What treatments are there to fight cancer? In this article we review current clinical therapies.
One in six deaths in the world is due to cancer . It is the second leading cause of death in the world, only behind cardiovascular diseases.
8.8 million people died from this condition in 2015. Taking into account that statistics indicate that approximately 1 in 3 women and 1 in 2 men will develop some type of cancer in their lifetime, the Oncology research is a primary public health issue.
The fight against cancer
Thanks to this work of researchers, treatments have been developed -and continue to be developed- that have allowed survival in the last twenty years to have increased by 20%. This improvement in the expectations of those affected by cancer comes from treatments that turn out to be more and more specific and effective.
Cancer research is the engine to ensure that mortality caused by cancer decreases, achieving increasingly effective prevention and turning it into a curable or, at least, chronifiable disease.
In this article we will review the treatments that are currently available , analyzing their characteristics and differences between them.
What are the types of treatments to fight cancer?
Through the synergy of various specialties in biology and medicine , we have managed to develop many different types of treatments to combat these malignant tumors. The treatment that a patient receives depends on several factors , especially the type of cancer that has developed and how advanced it is.
The prescription of one treatment or another is determined by the phase of diagnosis. That is why an accurate detection of cancer is essential to then apply a specific treatment depending on the nature of the tumor and the stage in which it is.
The importance of this diagnosis lies in the fact that each type of cancer requires a specific protocol that may even involve the use of several therapies at the same time, combining treatments. In fact, some of the most common cancers, such as breast and colon cancers, have high cure rates if detection is early and accurate.
As in any clinical setting, these treatments have the main objective of curing cancer or, failing that, prolonging the patient’s life as much as possible . In addition to this obvious purpose, these therapies also have to be focused on improving the quality of life of the patient, which can be achieved by offering palliative care, alleviating the symptoms of the disease, as well as psychological and social support.
These are the types of treatment currently used to fight malignant tumors.
Surgery is therapy in which a surgeon removes the tumor from the body of a cancer patient . Many affected by a malignant tumor are treated by this technique, which is advisable to practice when dealing with solid tumors contained in a limited area of the body. This is why it cannot be used for leukemia (blood cancer) or cancers that have metastasized, that is, that have spread to other areas of the body.
It is a local treatment, so affecting other areas of the body that do not suffer from cancer are risk free. Although surgery is sometimes the only treatment the patient will receive, this technique must often be used in combination with other treatments.
The risks of this technique are mainly pain and the possibility of infection. The degree of pain the patient will feel will depend on the extent of the operation and the area the surgeons worked on. In the case of infections, the risk of suffering them will be reduced if the advice for cleaning and disinfecting the wound is followed.
2. Radiation therapy
Radiation therapy or radiation therapy is cancer treatment in which high doses of radiation are used to kill cancer cells or shrink these tumors.
Low-dose radiation is used in medicine to make x-rays of the bones or teeth. These x-rays, when in high doses, begin to damage the DNA of cells, thus becoming a candidate to attack tumor cells.
Although high-dose radiation does not kill cancer cells immediately, after weeks of treatment the genetic material of these tumors will be so damaged that the lesions will be irreversible and they will stop dividing uncontrollably. After a while the malignant cells will begin to die, break down and eventually the body will expel them as waste.
The risk of using this treatment is that it not only destroys or slows the growth of tumor cells, but it can also affect healthy ones. The side effects of this attack on the patient’s own cells will depend on the affected area, although they are usually related to hair loss, skin changes, fatigue, nausea and vomiting, headache, blurred vision, urinary changes, etc.
Chemotherapy includes all those treatments to fight cancer that base their action on the use of drugs that stop or slow down the growth of tumor cells.
This therapy is used to treat many types of cancer and may be the only treatment they receive. However, its widespread use is due to the fact that chemotherapy is usually the previous step to the application of other treatments. It is often used to shrink the tumor before surgery or radiation therapy, as an adjunct to other treatments, or even to kill any cancer cells that may remain after surgery.
