Chapter 7-10: Approaches & Chief Complaints in Oncology

GENERAL APPROACHES TO TREATING CANCER

Surgery, radiation, and medications

• Surgery (surgical oncology): Resecting the tumor +/– local lymph nodes

• Radiation therapy (radiation oncology): Can be external beam therapy or internal (e.g., brachytherapy)

• Medications (medical oncology):

  • - Chemotherapy: Cytotoxic therapy that targets rapidly dividing cells

  • - Hormone Therapy: Medications to suppress endogenous hormones that drive the growth of certain tumor types

  • - Targeted Therapy: Medications that target specific genes and proteins that drive the growth of certain tumor types

  • - Immunotherapy: Medications that activate the patient’s own immune system to attack their cancer

Local vs. systemic treatment

• Local: Surgery, radiation. Sometimes sufficient for localized disease.

• Systemic: Medications (as above: chemotherapy, targeted therapy, immune therapy, hormone therapy). Goal is to treat cancer cells that may have spread throughout the body.

Timing/order of therapies

• Neoadjuvant: Treatment given before surgery to “shrink” the tumor to make it easier to resect and/or to better evaluate how the tumor responds to therapy before it is resected

• Adjuvant: Treatment given after surgery to kill any residual cancer cells and reduce recurrence risk

• Concurrent chemoradiation: When chemotherapy and radiation are given together; chemotherapy is usually radiosensitizing.