, researchers found that an
experimental vaccine for HPV types 16 and 18 was 100% successful
at preventing infection with these types of HPV and, thus,
are able to prevent the majority of cervical cancer cases[8].
Complementary and alternative medicine
Complementary and alternative medicine
(CAM) treatments are the diverse group of medical and health
care systems, practices, and products that are not presently
considered to be effective by the standards of conventional
medicine. Conventional medical practitioners may describe
non-conventional treatment methods as a "complement" to conventional
treatment, to provide comfort or lift the spirits of the patient,
while others are offered as alternatives to be used instead
of conventional treatments in hope of curing the cancer.
Some complementary measures include prayer or
psychological approaches such as "imaging" or meditation to
aid in pain relief, or improve mood. The benefits of these
approaches have not been scientifically proven and therefore
face skepticism. Other complementary approaches include traditional
medicine like Traditional Chinese Medicine.
A wide range of alternative treatments have
been offered for cancer over the last century. The appeal
of alternative cures arises from the daunting risks, costs,
or potential side effects of many conventional treatments,
or in the limited prospect for cure. Proponents of these therapies
are unable or unwilling to demonstrate effectiveness by conventional
criteria. Alternative treatments have included special diets
or dietary supplements (e.g., the "grape diet" or megavitamin
therapy), electrical devices (e.g., "zappers"), specially
formulated compounds (e.g., laetrile, and homeopathic remedies),
unconventional use of conventional drugs (e.g., insulin),
purges or enemas, physical manipulations of the body, various
herbs or herbal preparations such as essiac. Some of these
alternative treatments may be ineffective or dangerous. Using
these modalities as sole treatment for potentially fatal conditions
such as cancer are generally not recommended by the majority
of medical professionals.
Coping with cancer
Many local organizations offer a variety
of practical and support services to people with cancer. Support
can take the form of support groups, counseling, advice, financial
assistance, transportation to and from treatment, films or
information about cancer. Neighborhood organizations, local
health care providers, or area hospitals are a good place
to start looking.
While some people are reluctant to seek counseling,
studies show that having someone to talk to reduces stress
and helps people both mentally and physically. Counseling
can also provide emotional support to cancer patients and
help them better understand their illness. Different types
of counseling include individual, group, family, self-help
(sometimes called peer counseling), bereavement, patient-to-patient,
and sexuality.
Many governmental and charitable organizations
have been established to help patients cope with cancer. These
organizations often are involved in cancer prevention, cancer
treatment, and cancer research. Examples include: American
Cancer Society, Lance Armstrong Foundation, BC Cancer Agency,
Macmillan Cancer Relief , the Terry Fox Foundation, Cancer
Research UK, Canadian Cancer Society, International Agency
for Research on Cancer and the National Cancer Institute (US).
Social impact
Once referred to as "the C-word," cancer
has a reputation for being a deadly disease. While this certainly
applies to certain particular types, the truths behind the
historical connotations of cancer are increasingly being overturned
by advances in medical care. Some types of cancer have a prognosis
that is substantially better than nonmalignant diseases such
as heart failure and stroke.
Progressive and disseminated malignant disease
has a substantial impact on a cancer patient's quality of
life, and many cancer treatments (such as chemotherapy) may
have severe side-effects. In the advanced stages of cancer,
many patients need extensive care, affecting family members
and friends. Palliative care solutions may include permanent
or "respite" hospice nursing.
Cancer research
Cancer research is the intense scientific
effort to understand disease processes and discover possible
therapies. While understanding of cancer has greatly increased
since the last decades of the 20th century, radically new
therapies are only discovered and introduced gradually.
Targeted therapy which first became available
in the late 1990s has had a significant impact in the treatment
of some types of cancer, and is currently a very active research
area. This constitutes the use of agents specific for the
deregulated proteins of cancer cells. Small molecules (such
as the tyrosine kinase inhibitors imatinib and gefitinib)
and monoclonal antibodies have proven to be a major step in
oncological treatment. Targeted therapy can also involve small
peptidic structures as ´homing device´ which can bind to cell
surface receptors or affected extracellular matrix surrounding
the tumor. Radionuclides which are attached to this peptides
(e.g. RGDs) eventually kill the cancer cell if the nuclide
decays in the vicinity of the cell (vide supra Radiation therapy).
Especially oligo- or multimeris of these binding motifs are
of great interest, since this can lead to enhanced tumor specificity
and avidity.
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