Cancer varies with the individual. The treatment and effectiveness of the treatment varies between patients even with the same type of cancer. In this article we shall discuss cancer staging and the treatment options.
Read on to find out the answers to frequently asked questions about cancer treatment.
What is the importance of pathology diagnosis of cancer?
Successful cancer treatment begins with the actual diagnosis of cancer by a pathologist. The tumour is diagnosed as either benign or malignant. Furthermore, the type (classification) and grade (aggressiveness) of the tumour is evaluated at this time. Based on these findings, the optimal therapy is determined.
Except in rare emergency conditions, specific treatment should not be started until the diagnosis of cancer is absolutely confirmed by a pathologist.
What is cancer staging?
Cancer staging systems describe how far cancer has spread anatomically and attempt to put patients with similar prognosis and treatment in the same staging group. Cancer staging is accomplished either by a clinical examination or pathologic examination of a surgical specimen.
Cancer staging is used clinically to indicate the extension of cancer before definitive therapy begins and is important both for determining prognosis and for making decisions about treatment.
At the same time other factors, including a patient’s general health and treatment protocol contribute to determining the prognosis. So while the stage is important it is not everything.
What are cancer stages?
The concept of a stage is applicable to almost all cancers except for most forms of leukaemia. For most solid tumours, there are two related cancer staging systems, the Overall Stage Grouping, and the TNM system.
In the Roman Numeral Staging system, cases are grouped into four stages denoted by Roman numerals I through IV, or are classified as ‘recurrent.’
In general, Stage I cancers are small localized cancers that are usually curable, while Stage IV usually represents inoperable or metastatic cancer. Stage II and III cancers are usually locally advanced and/or with the involvement of local lymph nodes. Actually, these stages are defined precisely, but the definition is different for each kind of cancer.
In addition, it is important to realize that the prognosis for a given stage also depends on what kind of cancer it is, so that a Stage II lung cancer has a different prognosis from a Stage II cervical cancer.
The American Joint Committee on Cancer (AJCC) has developed a simple classification scheme that can be incorporated into a form for staging and universally applied. This scheme is designed to encompass the life history of a tumour and is referred to as the TNM system. The untreated primary tumour (T) will gradually increase in size, leading to regional lymph node involvement (N) and, finally, distant metastases (M)
How is a person’s cancer treated?
Four major treatments are widely used to combat cancer. These methods are surgery, radiation, chemotherapy, and immunotherapy (sometimes referred to as biological therapy). Surgery is the oldest method for treating cancer. It plays an important role in diagnosing and detecting the extent of cancer in the body. The newest method for treating cancer is immunotherapy, a process that relies on the body’s immune system to combat the disease.
The doctor may use one method or a combination of methods based on the type and location of the cancer, stage of cancer as well as the patient’s age, treatment preferences and general health.
What is chemotherapy?
Chemotherapy is a treatment that uses drugs or chemicals to stop the growth of cancer cells. Drugs are injected into the body with the aim of attacking cancer cells and eventually killing or damaging them. Ultimately, these drugs are meant to slow down the progression of the disease and force it into remission. The drugs used in chemotherapy are commonly taken before or after surgery. Sometimes, however, they are used by themselves.
What is radiation therapy?
In radiation therapy, high doses of radiation (such as those found in X-rays) are used to shrink or eliminate tumours. Radiation therapy is usually delivered as brachytherapy (the radiation source is placed close to the tumour) or teletherapy (radiation is delivered to the tumour with a linear accelerator, as a precise beam).
What is immunotherapy?
Immunotherapy is a treatment in which the body’s immune system is used to fight cancers of the blood. There are two types of immunotherapies: active and passive. Cancer vaccines are considered active immunotherapies because they ‘activate’ the immune system to attack the cancer cells. In contrast, passive therapy does not induce the body to attack the disease. One example of an active immunotherapy is a cancer vaccine.
What is biological therapy?
Biological therapy involves the restoration of the patient’s immune system. Imitative substances are created in a laboratory and strengthen the body’s defences against particular diseases or cancers. Such treatments include monoclonal antibody therapy and vaccine therapy.
Does conventional treatment work?
The majority of the people with cancer who present in the early stage can be cured, and most of these cures will be achieved by surgery. The other cures will be achieved by radiotherapy and chemotherapy (after or instead of surgery). In addition, conventional treatment can produce remissions in a proportion of cases when cure is not possible.
Why does radiotherapy and chemotherapy cause awful side effects?
Treatment is so awful mostly because cancer cells are only slightly different from normal cells and in order to kill them we (usually) risk doing considerable damage to normal cells or tissues. The side effects occur because the therapy hurts normal cells that divide frequently, as well as the cancer cells
How many people survive cancer?
Millions of people are living with cancer or have been cured of the disease. In fact, there are nearly nine million cancer survivors in America.
With current modes of treatment around 4 of 10 patients who get cancer will be alive five years after diagnosis. However, some cancers are very aggressive and still have a poor prognosis.
What a patient and family should be told by the doctor?
Before the start of anti-cancer treatment it is imperative to know the extent of cancer spread (cancer stage) and its origin (type of cancer). One should also be aware of the benefits and risks of treatments and possible consequences if no treatment is taken. A patient should know cost effectiveness of various treatment possibilities, planned breaks and the follow-up schedule.
How should a patient and family act once a family
member is detected as having cancer?
All issues of treatment strategies should be settled before starting any one therapy. Starting treatment in a hurry without proper consultation with all the specialists involved in diagnosing and treating cancer, without detailed investigations to correctly identify the cancer stage, leaving treatment midway, undergoing inappropriate surgery, lesser radiation sittings and low-dose chemotherapy – all of these can definitely compromise the chances of a permanent cure. Such a hasty start may allow the patient and attendants to feel falsely secure and may yield an initial temporary cure, or no response at all.
How can I help someone coping with cancer?
There are many ways that you can help people with cancer or the people who are caring for them. Having help with some practical or everyday parts of life can allow the person with cancer and their caregivers to concentrate on other things, such as treatment or getting some rest.
The staging system and treatment protocols for individual cancers are revised from time to time, and better results are being achieved with advances in our knowledge
by ongoing research.
We hope this article has answered some important common queries on cancer treatment.
Next week we will be publishing an article on breast cancer. Readers are invited to send their queries on breast cancer to Dr Ajay Gupta (email: ajaysurgeon@gmail.com) early for inclusion in the article.