Two important factors that determine the mode of treatment for carcinomas are – where the cancerous cells have developed and how far have they spread from the primary location.

Our body is made up of various tissues which are basically pile up of cells of various types. These cells undergo constant repair and replacement at various paces depending on the origin of tissue. During this cell replacement – which is called as cell division, there may be errors in copying the genetic information (DNA) which may lead to increase and uncontrolled cell division and tissue growth. These are called “Tumors” which can be of Benign or Malignant.

The building blocks of tissues – the cell are mainly 2 categories.

• Epithelial cells.
• Connective tissue cells.

Cancers of epithelial cell types are called carcinomas and that of connective tissue are called sarcoma.

Most cancers are diagnosed with biopsy and microscopic examination. Once diagnosed they are staged with scan and other investigations. Based on the stage of the disease, cancer treatment will be delivered.

Treatment comprises of once or combination of more than one of the below:

• Oncological Surgeries
• Chemotherapy
• Radiotherapy
• Hormonal therapy
• Targeted therapy
• Immunotherapy
• Palliative care

Surgical Oncology

Oncology Surgeries are different from regular surgical removal, as the former involves surgery directed at achieving a microscopic tumor clearance. Some surgeries involve the removal of its lymph nodes of the affected organ to stage and plan therapies.

Chemotherapy

In this mode of treatment, the patient is given specific drugs/ medication that will destroy cancer cells, either throughout the whole body, or in a specific area.

Lumps or inexplicable marks on the body and persistent pain must be treated as red flag. Carcinomas can occur in just about any part of the body and symptoms tend to be overlooked or dismissed as nothing. Once the cancer metastasizes, hope to treat it is miniscule. Stay in touch with your body and let your doctor know when you notice a change.

Radiation therapy

Radiation therapy(also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Radiation therapy generally uses Megavoltage X-rays, but protons or other types of energy also can be used.

Radiation therapy usually refers to external beam radiation therapy, where high-energy beams come from a machine outside the body that aims the beams at a precise point on your body. Brachytherapy is another type of radiation treatment where radiation is placed inside the body.

Radiation damages cells by destroying the genetic material which controls how cells grow and divide. The goal of radiation therapy is to destroy more cancer cells and fewer normal, healthy cells.

Hormone 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, is different from menopausal hormone replacement therapy (HRT).

Certain cancers rely on hormones to grow. In these cases, blocking the body’s ability to produce these hormones or changing how hormone receptors behave may slow or stop their spread.

Breast and prostate cancers are two commonly treated with hormone therapy. Most breast cancers have either estrogen (ER) or progesterone (PR) receptors, or both. Prostate cancer needs testosterone and dihydrotestosterone (DHT), to grow and spread.

Hormone therapy is available via pills, injection, or surgery.

Targeted therapy

A technique that uses computers to create a 3-dimensional picture of the tumor in order to mark the tumor as accurately as possible and give it the maximum possible dose of radiation while sparing normal tissue as much as possible

Immunotherapy

Immunotherapy is a type of cancer treatment that helps immune system fight cancer. Our immune system constantly detects and destroy abnormal cells and most likely prevent or curb the growth of many cancers. Tumor-infiltrating lymphocytes or TILs are a sign that the immune system is responding to the tumor.

Even though the immune system can prevent or slow cancer growth, cancer cells escape immune destruction by

• Genetic changes that make them less visible to the immune system.
• Producing special proteins on their surface that turn off immune cells.
• Changing normal cells around the tumor so they interfere with how the immune system responds to the cancer cells.

Immunotherapy helps the immune system to better act against cancer. Various types of immunotherapies are used to treat cancer including:

• Immune checkpoint inhibitors
• T-cell transfer therapy
• Monoclonal antibodies
• Treatment vaccines
• Immune system modulators.

Palliative Care

Palliative care is specialized medical care for people living with a serious illness. This focuses on providing relief from the symptoms and stress, improving quality of life for both the patient and the family.

This is provided by specially trained team of doctors, nurses and other specialists to provide an extra layer of support, based on the needs of the patient, not on the patient’s prognosis. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Hospice care is a type of palliative care. The goal of hospice care is to keep you as comfortable as possible when treatment is not expected to cure the cancer.

Reviewed By:

DR.RAJKUMAR P

CONSULTANT – SURGICAL ONCOLOGIST

MBBS, MS (GENERAL SURGERY), DNB (GENERAL SURGERY), DNB (SURGICAL ONCOLOGY), MCh (SURGICAL ONCOLOGY)