good for medicine students

1. PRINCIPLES OF
CANCER TREATMENT
Rakesh Kumar
Group :- 3rd
Course :-5th

2. Goals of cancer treatment
1- Primary goal
 Cure the patient
 Render him clinically and pathologically free
of disease and return their life expectancy to
that of healthy individuals of the same age
and sex.
 Current therapies do not offer cures for all
patients

3. Goals of cancer treatment
2- The best alternative goal
 To prolong survival while maintaining
the patient's functional status and
quality of life.
3- The 3rd goal
 Relive symptoms such as pain for
patients in whom the likehood of cure or
prolonged survival is very low

4. Modalities of cancer treatment
The Major Modalities
 Surgery
 Radiation
 Chemotherapy
 Biological therapy

5. Modalities of cancer treatment
The most appropriate type of therapy for
each individual patient is determined
by
 Type and extent of tumor involvement
 Treatment goals
 Performance status
 Age
 Concomitant disease
 Many patient receive 2 or 3 of these modalities
together

6. I-Surgery
 The oldest cancer treatment
 The most invasive method
 Requires patient be able to tolerate physical
challenges of surgery
 Was only method that could produce cures
 Still provides the best chance of cure for most
patients with solid tumors.

7. I-Surgery
 Uses
…Treat the primary cancer
…To remove isolated metastatic
masses
…To make other methods of treatment
possible e.g. providing access for
chemotherapy delivery (implanted
infusion pumps)

8. I-SURGERY
 Diagnosis and Staging
 Reconstruct anatomical defects to improve
function, cosmetic appearance, and quality of
life
 Prevention
… Permitting the removal of precancerous lesions
such as abnormal moles or colon polyps.

9. I-SURGERY
 Treat complication
… Hemorrhage
… Perforation
… Bowel obstruction
… Spinal cord compression

10. I-SURGERY
Debulking
…Reduce the size of the tumor even though
the entire tumor cannot be resected
 1ry to relive pain or other symptoms
 Increase effectiveness of radiation or
chemotherapy

11. I-SURGERY
Surgical removal of a source of hormone
…A form of hormonal therapy
…Used in to treat tumors whose growth
depends on those hormones
…Most common type: removal of testes in
prostate cancer and removal of ovaries in
breast cancer.

12. II- Radiation
 It is the destruction of cancer cells by ionizing
radiation
 A component of treatment for ½-2/3 of all
patients with cancer
 Radiation is usually generated by machines
outside the patient (external beam radiation)

13. II- Radiation
 Less commonly radiation sources are placed
close to the body surface or within the body
cavity (brachy-therapy)
 Sometimes radiation sources are implanted
into or around cancerous tissue (interstitial
brachytherapy)

14. II- Radiation
 Usually administered in small doses over
several weeks (fractionating)
 fractionating permits the administration of
levels of radiation sufficient to kill tumor
cells while allowing normal surrounding
tissue to recover from damage

15. II- Radiation
Side Effects
 Radiation can never be directed only at tumor and
normal cells and tissue are also damaged
 The most sensitive tissues are those that undergo
continuous cell renewal such as the skin, hair , GI
mucosa, bone marrow, reproductive tissue, and sweat
glands
 In slowly growing tissue such as lungs, effects of
radiation is seen much later

16. II- RADIATION
Side effects:
 the ability to produce a cure with radiation
will depend on the capacity of normal tissues
surrounding the tumor to withstand the toxic
effects
… if the normal tissue are very sensitive, the
range of radiation doses used may be
limited

17. II- Radiation
 Radiocurability: ability to cure by radiation
 Depends on
… The size and location of the tumor
… Type of tumor
… Tumor’s radiosensitivity
 Curative radiation is limited to localized
tumors like surgery

18. II- Radiation
Uses
 Curative for localized tumors
 Total body radiation to prepare for bone
marrow transplant , but highly toxic
 As supplement to surgery
 To destroy micro metasitasis

19. II- Radiation
Uses
 Palliatively
… the most common used is to relive pain
caused by skeletal bone metastases
… such as seizures associated with brain
metastases
… spinal cord compression caused by growth
of tumors on the spine

20. III-CHEMOTHERAPY
 refers to the use of conventional cytotoxic
drugs in addition to hormonal and
endocrine therapy.
 Originally started in 1941, when
Goodman and Gilman first administered
nitrogen mustard to patients with
lymphoma

21. III-CHEMOTHERAPY
 Now there are > 50 conventional
cytotoxic agents and > 15 hormonal
agents for cancer treatment

22. III-CHEMOTHERAPY
Cancer chemotherapy may be
 Primary
 Palliative
 Adjuvant
 neoadjuvant

23. Chemotherapy used alone with curative intent
Acute lymphocytic leukemia Acute myelogenous leukemia
Chemotherapy used as adjuvant therapy with curative intent
Breast cancer Colorectal cancer
Chemotherapy used as neoadjuvant therapy
Anal carcinoma Bladder cancer
Chemotherapy used to palliate symptoms in advanced disease
Bladder cancer Brain tumors
Chemotherapy has little or no effect on palliation
Hepatocellular cancer Renal cell carcinoma