Science Series #17: Benefits and risks of different cancer treatments

What are cancer treatments?

Cancer is a complex and often devastating disease that affects millions of people around the world. It occurs when abnormal cells grow and divide uncontrollably, eventually forming tumors. Various treatment modalities exist to combat this disease, including the use of surgery, radiation, medications and other therapies to: cure a cancer, shrink a cancer, or stop the progression of a cancer. Fortunately, there are many distinct treatment options available today that can help to manage and even cure cancer in some cases.

When choosing a cancer treatment option, it is important to consider a range of factors, including the patient’s overall health and medical history, the stage and type of cancer, and the potential benefits and risks of each treatment. Patients should also be aware of the potential treatment-related side effects and consider how these may impact their quality of life during and after treatment.

The best approach to cancer treatment will depend on the individual patient and their unique circumstances. By working closely with their healthcare providers and making informed decisions, patients can increase their chances of successfully managing or even curing their cancer.

Source: National Cancer Institute, 2023; Mayo Clinic, 2023.

Importance of comprehensive cancer treatment

After a cancer diagnosis, patients with cancer and their families have to make a number of decisions about medical treatment. These decisions can be complicated by anxiety, unfamiliar words, statistics, and a sense of urgency. Unless the patient is facing an emergency, they should take the time to research their options, ask questions, and talk with family and friends.

The ultimate goal of cancer treatment is to achieve a cure for the disease, enabling patients to live a normal life span. However, this may not always be possible depending on the individual’s specific case. In instances where a cure is not possible, treatments may be used to shrink the cancer or slow its growth, allowing patients to live symptom-free for as long as possible. Each of the previously mentioned treatments comes with its own set of potential benefits and risks, and it is important for patients to work closely with their healthcare providers to determine the best approach for their unique situation. By making informed decisions and staying engaged in their care, patients can increase their chances of successfully managing or even curing their cancer.

Source: American Society of Clinical Oncology, 2022.

Applications of cancer treatments

Cancer treatments applications vary depending on the type and stage of cancer, as well as the individual needs and preferences of the patient. There are various approaches that can be used to target cancer cells and improve patient outcomes. Treatments may be used as:

  • Primary treatment: to completely remove the cancer from the body or kill all the cancer cells.
  • Adjuvant treatment: to kill cancer cells that may remain after primary treatment in order to reduce the chance that the cancer will recur.
  • Palliative treatment: To relieve some of the side effects of treatment or signs and symptoms caused by cancer itself.

 

Source: Mayo Clinic, 2023.

Types of cancer treatments and their implications

Below is an overview of the different treatments for cancer and how they work:

