Surgery
Photodynamic therapy
Treatment for Non-Small Cell Lung Cancer
Treatment for Small Cell Lung Cancer
| GENERAL INFORMATION ON CANCER |
Possible contributory factors to cancer
Question: Why do people have cancer? Is there a possibility that we are all prone to cancer now because of our changing environment? Does air pollution, water or the food we eat have any bearing on this disease?
Answer: Although statistics show that most cancer results from genetic events and everyone is born with a complement of genetic material making all of us at risk of developing cancer if one or more of the causative genetic abnormalities exist, there is a growing acknowledgement that perhaps the environment and our lifestyles are contributory factors as well.
We live in an age of fast foods, sedentary lifestyles and most of all, a polluted environment. Although little, if any, evidence of a direct cause and effect relationship exists, this claim usually comes from epidemiological studies of exposure and association with cancer in case control studies. However, we can be certain that cancer, or any disease for that matter, is most probable to an unhealthy body. For example, smoking is among the causes of lung cancer. Just think what a nicotine-filled air can do to your body. You can be a second-hand smoker or you can be a passive smoker. In any case, certain environmental agents may be related to cancer and it is best to avoid them.
Principles of cancer treatment
Question: What are the major considerations in treating cancer?
Answer: You and your doctor should determine the natural course and stage of the disease and the status of your health so you can also assess the best treatment modality or modalities. Know what your body can take.
Once the diagnosis is made, these are the questions to ask your doctor regarding treatment: 1) aggressiveness of the cancer; 2) predictability of its spread; 3) morbidity and mortality of the therapeutic procedure; and, 4) cure rate for the therapeutic procedure under consideration.
Lastly, pay close attention when your doctor discusses the options available and the complications of the different treatment modalities. Tell him or her your expectations to help you can make an informed decision.
Radiation therapy and chemotherapy for breast cancer
Question: What is the difference between a radiation therapy and chemotherapy? Of the two, which is the best treatment for breast cancer?
Answer: Radiation therapy is a cancer treatment that uses high-energy rays to kill cancer cells while chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Both are given depending on the type and stage of the cancer being treated.
There is really no way to say which is a better treatment because it will all depend on the kind of cancer a patient has and his or her response to these treatments. But let me give you an overview of how these treatments work.
There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, wires, or catheters that are placed directly into or near the cancer.
On the other hand, when chemotherapy is taken by mouth or injected into a vein or muscle, the medications enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, the medications mainly affect cancer cells in those areas (regional chemotherapy). When chemotherapy is applied on the skin or mucous membrane, the effect is mainly in this area (local topical chemotherapy).
Question: Of these two treatments, which is more costly?
Answer: Although expense may vary based on the type of and stage of cancer, and the type of drug regimen chosen, and considering patient shoulders all expense, one chemotherapy session more or less cost around low of Php 20, 000.00 while a radiotherapy costs about a minimum of PhP 2000-5000 per session (excluding medical and professional fees). Usually there are about six chemotherapy sessions and 30 radiotherapy sessions.
In these hard times, cost should indeed be considered but I do hope that on top of that, you will seek the best medical advice and treatment in battling this disease. There are ways to seek for financial assistance. Government hospitals usually provide free physician services and subsidize machine costs particularly for service indigent patients. There are some Senators who have allotted part of their Priority Development Allocation Fund (PDAF) to cancer patients needing help. The Philippine Charity Sweepstakes also helps patients in need. There are also numerous humanitarian organizations peopled by volunteer doctors and non-doctors helping cancer victims like the Kythe Foundation, Inc. The latter is based at the East Avenue Medical Center and is principally run by volunteers from the Ateneo School system. This organization mainly helps children with cancer. I am not aware of the exact protocol but I hope you will explore financial assistance programs to help you.
Monoclonal antibody for HER2-positive tumors
Question: What is HER2?
Answer: It stands for Human Epidermal growth factor Receptor-2 or also known as neu (rat gene) and c-erbB-2. HER2-positive tumours are associated with poor prognosis and shortened disease-free/overall survival of cancer patients. It is observed in 20 to 30% of invasive breast cancers. It is linked to aggressive disease and poor clinical outcome independent of treatment because HER2 receptor overexpression or gene amplification plays a pivotal role in subsequent aggressive tumour behaviour.
Question: Is this exclusive to breast cancer?
Answer: No. Studies show that HER2 is also linked to as much as 60% of ductal carcinomas in situ (DCIS) and a number of other human tumours, e.g. bladder, colorectal, gastric and non-small cell lung cancer.
Question: What is the best treatment for breast cancer?
Answer: Although previously the survival rate is very low with these kinds of aggressive tumours, it was found out that HER2 receptor provides an extracellular target for novel and specific anticancer treatment. Fortunately, recent clinical trials discover its strong predictive value. Clinicians are now aware that HER2 is sensitive to anthracycline-based and taxane-based regimens, and is associated with resistance to hormonal therapy among other things.
Early testing is therefore crucial to stop these aggressive tumours from spreading. Once tested and approved for treatment, there are specific anticancer treatment known as monoclonal antibody that uniquely targets the HER2 receptor to provide effective treatment for women with HER2-positive breast cancer. Used first line, monoclonal antibody such as Trastuzumab induces durable responses and significantly increases patient survival in combination with chemotherapy. As monotherapy it has demonstrated efficacy as both first line and subsequent treatment. This monoclonal antibody is available in the Philippines and is distributed by leading pharmacies.
