Cancer treatment involves a host of options like surgery, radiation, medications and other therapies.
Cancer is a deadly disese in the sense unlike other diseases it has a tendency to quickly multiply and spread. Hence treating cancers should be seen as an emergency.
Our slogan has been - "CANCER IS CURABLE". There is a catch to this slogan - "IF it is caught early".
All treatment options in cancer are aggresive and involves co-lateral damage. Normal cells and cancer cells are all affected. The whole body is affected. Vital organs such as kidneys and liver are affected. While making a treatment plan for cancer, all these factors have to be taken into consideration.
There is no magical formula for treating cancers. Although there are clinical guidelines in each country like the USA (NCCN guidelines) and UK or Eurpean Union, all these are what it is called "guidelines". As every case of cancer is unique, one has to use great caution and discretion in treating cancer.
A timely plan is essential in treating cancer. A patient cannot be operated on and some portion of the cancer removed without properly timing radiation and chemotherapy. No single modality (such as surgery or chemotherapy) can handle cancer. Sometimes, combination therapy are best for the patient.
BE CAREFUL OF BARKING UP THE WRONG TREE AND WASTING YOUR TIME AND RESOURCES.
Cancer shoulld always be planned and carried out by a multi-disciplinary team (MDT). We have a MDT team which reviews all cancer cases every morning and plans treatment protocls. Discussions revolve on best treatment options for each patient. A treatment planning looks at the past, present and the future. A plan must include the very important aspect of the 5-year survival rate which would include a follow-up plan.
While on treatment, cancer patients develop numerous medical complications and hence it is crucial that during the course of the treatment, cancer patients should always be followed up regularly. Failure to do so will invite unpleasant surprises and affect the course and outcome of the treatment.
Our main aim is always to quickly shrink a cancer or stop the progression of a cancer.
The treatment options are not restricted to one or two types of treatment but may be a combincation of various options.How do we determine what type of treatment should be embarked on first? This largely depends on various factors:
- Clinical Condition
- Size and Shape of tumor(s) and Position of tumor(s)
What treatment comes first?:
Depending on the clinical condition of the patient, as an example - Radiation may be attempted first. The objective is to determine what treatment plan will effectivly eliminate cancer from the body ASAP.
Protruding bleeding cancers may require emergecy surgery or even radaition first.
Radiation Therapy - click here
The main aim of our treatment is to stop the cancer in its tracks and is therefore focused on reducing the size of the tumor or removing as much of the tumor as possible and contain its spread. Sometimes, chemotherapy is administered at the same time as radiation therapy. And sometimes radiation is administered immedaitely after surgery.
The goal of cancer treatment is to achieve a cure for your cancer, allowing you to live a normal life span. This may or may not be possible, depending on your specific situation. If a cure isn't possible, your treatments may be used to shrink your cancer or slow the growth of your cancer to allow you to live symptom free for as long as possible.
Various Cancer treatments options may be used such as:
- Primary treatment. The goal of a primary treatment is to completely remove the cancer from your body or kill all the cancer cells.
- If your cancer is particularly sensitive to radiation therapy or chemotherapy, you may receive one of those therapies as your primary treatment. Any cancer treatment can be used as a primary treatment, but the most common primary cancer treatment for the most common types of cancer is surgery.
- Adjuvant treatment. The goal of adjuvant therapy is to kill any cancer cells that may remain after primary treatment in order to reduce the chance that the cancer will recur.
- Any cancer treatment can be used as an adjuvant therapy. Common adjuvant therapies include chemotherapy, radiation therapy and hormone therapy.
- Neoadjuvant therapy is similar, but treatments are used before the primary treatment in order to make the primary treatment easier or more effective.
- Palliative treatment. Palliative treatments may help relieve side effects of treatment or signs and symptoms caused by cancer itself. Surgery, radiation, chemotherapy and hormone therapy can all be used to relieve symptoms. Other medications may relieve symptoms such as pain and shortness of breath.
- Palliative treatment can be used at the same time as other treatments intended to cure your cancer.
- Many cancer treatments are available. Your treatment options will depend on several factors, such as the type and stage of your cancer, your general health, and your preferences. Together you and your doctor can weigh the benefits and risks of each cancer treatment to determine which is best for you.
Cancer treatment options include:
- Surgery. The goal of surgery is to remove the cancer or as much of the cancer as possible.
- Chemotherapy. Chemotherapy uses drugs to kill cancer cells.
- Radiation therapy. Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation treatment can come from a machine outside your body (external beam radiation).
- Immunotherapy. Immunotherapy, also known as biological therapy, uses your body's immune system to fight cancer. Cancer can survive unchecked in your body because your immune system doesn't recognize it as an intruder. Immunotherapy can help your immune system "see" the cancer and attack it.
- Hormone therapy. Some types of cancer are fueled by your body's hormones. Examples include breast cancer and prostate cancer. Removing those hormones from the body or blocking their effects may cause the cancer cells to stop growing.
