By Dr Karthik K S
Mangaluru, Dec 6: Cancer is projected as a problem disease of this century. The disease incidence is projected to increase throughout the world. In India, 1 in 9 people - Nearly 10% of the people will have to face cancer diagnosis during their lifespan.
What are the options in cancer treatment?
Cancer can be solid or liquid. By Liquid, we mean Haematological cancers including Lymphomas. Such cancers are mostly treated by chemotherapy/Immunotherapy and Targeted therapy. The role of surgery is usually for diagnostic or symptomatic management. In solid cancers surgery has a pivotal role. Solid cancers, I mean the tumours can be operated and removed. Cancers of breast and thyroid which can be operated and removed for cure is a very good example. However, decisions in Oncology is done in MDT. Treatment and timing shall be planned to include Chemotherapy and Radiation Therapy whenever
Diagnosis: Biopsy / tissue diagnosis is the basis on which whole treatment shall be planned.Cross sectional Imaging may include CT scan, MRI or PET scan based on thecondition and organ. Ultra sonogram, Bone Scan, Mammogram are also quite an useful tool.
Surgery: Is probably the most important modality of treatment in Solid tumour management. Surgery can be done - Open or Minimally invasive. Minimal Invasive can be Laparoscopic or Robotic. The decision can be taken based on multiple factors based on the Disease and Patient. Surgically we have moved from a more radical to conservative approach without affecting the outcome and better quality of life like in breast conservation surgery for breast cancer.
Chemotherapy: These are pharmacologic agents used to kill cancer cells. Most of the agents are time tested. Nowadays with the advent of Immunotherapy and Targeted therapy, these agents are used in combination with one another. This approach broadened the definition of chemotherapy to include Immunotherapy and targeted therapy.
Immunotherapy: Eg - Pembrolizumab is an immunotherapy drug that works with the body's immune system to treat certain cancers, including those that express programmed death ligand 1 (PD-L1).
Targeted Therapy: Eg - Trastuzumab is a monoclonal antibody that binds to HER2, a protein that controls cell growth and repair. Many times these agents function by a combination of mechanisms.
Radiation Therapy: Invisible Beams of intense energy are used to kill proliferating cancer cells. This is part of local therapy many times used in adjunct to surgery. Many forms of this treatment is in use based on the organ and the disease. Cancer is a disease treated with combined modality treatment. These decisions transfer into the outcome for the patient. Knowing about options of treatment helps patients to decide and accept the treatment modalities.
Dr Karthik K S, Surgical Oncology, KMC Hospital Dr B R Ambedkar Circle Mangaluru.