Radiation & Cancer Therapies

Biopsy | Radiation | Chemotherapy | Hormone therapy | Targeted therapy | Genomic therapy | Bone-directed therapy | Follow-up care

It is important to discuss all of your treatment options and side effects so that you and your doctors are able to design a specific treatment plan that will eradicate your cancer and facilitate a rapid return to a meaningful and disease free life.

Biopsy

A biopsy is done when other tests show that you have a mass which may be cancerous. During this test, tissue from the area of concern is removed so it can be studied in the pathology lab. A biopsy is the only way to know for sure if the mass is cancer.

Radiation

Radiation therapy is treatment with high-energy rays or particles that kill cancer cells. Radiation therapy may be used to kill cancer cells that still remain in the body after surgery. Radiation treatment is similar to getting an regular x-ray, except radiation therapy is a lengthier process. Treatment is usually given 5 days a week, for six weeks. Each radiation treatment lasts only a few minutes and is painless.

Types of radiation treatments:

• 3D-CRT: Three-dimensional conformal radiation therapy combines multiple radiation treatment fields to deliver precise doses of radiation.
• IMRT: Intensity modulated radiation therapy is a sophisticated radiation planning and delivery technology that allows radiation doses to closely conform to the shape of the tumor, regardless of the shape or size.
• IGRT: Image-guided radiation therapy is a process of taking images of the patient while in the treatment position immediately prior to delivering radiation to ensure that the patient is accurately positioned.
• HDR: High-dose rate brachytherapy is a small amount of radiation is delivered over a short period of time through a very small radioactive source on the end of a flexible, computer-controlled cable.
• APBI: Accelerated partial breast irradiation uses either HDR brachytherapy or 3D-CRT to deliver radiation therapy to the breast after lumpectomy.
• SBRT: Stereotactic body radiation therapy is a new technique that delivers much higher doses of radiation to the tumor in fewer treatment sessions while giving much lower doses of radiation to the surrounding healthy tissue.
• Gamma Knife Radiosurgery: A non-invasive, one-session treatment that uses gamma rays to destroy both cancers and certain benign growths.
• Prostate seed implantation: Small radioactive ‘seeds’ are placed into your body at the tumor site and radiation is then used.
• Radionuclide treatments: liquid radioactive isotopes are placed into the body and absorbed by tumor cells to deliver high doses of radiation on a cell-by-cell level.

Chemotherapy

Chemotherapy is the treatment practice of adding cancer-killing drugs into your bloodstream to help kill any cancer cells that have spread to distant organs. While these drugs kill cancer cells, they also damage some normal cells, which leads to side effects. The side effects of chemotherapy depend on the type of drugs used, the amount given, and the length of treatment.

You could experience some of these short-term side effects:

• Hair loss
• Loss of appetite
• Nausea and vomiting
• Fatigue

You could experience some of these long-term side effects:

• Menstrual changes
• Nerve damage
• Heart damage- (if drugs were used for a long time or in high doses)

Hormone therapy

Cancers that have hormone receptors in their cell membranes are called hormone receptor-positive. In breast cancer, estrogen promotes the growth of breast cancer, so drugs are administered to stop estrogen from telling cells to grow and divide. In general, hormone therapy can be used to help reduce the risk of cancer from coming back after surgery. Hormone therapy has been very helpful in treating advanced breast cancer.

Targeted therapy

As researchers learn more about the gene changes that cause cancer cells to form and multiply, they have been able to develop newer drugs that seek to go after the inner workings of cancer cells while doing minimal damage to normal cells.

In short, targeted therapy is therapy designed specifically to target cancer cells. Targeted therapy does not work the same as standard chemotherapy drugs and often has different and less severe side effects.

Genomic therapy

This therapy technique involves the scientific expertise of examining each tumor or cancer area in detail to determine gene-expression profiles, which then guide the physician toward the most effective treatment option targeted to your specific cancer. Genomic therapy is a personalized medicine approach that attacks the specific causes of certain cancers.

Bone-directed therapy

When cancer spreads to the bones, it can weaken them and even lead to the bones breaking, causing extreme pain. Drugs like bisphosphonates and denosumab can help prevent those problems. Bisphosphonates can strengthen bones that have been weakened by invading cancer cells and reduce the risk of pain, fractures, breaks or osteoporosis. Denosumab is a newer drug that can also be used to help reduce the risk of problems from cancer that have spread to the bone. It is given as an injection, used to prevent osteoporosis twice a year.

Follow-up care

After your treatment is over, ongoing follow-up care is needed to watch for treatment side effects and to check for cancer that may come back or spread. During these visits, your doctor will ask about any symptoms you may have and perform a physical examination, as well as ordering blood tests and imaging studies as needed.

Making lifestyle changes to improve your health, over the long term, after cancer treatment and recovery is important. These lifestyle changes include: maintain a better diet, stop smoking, exercise more often, reduce stress and take the time to get proper rest in order to allow your body to recover.