Immunotherapy: A Modern Treatment For Cancer
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Following a cancer diagnosis, you may be overwhelmed by the need to make critical therapeutic decisions in a short span of time. You may not know what to expect and feel directionless about the choice of therapeutic path. The fear, anxiety and uncertainty surrounding treatment decisions can be overcome by the power of awareness.
At Cytecare, Patient Education and involving patients in a Shared Decision Making regarding their treatment are among our core principles. Therefore we consider it as our responsibility to equip every patient and their caregiver with the information on the possible treatment modalities and facilitate therapeutic decision making.
There are more than 100 types of cancers, affecting various organs in our body. Cancers can be indolent (slow growing) or aggressive. Some cancers show more prevalence in specific age groups or gender. Cancers may differ in the rate and primary site of metastasis too. They may also vary in the way they respond to therapy (drugs, radiation, hormones etc). Because of such as diverse behavior of Cancer, its treatment can never follow a “One size fits all” approach. Several factors such as the type of cancer, the site or organ of location, the stage of cancer, the age and overall health of the patient at the time of diagnosis, the tumor pathology, immunohistochemistry etc influence the choice of treatment. Most often, Cancer treatment follows a multi-modality approach. This means, a combination of one or more treatments may be used to effectively fight cancer for purpose of achieving the best outcome.
At Cytecare, we provide cancer care in consensus with global standards. Each patient case is critically reviewed by our multi-disciplinary tumor board members. Some of the treatment modalities of cancer include:
Surgery: Surgery is often the first line of choice for solid tumors, whenever possible. Surgery may/may not be combined with other modalities. The size, type, location of tumor and factors such as age, comorbid conditionsof a patient are key determinant factors in choosing surgery. In some cases where primary tumor has not metastasized surgery may be considered as curative therapy. Surgical resection of tumors may often be accompanied by removal of adjacent normal tissues, regional lymph nodes or organs etc (Radical Surgery) At times, surgery may be performed to reduce the tumor burden (Cytoreduction) when removal of complete tumor is not possible. Surgery may also be used to relieve symptoms of pain or alleviate symptoms caused due to obstruction to an adjacent organ, duct or vital structures from tumor and improve the quality of life (Palliative Surgery). In case of some cancers such as, head and neck cancer or breast cancer, a reconstructive surgery may also be performed after tumor resection surgery. This type of surgery tries to reconstruct and restore the morphology of the body part that may be lost completely or partially during a tumor resection surgery. All patients will undergo a careful pre-operative assessment to determine their eligibility to surgery. Additionally procedures using specialized techniques of minimally-invasive surgery and/or image-guided procedures are routinely implemented at Cytecare for management of cancer. These procedures offer distinct advantage of quick recovery time, reduced post-operative complications, shorter hospital stay.
Radiation therapy: High energy waves such as x-rays, gamma rays or electron beams may be used to destroy or shrink tumor cells. You may be offered radiation therapy prior to or following a surgery or chemotherapy. It can also be used for palliation to relieve symptoms of pain caused by tumor lesions that are inoperable. The outcome of a radiation therapy is dependent on several factors such as dose, duration, mode of radiation delivered and the properties of the tumor such as its molecular properties, sensitivity to radiation, oxygenation etc. In order to minimize side effects and be effective, you will receive radiation therapy in small doses called fractions, spread across weeks. As radiation does not bifurcate between the normal and malignant cells, you may experience side effects depending on the area of irradiation. At Cytecare, we integrate radiation planning with state of the art technology to deliver effective radiation therapy with an aim to minimize its effects on adjacent healthy cells and improve outcome. Cytecare is the first hospital to bring the Elekta Versa HD – a ground breaking piece of technology used in Radiation Therapy – to the state of Karnataka.
Chemotherapy: Also referred to as “Chemo”, uses drugs that destroy or kill cancerous cells. A wide variety of chemotherapeutic drugs are available and may be delivered by various modes (Intra venous, intra muscular, intra thecal, intra peritoneal etc) depending on individual cancer case. You may receive chemotherapy in combination with surgery and radiation. Similar to the effects of radiation, chemotherapeutic drugs also affects healthy normal cells. The side effects may vary depending on the type of drug, dose, duration and the nature of cancer, age of patient etc. It is important that patients discuss the side effects with their oncologist, as these can be managed effectively during your therapy.
Targeted Therapy: Also termed as precision medicine. These molecules are specifically tailored to target tumour cells. This may be used in conjunction with other treatment modalities. It is important to note that, not every patient is a candidate for targeted therapy. Cancers with tumors that express certain targets for this class of drugs can only be treated using this therapy. Targeted therapy may work in one of the following ways-
- Trigger a patient’s own immune system to destroy cancer cells (immunotherapy)
- May interfere with signals or proteins that prevent tumor cells from dividing.
- Hormone therapy- they may be specifically used on hormones that have receptors to hormones.
Palliative Care: During the entire duration of cancer therapy, patients often experience symptoms of fatigue, depression, insomnia, pain etc. It is important that a patient is able to maintain a good quality of life throughout the treatment trajectory. Palliative care, also called “Comfort care” or “supportive care” provides a continuous care to improve quality of life, ease symptoms of cancer treatment and provide psychological, social and spiritual support. Palliative care begins with cancer diagnosis and continues through treatment, follow-up care and post-treatment management. Under Palliative care, a patient will receive support in areas such as Pain Management, Sleep Issues & Insomnia, Chronic fatigue management, Spiritual wellbeing and support, Skin-toxicity & Wound management, Physical & Occupational Therapy, Psychological counseling, anaemia management, Cancer nutrition, medication for symptom control- nausea, vomiting, diarrhea etc
Nuclear Medicine: The rationale of nuclear medicine is to provide diagnosis using radioactive isotopes of molecules. At Cytecare, the department of Nuclear medicine provides both diagnostic and therapeutic services to cancer patients. For instance, in cancers such as those affecting the thyroid gland I-131 theray (radioactive iodine) is used. Intervention Radiology: A sub-specialty of Radiology that uses minimally-invasive procedures has been a boon to many patients both in diagnosing cancer as well as management of cancers. Image-guided, minimally invasive procedures such as radiofrequency ablation, chemoembolization, trans-arterial catheterization (TAC) etc are carried out with the help of MRI, CT, ultrasonography, fluoroscopy etc. The procedures of intervention radiology have provided new hope to many patients who have unresectable tumors too. It has helped in reduced hospital time, minimizing risk of post operation procedures and has improved the accuracy of cancer care.
As care providers at Cytecare, we encourage patients and caregivers to completely understand the different options of treatment modalities in context of their diagnosis and discuss all concerns with our oncologist. It is needless to say that our mission is to provide treatment that best suits the patient in order to achieve best outcome.