Surgical treatment in Cancer Types

Surgery is the removal of cancerous tissue from the body.

In many cancers, surgical treatment is the first method, and in some cancers, surgical treatment can be cured.

Surgery is also a treatment method used to confirm the diagnosis (biopsy), staging, and reduce side effects and pain.

Some surgeries in cancer are performed in outpatient clinics or doctor’s offices, and most are performed in hospitals.

Side effects of surgical treatment depend on the type of surgery and the patient’s general health before treatment.

The most common side effect is pain, which is easily treatable and can be undercontrolled with medications in most patients.

Radiation Therapy

Radiation therapy can be applied as a single method in patients with cancer in Radiation Oncology Clinics, or it can be applied simultaneously or sequentially with surgery and chemotherapy. Radiation therapy is applied to 52% of all cancer patients at some stage of treatment.

Radiation therapy, or more commonly known as radiotherapy, begins with the evaluation of the patient by a Radiation Oncology specialist and the decision to apply it. After the simulation process, planning and physics calculations are made with the participation of Physics engineers trained in radiation. The application is carried out by radiation technicians under the control and supervision of specialist doctors and physics engineers.

Ionizing radiation is used in radiotherapy. Its purpose can be summarized as destroying cancerous cells and shrinking the tumor. It is one of the main objectives of planning to ensure that the normal tissues that can be affected by radiation are at a minimum level.

Radiotherapy can be applied externally (externally) and internally (internally). Rarely, systemic radiation can be applied in some diseases. External radiotherapy is the most commonly used form of radiotherapy, and a radiation beam source is given to the diseased area from outside with the help of a machine. In internal radiotherapy, radioactive material is placed in the body for a certain period of time. In systemic radiation therapy, the radioactive substance is given to the patient intravenously or in the form of oral pills. It may be necessary to stay in the hospital for a certain period of time for internal therapy and systemic radiation therapy.

A Brief Guide for the Patient to be Treated with Radiotherapy

It is normal for patients who will receive radiation therapy for the first time to be a little excited and distressed. Talking to your Radiation Oncology specialist in detail before treatment will help reduce your excitement and distress. Your doctor will give you information about the treatment and answer your questions.

The first application is the process called simulation to determine the area to be radiotherapy. For this process, a machine called a simulator, which is also used as an x-ray device, or if 3D planning is to be made, devices called computerized tomography (CT) simulators are used. You will be notified in advance of when and how you will arrive for these examinations.

Then you will be told on which machine and when you will be treated. Physical planning, physical calculations, and if there are in-field protections, these are made of blocks with special mixture castings suitable for your treatment area, during the period between the simulation and the start of your treatment. Radiotherapy planning can often be done several times during the treatment to reduce the treatment area.

The first application for radiation therapy is done together with radiotherapy technicians under the supervision and supervision of your specialist doctor and physical engineer, and your treatment is continued by radiotherapy technicians in the following days. During the radiation treatment, you will have a control examination with your doctor at certain periods. The treatment process is usually completed within 10-15 minutes, depending on the number of areas, and your doctor will tell you the entire treatment time. This period usually varies within 2 to 6 weeks. Sometimes it can be shorter or longer. External radiotherapy application is usually applied 5 days a week. No application is made for normal tissues to renew themselves for two days.

Externally applied radiotherapy does not cause any pain in you, you must stay still during the treatment. Don’t worry about giving radiation to your surroundings, getting radiation does not prevent you from being with pregnant women or small children, you can continue your normal life.

During radiation therapy, side effects may occur. The most common side effects are fatigue and loss of appetite. Depending on your treatment area, different side effects may occur, most of them are temporary, your doctor will help you with this.

Radiotherapy will cause discoloration in the area (skin) within the irradiated area. Although this area varies from patient to patient, it becomes more sensitive as radiotherapy progresses. This area should not be irritated. For this, your clothes should be soft and you should avoid irritating applications such as shaving, scrubbing and rubbing.