Like radiation therapy, the action of chemotherapy is not specific to cancer cells, thus affecting the growth of healthy cells that divide rapidly, such as those that line the intestines or those that make hair grow. That is why the most common side effects of this therapy are fatigue, hair loss, nausea, mouth sores and vomiting. However, these side effects often get better or go away after treatment ends .
Immunotherapy is treatment that involves helping the immune system fight cancer . It is considered as a biological therapy in which substances produced by organisms are used to treat tumors.
Although this therapy has been approved to treat many different types of cancer, it is not yet used as much as surgery, chemotherapy, or radiation therapy. Future projections indicate that as more clinical studies are conducted, its use will become much more widespread.
One reason why tumor cells thrive and are not killed by our bodies is because they have the ability to hide from the immune system. The action of immunotherapy consists of marking these cancer cells and thus alerting the immune system where they are so that it, also strengthened by the treatment, can naturally fight the tumor.
This therapy is usually administered intravenously, so the side effects are related to our reaction to this injection: pain, redness, and flu-like symptoms (fever, chills, weakness, nausea, vomiting, etc.).
5. Targeted therapy
Targeted therapy is a type of treatment that acts on the functioning of tumor cells , affecting properties related to their growth, division and spread.
It is in this therapy that most reflects the need to continue investigating the nature of malignant tumors, since by knowing them in depth we will be able to find new targets to block the harmful characteristics of these cells.
This treatment consists of using micromolecular drugs, which penetrate tumor cells and inhibit their functions, or monoclonal antibodies, which adhere to the surface of cancer cells to also inhibit their properties.
It is indicated for patients with some type of cancer with cells that we know well and for which there is a target on which these drugs can act. To determine this, it will be necessary to do a biopsy, that is, to remove a part of the tumor and analyze it. Performing a biopsy carries risks, which added to the fact that cancer cells can become resistant to drugs and that there are adverse side effects, explains why this therapy is not completely widespread.
6. Hormone therapy
Hormone or endocrine therapy is a treatment used to fight breast and prostate cancer , since the tumor cells that cause them use hormones (that our own body generates) to grow.
This therapy can block the body’s ability to make hormones or interfere with the way hormones behave in the body. Both actions seek to prevent tumor cells from having their growth substrate and thus stop their expansion or, at least, alleviate the patient’s symptoms.
The side effects of this treatment are given by the hormonal inhibition that the patient suffers: hot flashes, fatigue, sensitive breasts, changes in women’s periods, vaginal dryness, nausea, loss of sexual appetite, weak bones, etc.
7. Stem cell transplants
Stem cell transplants are a type of treatment that does not act directly against cancer, but rather helps the patient to regain their ability to generate stem cells after chemotherapy or radiation therapy .
In very high-dose chemotherapy or radiation therapy, blood cells are destroyed. With this transplant, stem cells are transfused into the bloodstream, thus traveling to the bone marrow and then replacing cells that died during treatment. Thus, the patient recovers the ability to produce white blood cells, red blood cells and platelets, essential components of the circulatory system.
Although its possible use is being studied in other types of cancer, this treatment is currently used to help patients with leukemia and lymphoma, although it is also often used in patients with neuroblastomas and multiple myeloma.
The adverse effects of this treatment are bleeding, an increased risk of infections and a possible rejection of the donated tissue, so it is necessary to ensure that the cells received are as compatible as possible with the patient.
The importance of precision medicine
Traditionally, the selection of therapies to treat cancer has been similar to a mathematical equation: based on the type of cancer and its stage, the treatment is chosen.
Despite the obvious successes of this approach, the relatively recent discovery that tumors undergo genetic changes as they grow and spread, and that these are different for each patient, has led researchers to focus research on the direction of what is known as precision medicine.
This precision medicine arises from the need to select treatments that are more likely to help the patient based on the genetic variables of the tumor cells. Somehow we work with a personalized medicine very focused on the individuality of the patient, taking into consideration many more variables than a few years ago.
With this precision medicine we pursue that the prescribed treatment is the most appropriate, trying to guarantee both the patient’s chances of survival and an improvement in their quality of life.