Introduction to Cancer Treatments

Main Types of Cancer Treatment

• Surgery: Aims to physically remove the tumor
  • Curative treatment or palliative (to improve quality of life)
  • Example: Removing a bowel obstruction or tumor pressing on the spinal cord
• Radiotherapy: Uses targeted radiation to kill cancer cells
  • High-energy rays (e.g., x-rays, electrons)
  • External: Directed at tissue from a machine
  • Internal: Radioactive material placed near cancer cells
• Medical Therapies: Medications to kill cancer cells
  • Cytotoxic Chemotherapy: Drugs that kill fast-dividing cells
  • Other Medical Treatments: Hormone therapies, antibody therapies, immunotherapies, targeted therapies
    • Example: Targeted therapies inhibit mutated proteins in specific cancer cells

Decision-Making and Multidisciplinary Team (MDT)

• MDT Involvement: Collaborative approach involving various professionals
  • Oncologists: Medical doctors specializing in cancer treatment
  • Surgeons: Perform tumor-removal surgeries
  • Radiologists & Histopathologists: Provide cancer staging and grading information
  • Other Medical Doctors: Gastroenterology, respiratory, etc., involved in diagnostics and treatment
  • Palliative Care Doctors: For symptom management
  • Specialist Nurses: Communication, monitoring, and delivering treatment

Intentions of Treatment

• Curative (Radical) Treatment: Aims to cure the disease
• Palliative Treatment: Aims to improve symptom control and quality of life
  • Not aimed at curing, but extending life and managing symptoms
  • Quality of life is prioritized over merely extending life

Treatment Timing

• Neoadjuvant: Given before the main treatment
  • Example: Pre-surgery radiotherapy or chemotherapy to shrink the tumor
• Adjuvant: Given after the main treatment
  • Example: Post-surgery chemotherapy to prevent recurrence

Factors in Selecting Treatments

Tumor Factors

• Type and spread of the tumor
  • Impacts the choice between curative and palliative approaches

Treatment Factors

• Availability and efficacy of treatment
  • Likelihood of working as intended without significant side effects

Patient Factors

• Patient fitness and overall health
  • Example: Radical surgery may not be suitable for patients with other serious health issues
• ECoG Performance Status: Used to assess patient fitness
  • 0: Fully active
  • 1: Restricted in strenuous activities
  • 2: Up and about >50% of the day
  • 3: Up and about <50% of the day
  • 4: Bed-bound
  • 5: Death (mainly for research)
• Patient preferences and informed consent

Key Questions for Treatment Selection

• Type and stage of cancer (histology and scans)
• Available and effective treatments
• Side effects and patient fitness
• Patient's own treatment preferences

Summary

• Determine if the cancer is curable or requires palliative care
• Select appropriate treatments: surgery, radiotherapy, medical therapy
• Decide on the treatment order: primary, neoadjuvant, adjuvant, concurrent

Thank you for listening! Comments and questions are welcome. Please subscribe if you enjoyed the video.