Malignant tumors, also known as cancers, are life-threatening growths that can spread to other parts of the body. Treating cancer is complex and usually involves a combination of therapies tailored to the specific type and stage of cancer. The main treatments for malignant tumors include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and palliative care.
Surgery
Surgery is often the first line of treatment for malignant tumors. The goal of cancer surgery is to remove the tumor and some surrounding healthy tissue. Common cancer surgeries include:
- Lumpectomy: Removal of the tumor and some normal tissue around it, often used to treat breast cancer.
- Mastectomy: Removal of the entire breast, often used to treat breast cancer.
- Prostatectomy: Removal of the prostate gland, often used to treat prostate cancer.
- Colectomy: Removal of part or all of the colon, often used to treat colon cancer.
- Pneumonectomy: Removal of an entire lung, often used to treat lung cancer.
- Hysterectomy: Removal of the uterus and possibly other reproductive organs, often used to treat endometrial or cervical cancer.
The goal of cancer surgery is to remove the entire tumor along with a margin of healthy tissue around it. This helps ensure no cancer cells are left behind. Surgery alone can be curative for some malignant tumors if they are detected at an early stage before spreading. At later stages, surgery is often combined with other treatments like chemotherapy or radiation.
Risks and side effects
All cancer surgeries carry risks, including:
- Bleeding and infection
- Damage to nearby organs and tissues
- Blood clots
- Adverse reactions to anesthesia
The specific side effects depend on the type and location of the surgery. For example, removing the bladder (cystectomy) can lead to urinary incontinence while removing sections of the lung can reduce breathing capacity.
Radiation Therapy
Radiation therapy uses high-energy particles or waves like x-rays, gamma rays, electrons, and protons to destroy cancer cells. Radiation can be delivered in two ways:
- External beam radiation: A machine aims radiation at the tumor from outside the body.
- Internal radiation (brachytherapy): Radioactive material is placed inside the body near the tumor itself.
Radiation is commonly used to treat many types of cancer including breast, prostate, lung, colon, brain, and head and neck cancers. It can be used alone or along with surgery and chemotherapy. Radiation may be used to:
- Try to cure cancer by destroying the tumor and margin of healthy tissue
- Control cancer by keeping it from growing and spreading
- Relieve symptoms like pain, bleeding, and pressure caused by the tumor
Side effects
Side effects of radiation depend on the dose given and area of the body being treated but can include:
- Fatigue
- Skin irritation or redness
- Loss of hair in the treated area
- Nausea and vomiting
- Sore mouth and throat
- Diarrhea
Radiation can also damage healthy cells leading to long-term effects like infertility and increased risk for another cancer.
Chemotherapy
Chemotherapy uses anti-cancer drugs that circulate throughout the body to kill cancer cells. It can be given as a pill or injected into a vein. Chemotherapy is commonly used to treat cancers like leukemia, lymphoma, pancreatic cancer, lung cancer, ovarian cancer, and breast cancer. Goals include:
- Curing cancer – Used after surgery to kill any remaining cancer cells
- Control cancer – Keep it from spreading and slow its growth
- Reduce symptoms – Shrink tumors pressing on organs and causing pain
Chemotherapy can be used alone but is more often combined with surgery, radiation, or both. Giving multiple chemotherapy drugs together increases effectiveness. This combination therapy can:
- Kill more cancer cells
- Prevent resistance to any one chemotherapy drug
Side effects
Chemotherapy targets all rapidly dividing cells, including healthy ones. This can lead to significant side effects such as:
- Hair loss
- Nausea and vomiting
- Fatigue
- Increased risk of infection
- Easy bruising or bleeding
- Appetite changes
- Nerve and muscle effects like numbness, tingling, and pain
Side effects vary depending on the type and dose of chemotherapy drugs used. Most side effects go away once treatment is complete.
Targeted Therapy
Targeted cancer therapies are drugs that specifically attack cancer cells while causing minimal damage to healthy cells. They work by targeting genetic mutations or proteins found predominantly in cancer cells that help them grow and spread. Examples include:
- HER2 inhibitors: Trastuzumab (Herceptin) targets the HER2 protein commonly found in aggressive breast cancers.
- PARP inhibitors: Olaparib (Lynparza) targets the BRCA gene mutation found in breast, ovarian, and prostate cancers.
