Cancer, a term that can instill fear and uncertainty, is not just one disease but a family of related diseases that can occur almost anywhere in the body. In our previous blog, we discussed identifying cancer diagnosis, its type and stages, let us dive deep into the treatment modalities of cancer this time. 

While a cancer diagnosis can be overwhelming, understanding the multitude of treatment options available can provide hope and direction for patients and their families. As research progresses, the range of treatments is continually expanding and evolving. 

Here are some current treatment modalities available for cancer patients.

1. Surgery

Surgery provides the best chance of a cure for many types of cancer, especially if the cancer hasn’t spread to nearby tissues and organs. The primary goal is to remove the entire tumour and sometimes, the surrounding tissue. Types of surgical treatments include:

• Curative Surgery: The entire tumour is removed by surgeons.
• Preventive Surgery: Surgeons remove tissue that does not yet contain cancer cells but might become malignant in the future.
• Diagnostic and Staging Surgery: This surgery determines the extent, location, and types of cancer in the body.
• Palliative Surgery: This is done to alleviate symptoms without curing cancer. Other therapies are often the next step after this surgery.

2. Radiation Therapy

Radiation therapy uses high-energy particles or waves, like x-rays, gamma rays, or electron beams. These target the DNA within cells and damage it. Normal cells have mechanisms to repair this damage, but cancer cells often do not. This is because cancer cells have mutations in their DNA that make them more susceptible to radiation damage. As a result, the damaged cancer cells stop dividing and eventually die over time. 

Radiation therapy can be used after surgery or alongside other treatments, such as chemotherapy to eliminate any remaining cancer cells. This therapy is the first line of treatment for early-stage cancers of the cervix (cervical cancer). Some common side effects of radiation therapy are fatigue, changes in the skin (such as redness and irritation), and localised hair loss. These usually subside after the completion of therapy. 

3. Chemotherapy

Chemotherapy is a commonly used treatment for cancer that utilises medications to target and eliminate rapidly dividing cancer cells. It can be administered through intravenous injections, oral pills, or other methods depending on the specific drug and type of cancer. Chemotherapy is highly effective in treating many types of cancers, especially those that have spread or metastasised. It can also impact healthy cells and cause side effects such as fatigue, nausea, hair loss, and a weakened immune system. 

Treatment plans for chemotherapy are personalised based on factors like the type of cancer, its stage, and the patient's overall health. In most cases, chemotherapy is combined with other treatments like surgery or radiation to achieve optimal therapeutic outcomes.

4. Targeted Therapy

This approach targets the specific genes or proteins contributing to cancer growth. It affects cancer cells while sparing most normal cells, leading to fewer side effects than traditional chemotherapy. Types of targeted therapy are:

• Small Molecule Drugs: These are low molecular weight drugs that can penetrate the cell membrane to interact with targets inside the cell. 
• Monoclonal Antibodies: These are proteins engineered in the lab to bind to specific targets located on the cell surface.
• Angiogenesis Inhibitors: These block the formation of new blood vessels that tumours need to grow.
• Apoptosis Inducers: These inducers encourage cancer cells to undergo apoptosis, a type of programmed cell death.

5. Immunotherapy

Immunotherapy is a newer form of cancer treatment that boosts the body's natural defences to fight cancer. These therapies can help the body recognise and destroy cancer cells by stimulating the immune system. 

• Checkpoint Inhibitors: These drugs 'unlock' the immune response against cancer cells by targeting proteins that function as immune system 'brakes,' preventing it from attacking cancer. 
• Monoclonal Antibodies: Lab-created molecules are designed to attack specific parts of cancer cells.
• Adoptive T-cell Therapy: T-cells are extracted from the patient, multiplied in the lab, and reintroduced to boost the native immune response.
• Cytokines (Interleukins and Interferons): These proteins play vital roles in immune cell signalling and proliferation.

Cancer Vaccines to Prevent Cancer:

With advances in treatment, cancer vaccines have become a reality for certain types of cancers. These are substances introduced into the body to provoke an immune response against specific cancer-associated molecules. Unlike traditional vaccines that protect against infectious diseases, cancer vaccines aim to enhance your immune system's ability to identify and destroy cancer cells and reduce the risk of developing cancer. HPV vaccines for cervical cancer and Hepatitis B Vaccine (HBV) are examples of cancer vaccines. Bacille Calmette-Guerin (BCG) Vaccine and Sipuleucel-T for prostate cancer are examples of therapeutic or treatment vaccines now in use.

Other Modes of Treatment:

Hormone Therapy is used primarily for breast and prostate cancers and slows or stops the growth of cancers that use hormones to grow. Bone Marrow transplant replenishes the body with healthy blood-forming cells after high chemotherapy or radiation therapy doses.

The best treatment option often depends on numerous factors, including the type and stage of cancer, the patient's overall health, and treatment goals (curative vs. palliative). Patients and caregivers must engage in open conversations with their oncology team. This collaborative approach ensures that patients are well-informed, empowered, and on a clear path to healing.