Cancer treatments – what works best for you

Chemotherapy, radiation therapy or surgery… Each treatment modality has its own advantages and side-effects and it is better to understand what each of it entails before asking your doctor to go ahead with it

There is immense research in progress to ensure that healthy cells and other parts of the body do not get affected by cancer treatment. As a result, cell-targeted therapies which work only on cancer cells, VMAT radiation therapies which do not affect other parts, keyhole surgeries which help the lesser cuts possible have come into wide use. The other treatment modalities are:

Surgery: It is often done for cancer other than cancers related to blood. If cancer is detected at a stage when it does not spread to other parts, cancer can be fully cured with surgery. Nowadays, these surgeries are performed with small cuts (incisions) as part of day-care procedures.

Preventive surgery: Polyps seen at the edge of large intestine (with colon), even if there are no cancer symptoms, should be surgically removed. If the incidents of breast cancer in family history and blood relations are more, the breast is removed (mastectomy) knowing the possibility of the onset of cancer in advance with BRCA1, BRCAI2-like gene mutation tests. If there are symptoms in pap smear test, the uterus is removed through hysterectomy. All these surgeries are preventive to nullify the doubts.

a) Curative surgery: These surgeries are performed to cure completely after conducting radiation, chemo or other therapies after surgery when found in initial stage. Sometimes radiation is given while conducting surgery.

b) Palliative surgery: These surgeries are performed to lessen the problem to some extent, reducing the size of the tumour when cancer is detected belatedly. Sometimes supportive surgeries are also performed to facilitate other treatments.

c) Restorative or reconstructive surgery: The cancer affected part and the lymph nodes present around cells are normally removed with surgeries in cancer treatments. But when the surgery is done to externally visible parts like breast, mouth, head and neck cancers, to improve the functionality of those parts and to remove inferiority complex of the victims, reconstructive surgery is conducted either immediately or after cancer treatments by using cells, bones and prosthetics.

d) Chemotherapy: The very term chemotherapy scares many people. Chemotherapy may cause vomiting, nausea, loss of weight, fatigue, change of colour of eye lashes, hair fall etc. All these side-effects are temporary. Once the treatment is over, everything comes back to normalcy. This therapy is being done since 1950. There are at least 100 varieties of cancer medicines like pills, liquids, injections, oral ointments and injections that are given to back bone and stomach etc, These medicines are also used in various conditions to kill the cancer cells and to prevent recurrence. Some patients notice not only bodily changes, but also depression due to chemo. Besides, these treatments last for months to over a year in which time the problems like decreased fertility and diminished sexual desire, decreased immunity may also add to the trouble. Patients should take good food, practice yoga and drinking healthy liquids.

e) Radiation therapy: Many changes have occurred in radiation therapy, a treatment modality that is more than 100 years old. The treatment duration lasts for a few minutes (which would previously last for half an hour). It promises quicker treatment. Although it also has side-effects, this technique is useful as it does not affect other parts and the impact of radiation is restricted to the cancer tumour alone. The other treatments like lasers in stem cell therapy surgeries, photo dynamic therapies using light, treatments using extreme heat or cold can improve our immunity and immune therapies. Molecule-targeted therapies in cancer treatments have brought about revolutionary changes.

(The doctor is MS (Gen), DNB (Surg), Mch (Surg, Onco), FRCS, (Edin) Diploma in lap Surg (France) Chief Surgical Oncologist, Vamsy1964@gmail.com 9848011421)