CANCER Treatment in Raipur (Chattisgarh)

CANCER Treatment in Raipur (Chattisgarh)

OVERVIEW OF CANCER TREATMENT Making a right choice for cancer treatment depends on several factors, for example the specific type of cancer; general condition; comorbidities, stage of cancer and whether the intent of treatment is to cure cancer or prolong life with better quality, or to relieve the symptoms (palliative) caused by cancer. Based on these factors, the Oncologist will decide on a specific therapy or a multimodal therapy  

  • Surgery including minimal invasive
  • Chemotherapy
  • Radiation therapy
  • Hormonal therapy
  • Targeted therapy
  • Biological therapy
  One or more of the above modalities will be used by the Oncologist. With the advent of better understanding of the biology of cancer we tend to use several treatment modalities together (concurrently) or we sequence them in order to achieve maximum survival and prevent recurrence. This approach is known as multi-modality treatment of the cancer.   SURGERY Surgery is the most common modality of cancer treatment. It is used to diagnose cancer (biopsy), also to determine its stage (staging laparoscopy, surgical staging) and to treat cancer( removing the cancerous part with adequate margins). Biopsied tissue samples  or surgical specimens are examined by a  pathologist to define the histology, grade and stage of cancer.     CHEMOTHERAPY Chemotherapy or anti cancer drugs refer to the usage of drugs to kill cancer cells. Cancer chemotherapy consists of either a single drug or a combination of different drugs ( RCHOP, ABVD, AC, TCH etc). It is administered through a vein( peripheral vein, PICC line, chemoport etc), or  injected into a body cavity (HIPEC) or delivered orally in the form of a pill (ORAL CHEMO). Chemotherapy is a systemic treatment as the drugs circulate in the blood to all parts of the body where the cancer cells may have spread.   Majority of cancer patients receive chemotherapy. Neoadjuvant chemo is done to shrink the tumour and make it operable. Adjuvant chemo is done after surgery to address the micrometastatic disease. Palliative chemotherapy is done to prolong survival and better the quality of life.   RADIATION THERAPY Radiation therapy uses high-energy rays to kill cancer cells. Similar to surgery, radiation therapy is a local treatment used to eliminate or eradicate visible tumors. It can be either external or internal. When the delivery of high-energy rays is direct to the tumor site from a machine outside the body it is called External Radiation. Internal radiation a/k/a brachytherapy, usually involves implantation of a small radioactive material in or near the tumour site. Concurrent Radiation is used along with chemotherapy for lung, cervical cancers. Paliiative radiation is used to address Brain and Skeletal metastasis. Definitive Radiation therapy is particularly used in Head and neck cancers.   HORMONAL THERAPY Hormonal therapy blocks the hormone production or change the way hormones work. It also amounts to  removal of organs that secrete hormones, such as the ovaries or testicles. Hormonal therapy is a systemic treatment. It is particularly used in Prostate, Breast and gynaecological cancers.   TARGETED THERAPY Targeted therapies are designed in a fashion that they treat only the cancerous cells and minimize damage to otherwise healthy cells. It improves treatment outcomes and decreases side effects. It can be a tablet (IMATINIB, OLAPARIB) or injectable (Bevacizumab, Cetuximab)   BIOLOGICAL THERAPY Biological therapies are also known as immunologic therapy or immunotherapy. Its mechanism of action is by using the body’s immune system to target and neutralise the cancer cells. Variety of therapies like interferons, interleukins, monoclonal antibodies (Rituximab), checkpoint inhibitors (Pembrolizumab) and cancer vaccines, CART therapies come under this umbrella.   PERSONALIZED CANCER CARE AND PRECISION MEDICINE In this era there isn’t a single approach to cancer treatment. Every cancer and its subtype is different. Hence we need to be more precise and use a  personalised approach to facilitate individualised cancer treatment.   Precision medicine is based on understanding this  molecular signatures, including DNA sequencing (NGS), to identify cancer driver genes and targeting them with a novel drug.   To summarise there isn’t a one size fits for all approach , we have evolved into a personalised cancer treatment approach.   Dr Ravi Jaiswal Medical Oncologist