Cancer treatments vary depending on the specific type of cancer you may have and the extent of its development. For most forms of cancer – and for most people – there are three major areas of treatment: surgery, radiation and medical oncology (chemotherapy and/or hormone therapies). These treatments are often used in combination with each other.
Surgery is often one of the first steps for many cancer patients. It can be used in obtaining a biopsy as part of the diagnosis, or it can be part of the treatment plan. Unlike radiation and chemotherapy which destroy the cancer cells but leave them in the body, surgery tries to remove the cancerous tumor or tissues from the body. In many cases, lymph nodes found near the tumor are also removed to help determine if the cancer has spread. Depending on the type of cancer and its location in the body, different types of surgeons may be involved in your care. For example, a urologist would perform prostate surgery, while a thoracic surgeon would perform lung cancer surgery.
The advances in surgical technology in recent years have been significant. While not suited for every patient and every diagnosis, less-invasive approaches to surgery, which help patients recover faster, are used whenever appropriate. Riverside also offers robotic-assisted surgery which brings greater precision, less pain and faster recovery to patients with prostate cancer. This advanced technique is also being used in a growing number of gynecologic cancers.
Radiosurgery is a comparatively new and expanding field which offers “knifeless surgery” for some patients. The Riverside and University of Virginia Radiosurgery Center offers Gamma Knife® treatment for brain tumors and several other diagnoses. The Gamma Knife® uses a highly accurate beam of radiation to destroy cancer but does not involve conventional, open surgery, so it can usually be carried out in a single day. The Synergy S® system is also available, offering similar treatments for tumors outside of the brain.
The goal of radiation is to destroy or damage cancer cells in the area being treated while doing as little harm as possible to surrounding, healthy tissue. There are different types of radiation therapy or treatment and different ways to deliver it to the tumor site. These differences are based on the type of cancer, how deeply the beams of radiation need to penetrate, and for how long.
There are two basic forms, external beam radiation and internal beam radiation. External beam radiation enters the body from equipment positioned outside. Internal beam radiation (also called brachytherapy) is less common and consists of placing the radiation source inside the body. For prostate cancer, this treatment is done by placing radioactive “seeds” inside the prostate to directly treat the tumor site. Forms of brachytherapy are also used for some breast cancer patients using the Mammosite® technology and for a number of other cancer diagnoses. Some form of radiation therapy is used by about half of cancer patients, either with other treatments or alone.
Medical oncology uses medical interventions to treat the cancer through a systemic approach – meaning that medicine travels throughout the body, unlike radiation and surgery which are directed to a single site. The type of medicine is determined by the particular cancer diagnosis, but it often includes chemotherapy and/or hormone therapy. While some medications are taken at home, most chemotherapy treatments are given by an IV in the physician’s office.
Although chemotherapy drugs are selected for their action against a specific cancer, they can also interrupt normal cell growth and division, especially in fast growing cells, such as those in the hair and the digestive tract. This effect is why some patients lose their hair while taking chemotherapy, or might experience nausea or changes in taste.
Your physician will closely monitor your care during treatment, including any side effects. Often side effects can be managed or relieved by additional medication. If necessary, your doctor may change the type of chemotherapy you are receiving or adjust your medication. Over 50 percent of all people being treated for cancer receive chemotherapy, which can be given in various ways. Chemotherapy may be used alone, or provided before, after, and in some cases during, cancer surgery, or in combination with radiation therapy.