Another issue that you should pay attention to during the treatment is your diet. In order to benefit from the treatment at the maximum level, you should eat a balanced and adequate diet and maintain your weight. Consider your doctor’s recommendations in this regard. After the radiotherapy treatment is completed, your doctor will give you detailed information about the treatment and the continuation of your treatment and will call you for control if necessary. In general, patients are called for controls after radiotherapy in order to evaluate the response of the treatment and to see possible side effects, the first control is usually after 1-2 months, and the following controls are every 3 months.

The Chemotherapy Treatments

Chemotherapy is treatment using anticancer drugs to destroy cancer cells or control their growth. It can be used alone or in combination with surgery and radiotherapy in cancer treatment.

The aim of chemotherapy in cancer treatment varies according to the type and extent of the disease. Goals of chemotherapy:

to treat the disease

To control the disease by preventing the proliferation of cancer cells and slowing their spread.

To increase the quality of life of the person by eliminating the complaints and symptoms related to the disease

Reducing disease recurrence when administered after surgery or radiotherapy

To facilitate local treatments to be applied before surgery or radiotherapy

Palliative Treatment

Although cancer is curable, it is not always possible.

The aim of palliative treatment is to make the person feel as good as possible, regardless of the stage of the cancer.

Palliative treatment may be directed towards the physical, mental, psychological and social needs of the person. Palliative therapy can continue at the same time as curative therapy.

The five goals of palliative therapy are:

Treatment of pain and other signs of cancer or treatment

Addressing the individual’s spiritual needs and concerns,

Meeting the social and financial needs of the person and basic needs such as transportation,

Treatment of the person’s psychological needs and depression,

After the death of the patient, the patient’s relatives, friends and caregivers are provided with support.

Children also receive palliative therapy. WHO defines palliative treatment for children as providing care for the mind, spirit and body of the child. The patient’s family works with a professional healthcare team consisting of a doctor, nurse, social worker, dietitian, and physiotherapist to make their children as comfortable as possible.

Biological Therapy

Biological therapy, also known as immunotherapy, activates the body’s defense mechanisms against cancer.

Biological agents such as interferon and colony stimulating factor restore body defense mechanisms. Researchers are also developing specific biological treatments such as monoclonal antibodies and vaccines.

Monoclonal antibodies are substances produced in the laboratory that bind to specific areas on cancer cell surfaces. When they bind to the cancer cell surface, they affect the synthesis of proteins that function in the cell.

For example, trastuzumab binds to the HER2/neu protein, which is produced in excess in breast cancer cells, preventing the growth and division of cancer cells. Other monoclonal antibodies used in cancer treatment are cetuximab (Erbitux), rituximab (Rituxan), and bevacizumab (Avastin).

Cancer vaccines enable the body to recognize cancer cells by influencing the immune system, clinical studies on cancer vaccines continue. However, it is still a very experimental treatment method.

Determining the stage of the cancer process?

Staging is the definition of where the cancer is located, where it has spread, or whether it affects other organs in the body.

Doctors use diagnostic methods to define the stage of cancer, so staging is not complete until all tests are done. Knowing the universe helps the doctor in choosing the most appropriate treatment method for the patient and predicting the course of the disease. There are different stage definitions for different types of cancer.

The most widely used of the various staging systems today is the TNM staging system prepared by the AJCC (American Cancer Committee). TNM stands for T(tumor), N(node=lymph node) and M(metastasis).

The doctors look at three factors to determine the stage of the cancer.

What is the size of the first tumor and where is it located? (Tumor, T)

Has the tumor spread to the lymph nodes? (Node=N)

Has the cancer spread (metastasized) to other parts of the body? (M=metastasized)

T, N, M results are combined to determine the stage of the cancer. The stage is written in Roman numerals from 1 to 4 (I, II, III, IV).

When stage 0 cancer is diagnosed, it means the cancer is limited to where it started and has not spread to surrounding tissues. Stage 0 cancer is also called carcinoma in situ.

Targeted Therapies

These agents bind directly to proteins in cancer cells, so unlike chemotherapy drugs, they only kill cancer cells without affecting healthy cells.

Examples of targeted therapy are imatinib, gefitinib, and erlotinib. Most targeted therapies are also experimental and are used in conjunction with other treatment modalities.