  • Surgery: involves the removal of cancerous tissue from the body. This can be an effective option for some types of cancer, particularly those that have not spread to other parts of the body. It is a common treatment for cancer and can be used alone or in combination with other treatments. There are two main types of surgery used to treat cancer: curative and palliative. Curative surgery is used to remove the cancerous tissue completely, while palliative surgery is used to relieve symptoms caused by cancer, such as pain or difficulty breathing. However, this procedure can be risky and may require a long 
  • Chemotherapy: is a common treatment that involves the use of medications to target and eliminate cancer cells. It can be used alone or in combination with other treatments such as surgery and radiation therapy. It may be used to make a tumor smaller before surgery or radiation therapy, to destroy cancer cells that may remain after surgery or radiation therapy, to help other treatments work better, or to kill cancer cells that have spread through the body. Drugs target rapidly dividing cells, including the cancerous ones, but also other cells such as those in the hair follicle. The drugs can damage or destroy these cells, leading to hair loss or thinning. This side effect is usually temporary and hair regrowth typically occurs after treatment ends. Healthy cells can usually recover from the effects of chemotherapy, while cancer cells are less able to do so.
  • Radiation: uses high-energy x-rays, particles, or radioactive seeds to target and kill cancer cells. Because radiation is most harmful to quickly growing cells, radiation therapy damages cancer cells more than normal cells. This prevents the cancer cells from growing and dividing, and leads to cell death. This treatment can be delivered externally or internally, depending on the type and location of the cancer. Like chemotherapy, radiation therapy can cause side effects, including fatigue, skin irritation, and damage to nearby healthy tissue.
  • Targeted therapy: focuses on specific molecules in cancer cells, commonly known as targets. Through them, the drug disables the cancer cells so they cannot spread. This is a newer form of cancer treatment that involves using drugs or other substances to target specific molecules or pathways involved in cancer growth. It does this with less harm to normal cells than other treatments. Targeted therapy drugs work in a few different ways. They may halt the process of the cancer cell growth and spread, trigger cancer cells to die on their own, or directly eliminate cancer cells. This approach can be more precise than chemotherapy or radiation therapy, but it may also be more expensive and may not work for all patients.
  • Immunotherapy: uses the body’s own immune system to fight cancer cells. Immunotherapy works by stopping or slowing the growth of cancer cells, preventing cancer from spreading to other parts of the body and boosting the immune system’s ability to get rid of cancer cells. This approach can be highly effective in some cases, but it can also cause side effects such as fatigue, fever, and muscle aches.
  • Hormonal therapy: used for cancers that are sensitive to hormones, such as breast, prostate, and ovarian cancers. It uses surgery or drugs to stop or block the production of hormones in the body, which can slow or stop the growth of cancer cells. This type of treatment is often used in combination with other therapies, such as surgery or radiation. Drugs can be given by injection or as pills.
  • Hyperthermia: uses heat to damage and kill cancer cells without harming normal cells. It can be delivered externally (using a machine to heat the area around the cancer) or internally (using a probe to heat the cancer from inside the body). Hyperthermia can be used on its own or in combination with other treatments like chemotherapy and radiation therapy.
  • Laser therapy: Laser therapy uses high-energy light to destroy cancer cells. It can be used for surface cancers like skin cancer, or for cancers that are deeper in the body. Laser therapy is often used in combination with other treatments like surgery and radiation. This treatment is often given through a thin, lighted tube that is put inside the body. Thin fibers at the end of the tube direct the light at the cancer cells. Lasers are also used on the skin.
  • Photodynamic therapy: Photodynamic therapy is a type of treatment that uses a special drug and a specific type of light to kill cancer cells. The drug is injected into the body and then activated by the light, which causes it to destroy the cancer cells. This type of treatment is often used for skin cancers and some types of lung cancer.
  • Cryotherapy: utilizes extreme cold to kill cancer cells. It can be delivered externally (using a machine to freeze the area around the cancer) or internally (using a probe to freeze the cancer from inside the body). Cryotherapy is often used for skin cancers and some types of prostate cancer. It is sometimes used to treat cells that might turn into cancer (called pre-cancerous cells) on the skin or cervix.
  • Stem cell transplant (bone marrow transplant): involves replacing damaged or diseased bone marrow due to very high doses of chemotherapy or radiation therapy with healthy stem cells. It is most commonly used to treat blood cancers and cancers that start in the lymph nodes.

 

Source: National Institutes of Health, 2023; Mayo Clinic, 2023, Memorial Sloan Kettering Cancer Center, 2023; Centers for Disease Control and Prevention, 2023.

Cancer treatment adherence

Adherence to cancer treatment is crucial for achieving the best possible outcome. It is important for patients to follow their treatment plan as prescribed by their healthcare provider, including taking medications on time, attending all scheduled appointments, and following any dietary or lifestyle recommendations. Failure to adhere to treatment can result in reduced effectiveness, increased risk of complications, and even disease progression.

This can be challenging, as cancer treatment can be physically and emotionally taxing. Patients may experience side effects such as nausea, fatigue, and pain, which can make it difficult to stick to their treatment plan. However, there are strategies that can help, such as taking medications at the same time each day, using reminder tools like phone alarms, and seeking support from loved ones or a healthcare team.

Patients who are struggling with adherence should talk to their healthcare provider to adjust the treatment plan or provide additional support to help patients stay on track. Adherence is a key component of successful cancer treatment, and by working together with their healthcare team, patients can increase their chances of achieving a positive outcome.

Source: Oncology Nursing Society, 2021.

References

American Society of Clinical Oncology (2022) Making Decisions About Cancer Treatment. Access: https://www.cancer.net/navigating-cancer-care/how-cancer-treated/making-decisions-about-cancer-treatment

Cazeau, N (2021) Mobile Health Interventions: Examining Medication Adherence Outcomes Among Patients With Cancer. Clinical Journal of Oncology Nursing. Oncology Nursing Society. Access: https://store.ons.org/cjon/25/4/mobile-health-interventions-examining-medication-adherence-outcomes-among-patients-cancer

Centers for Disease Control and Prevention (2023) Cancer Treatments. Access: https://www.cdc.gov/cancer/survivors/patients/treatments.htm

Mayo Clinic (2023). Cancer Treatment. Access:
https://www.mayoclinic.org/tests-procedures/cancer-treatment/about/pac-20393344

Memorial Sloan Kettering Cancer Center (2023) Types of Cancer Treatments. Access: https://www.mskcc.org/cancer-care/diagnosis-treatment/cancer-treatments

National Cancer Institute (2023). Types of Cancer Treatment. Access: https://www.cancer.gov/about-cancer/treatment/types

National Institutes of Health (2023) Cancer treatments. National Library of Medicine. MedlinePlus. Access: https://medlineplus.gov/ency/patientinstructions/000901.htm

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