- Targeted drug therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive.
- Cryoablation. This treatment kills cancer cells with cold. During cryoablation, a thin, wandlike needle (cryoprobe) is inserted through your skin and directly into the cancerous tumor. A gas is pumped into the cryoprobe in order to freeze the tissue. Then the tissue is allowed to thaw. The freezing and thawing process is repeated several times during the same treatment session in order to kill the cancer cells.
- Having all these facilities under one roof is a great boon to any cancer patient. The establishment of MRI and CT scans together with X-ray and Ultrasound, have added to the benefits of having everything in one place.
- Having experienced staff administer various cancer treatments is again of great significance.
- We try and provide the best of services for all our cancer patients. It is no longer necessary for any cancer patient to go out of the country for cancer treatment.
FIRST THINGS FIRST
- Before embarking on a plan of treatment, it is very very important to accurately diagnose the cancer you are dealing with. We follow the W.H.O classiification known as the ICD code. (https://www.who.int/classifications/icd/en/)
- Once a code is identified, we have to know the type and nature of the tumor. This invoves the process of staging the cancer.
- There are 2 main ways of staging cancer. The first s clinical staging and the second is staging through fluid or biopsy called histological or pathological staging.
- Then there is the aspect of grading the tumor to see how aggresive the tumor is.
- Note has to be made of the number, size, shape and position of the tumor(s).
- And finally note has to be made of the number of lymph nodes affected if any.
All these parameters are eventually translated into what is called TNM classification: The abbreviation “TNM” stands for tumor (T), nodes (N), and metastases (M). “Nodes” indicates whether or not the tumor has spread into neighboring (regional) lymph nodes. These are lymph nodes that are located in the drainage area of the affected organ. The TNM Classification of Malignant Tumors (TNM) is a globally recognised standard for classifying the extent of spread of cancer. It is a classification system of the anatomical extent of tumor cancers. It has gained wide international acceptance for many solid tumor cancers, but is not applicable to leukaemia and tumors of the central nervous system. Most common tumors have their own TNM classification.
- T = Tumor. The T score is a rating of the extent of the primary tumor. The primary tumor is the first mass of cancer cells in the body. ...
- N = Nodes. The N category reflects the extent of cancer within nearby lymph nodes. ...
- M = Metastasis. The M category tells you if the cancer has spread to distant sites.
In the TNM (Tumor, Node, Metastasis) system, clinical stage and pathologic stage are denoted by a small "c" or "p" before the stage (e.g., cT3N1M0 or pT2N0). ... Clinical stage is based on all of the available information obtained before a surgery to remove the tumor.
T: size or direct extent of the primary tumor
Tx: tumor cannot be assessed
Tis: carcinoma in situ
T0: no evidence of tumor
T1, T2, T3, T4: size and/or extension of the primary tumor
N: degree of spread to regional lymph nodes
Nx: lymph nodes cannot be assessed
N0: no regional lymph nodes metastasis
N1: regional lymph node metastasis present; at some sites, tumor spread to closest or small number of regional lymph nodes
N2: tumor spread to an extent between N1 and N3 (N2 is not used at all sites)
N3: tumor spread to more distant or numerous regional lymph nodes (N3 is not used at all sites)
M: presence of distant metastasis
M0: no distant metastasis
M1: metastasis to distant organs (beyond regional lymph nodes)
The Mx designation was removed from the 7th edition of the AJCC/UICC system, but referred to cancers that could not be evaluated for distant metastasis.
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated)
S (0–3): elevation of serum tumor markers
R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not)
L (0–1): invasion into lymphatic vessels
V (0–2): invasion into vein (no, microscopic, macroscopic)
C (1–5): a modifier of the certainty (quality) of the last mentioned parameter (has been removed in the TNM 8th edition)
c: stage is determined from evidence acquired before treatment (including clinical examination, imaging, endoscopy, biopsy, surgical exploration). The c-prefix is implicit in absence of the p-prefix.
p: stage given by histopathologic examination of a surgical specimen
y: stage assessed after chemotherapy and/or radiation therapy; in other words, the individual had neoadjuvant therapy.
r: stage for a recurrent tumor in an individual that had some period of time free from the disease.
a: stage determined at autopsy.
u: stage determined by ultrasonography or endosonography. Clinicians often use this modifier although it is not an officially defined one
And finallly beware of folks who are expert in taking you for a ride: Eat this ... drink that .. wear this ... rub this ... and the list goes on and on and eventually the patient lands up at our doorstep with a huge tumor heavily infected and purulent which requires emergency attention.
Beware also of quackery in this industry.
Many have phoned in to ask about a recent stem cell product supplement. Like in all medicine, there is the Good, Bad and Ugly. We consider this in the 'Bad' section because it is just a herbal product with anti-oxidant properties, solely marketed and sold for commercial purposes. One will be better off drinking lime juice three times a day than spending money on this costly product.