Cancer therapy involves a combination of treatments aimed at destroying cancer cells, slowing tumor growth, and improving the patient’s survival and quality of life. Understanding the basic principles of cancer therapy helps in choosing the right treatment based on the type, stage, and behavior of the tumor. Treatment often includes chemotherapy, radiation, surgery, targeted therapy, and supportive care.
Goals of Cancer Therapy
- Curative: Complete eradication of cancer
- Control: Slow disease progression
- Palliative: Relieve symptoms and improve comfort
Types of Cancer Treatment
1. Surgery
- Removal of solid tumors
- Used for early-stage cancers
- May be followed by chemotherapy or radiation
2. Radiation Therapy
- Uses high-energy radiation to kill cancer cells
- Targets specific tumor areas
- Used before or after surgery
3. Chemotherapy
- Uses cytotoxic drugs to kill rapidly dividing cells
- Can treat cancer spread throughout the body
- Often combined with surgery or radiation
4. Targeted Therapy
- Acts on specific proteins or pathways in cancer cells
- More selective, fewer side effects
- Examples: tyrosine kinase inhibitors, monoclonal antibodies
5. Immunotherapy
- Boosts the immune system to fight cancer
- Includes checkpoint inhibitors and CAR-T therapy
6. Hormonal Therapy
- Used for hormone-sensitive cancers like breast and prostate cancer
- Blocks or lowers hormone levels
Principles of Chemotherapy
1. Cell Cycle Specificity
- Some drugs act on specific phases (e.g., S-phase, M-phase)
- Others are cell-cycle nonspecific
2. Combination Chemotherapy
- Using multiple drugs increases effectiveness
- Reduces drug resistance
- Drugs with different mechanisms and toxicity profiles are selected
3. Dose and Schedule Optimization
- Given in cycles to allow recovery of normal cells
- Dose intensity must be maintained for best outcomes
4. Mechanisms of Action
- Damaging DNA (alkylating agents)
- Interfering with DNA synthesis (antimetabolites)
- Blocking mitosis (vinca alkaloids, taxanes)
- Targeting specific oncogenes or signaling pathways
Adverse Effects of Cancer Therapy
Most anticancer drugs affect rapidly dividing normal cells, causing:
- Hair loss
- Bone marrow suppression
- Nausea and vomiting
- Mouth ulcers
- Fatigue
- Organ toxicity (heart, kidney, liver)
Supportive Care in Cancer Therapy
- Anti-emetics to control nausea
- Growth factors for bone marrow protection
- Pain management
- Antibiotics for infections
- Nutritional support
Drug Resistance in Cancer
- Decreased drug uptake
- Increased drug efflux (P-glycoprotein)
- Drug target modification
- Enhanced DNA repair
Patient Counseling
- Explain treatment goals clearly
- Adherence to chemotherapy schedule is crucial
- Report side effects such as fever, bleeding, or severe vomiting
- Maintain proper nutrition and hydration
- Avoid self-medication or herbal remedies without medical advice
- Emotional and psychological support is important
Detailed Notes:
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