- Tyrosine kinase inhibitors: Imatinib (Gleevec) targets the BCR-ABL gene mutation found in chronic myelogenous leukemia (CML).
Targeted therapies are often used together with chemotherapy. They can make chemotherapy more effective against cancer cells while also reducing side effects. The specific targeted therapy used depends on the genetic mutation driving cancer growth.
Side effects
Side effects of targeted therapies may include:
- Skin problems like rashes and dryness
- Diarrhea
- Liver problems
- Nerve damage
- Heart problems
- Lung damage
But in general, targeted therapies are better tolerated than chemotherapy drugs.
Immunotherapy
Immunotherapy boosts the body’s immune system to attack cancer cells. Types include:
- Immune checkpoint inhibitors: Block proteins that stop immune cells from killing cancer cells.
- Cancer vaccines: Boost the immune system’s ability to detect and destroy cancer cells.
- Adoptive cell transfer: Take immune cells from the patient, modify them to enhance their cancer-fighting ability, grow them in the lab, and inject them back into the patient.
Immunotherapy can be effective against different cancer types including melanoma, non-small cell lung cancer, bladder cancer, and Hodgkin lymphoma. Goals include:
- Slow cancer growth and spread
- Keep cancer from returning after remission
- Allow immune system to destroy small tumors left after surgery or chemotherapy
Immunotherapy can cause inflammation around tumors which can make side effects more severe when combined with other therapies. So combination therapies need to be carefully timed.
Side effects
Immunotherapy sometimes causes the immune system to attack healthy organs and tissues. Common side effects include:
- Fatigue
- Nausea
- Loss of appetite
- Fever
- Rash or redness
- Diarrhea
- Joint pain
More serious side effects can include damage to the lungs, intestines, liver, kidneys, or hormone-producing glands.
Palliative Care
Palliative care focuses on managing symptoms and improving quality of life for patients with serious illnesses like cancer. The goals are to:
- Relieve pain and other distressing symptoms
- Address psychological, social, and spiritual needs
- Improve ability to cope and enjoy life
- Provide support to family and caregivers
Palliative treatments may include:
- Medications – To manage pain, nausea, anxiety, depression, trouble sleeping, etc.
- Nutritional support – To maintain strength and weight during treatment
- Physical and occupational therapy – To maintain functioning and mobility
- Counseling – To help with distress, fears, and change in body image
Palliative care can be used along with treatments aimed at curing cancer. It helps ensure the best possible quality of life at any stage of the disease.
Choosing a Treatment Plan
Doctors consider many factors when choosing a treatment plan including:
- Cancer type, location, size, and stage
- If the cancer has certain genetic mutations
- Patient’s age, health status, and medical history
- Type of treatment the patient prefers
- How treatments will affect patient’s quality of life and future fertility
Treatment usually involves a combination of therapies. Surgery and radiation aim to eliminate the tumor. Chemotherapy, targeted therapy, and immunotherapy attack remaining cancer cells and help prevent recurrence. Palliative care provides comfort and support throughout the process.
New treatments continue to be developed and tested through clinical trials. Doctors should discuss all appropriate options with patients including standard treatments, clinical trials, and comfort care options.
| Cancer Type | Common Treatments |
|---|---|
| Breast Cancer | Surgery (lumpectomy, mastectomy), radiation, chemotherapy, hormonal therapy, targeted therapy |
| Lung Cancer | Surgery, radiation, chemotherapy, targeted therapy, immunotherapy |
| Prostate Cancer | Surgery, radiation, hormonal therapy, chemotherapy |
| Colorectal Cancer | Surgery, radiation, chemotherapy, targeted therapy, immunotherapy |
| Melanoma | Surgery, radiation, immunotherapy, targeted therapy |
This table shows some of the most common treatment approaches for different types of cancer. But each patient’s personalized treatment plan depends on specific characteristics of their cancer and health status.
Conclusion
Treating cancer often requires an integrated approach using surgery, radiation, systemic therapies like chemotherapy, and palliative care. Goals include eliminating or controlling the cancer, managing symptoms, and maintaining quality of life. New targeted therapies and immunotherapies allow more personalized treatment based on the specific cancer’s genetic profile. With an increasing array of treatment options and an understanding of each patient’s unique cancer characteristics, outcomes continue to improve.