General questions on prostate cancer
Question: Will removal of my testicles assure me that I will not have prostate cancer anymore?
Answer: No. Although after orchiectomy or treatment with an LH-RH agonist, the body no longer gets testosterone from the testicles, the adrenal glands still produce small amounts of male hormones. Sometimes, the man also receives an anti-androgen, which blocks the effect of male hormones made by the adrenal glands. This combination of treatments is known as total androgen blockade. Studies have not shown whether total androgen blockade is more effective than orchiectomy or an LH-RH agonist alone.
Prostate cancer that has spread to other parts of the body usually can be controlled with hormonal therapy for a period of time, often several years. Eventually, however, most prostate cancers are able to grow with very little or no male hormones. When this happens, hormonal therapy is no longer effective, and the doctor may suggest other forms of treatment that are under study.
Question: One of my colleagues at work has prostate cancer but his doctor did not advise him to undergo surgery or ay kind of radiation therapy and told him to wait until his condition is well established. Do you think he should get a second opinion?
Answer: If it will make him feel better, by all means, he should get a second and even a third opinion. In fact, we doctors advice our patients to do this. But I think I understand what his doctor wants to do. In medical parlance, this is what we call “watchful waiting”.
Men, after their doctors discuss with them the risks and benefits, sometimes choose watchful waiting when the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits.
Men who choose watchful waiting are offered treatment when symptoms occur or get worse. Watchful waiting may be advised for older men or for men who have prostate cancer and other serious medical problems. Also, watchful waiting may be suggested for some men who have prostate cancer that is found at an early stage and appears to be growing slowly.
Question: I recently found out I have prostate cancer. What are the treatments available?
Answer: Treatment for prostate cancer may involve surgery, radiation therapy, hormonal therapy, or watchful waiting. A man may have a combination of treatments. If the doctor recommends watchful waiting, your health will be monitored closely and treatment will be given only if symptoms occur or worsen.
At any stage of disease, a man with prostate cancer may have treatment to control pain and other symptoms, to relieve the side effects of therapy, and to ease emotional and practical problems. This kind of treatment is called supportive care, symptom management, or palliative care.
General questions on Hodgkin’s Lymphoma
Question: Who are at high risk of Hodgkin’s Lymphoma?
Answer: Although there is still no conclusive profile of those at high risk, studies of cancer population seemed were able to established some common risk factors. Hodgkin's disease occurs most often in people between 15 and 34 and in people over the age of 55. It is more common in men than in women.
Question: Is this contagious? Or hereditary?
Answer: Hodgkin's disease is not caused by an injury, and it is not contagious. Genetics may come into play and may be one of the factors for this disease. Recent studies show that brothers and sisters of those with Hodgkin's disease have a higher-than-average chance of developing this disease.
Hair loss and other side effects
Question: I will undergo my first chemotherapy soon. Is there any way for me not to lose hair while undergoing treatment?
Answer: Chemotherapy is the use of drugs to kill cancer cells and usually consists of a combination of several drugs. It may be given alone or followed by radiation therapy. Unfortunately, one of the side effects is very visible--hair loss. Why does it cause hair loss? Because your system gets an extra dose of cancer-killing drugs that dry up your hair follicles causing your hair to fall.
But keep in mind that of all cancer therapies, this is actually the one that does not disrupt your life so much. Usually, a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). At the most. depending on which drugs are given and the patient's general health, you only need to stay at the hospital for a short time. Since it is also given in cycles, you can actually work your activities around your schedule to optimize your time. There is a treatment period followed by a recovery period, then another treatment period, and so on. With all these, hair loss seems like a small price to pay if it means beating the disease.
In today’s fashionable world, you can really be creative and find ways to “adjust” to a temporary hair loss. Wear a bandana or a cap and most of all, wear a positive attitude. It will also help a great deal if you open up to your family and friends. Let them help you get thru this time in your life.
Question: What are the side effects of chemotherapy? Why do people feel nauseous after chemotherapy?
Answer: Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Just like in taking a strong dose of certain medications, our body’s way of adjusting is to abruptly respond to their effects and this explains the nausea being felt by a patient.
Question: How exactly is chemotherapy administered and how does this work??
Answer: The way the chemotherapy is given depends on the type and stage of the cancer being treated. When chemotherapy is taken by mouth or injected into a vein or muscle, the medications enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, the medications mainly affect cancer cells in those areas (regional chemotherapy).
Radiation therapy and chemotherapy for breast cancer
Question: What is the difference between a radiation therapy and chemotherapy? Of the two, which is the best treatment for breast cancer?
Answer: Radiation therapy is a cancer treatment that uses high-energy rays to kill cancer cells while chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Both are given depending on the type and stage of the cancer being treated.
There is really no way to say which is a better treatment because it will all depend on the kind of cancer a patient has and his or her response to these treatments. But let me give you an overview of how these treatments work.
There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, wires, or catheters that are placed directly into or near the cancer.
On the other hand, when chemotherapy is taken by mouth or injected into a vein or muscle, the medications enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, the medications mainly affect cancer cells in those areas (regional chemotherapy). When chemotherapy is applied on the skin or mucous membrane, the effect is mainly in this area (local topical chemotherapy).
Question: Of these two treatments, which is more costly?
Answer: Although expense may vary based on the type of and stage of cancer, and the type of drug regimen chosen, and considering patient shoulders all expense, one chemotherapy session more or less cost around low of Php 20,000.00 while a radiotherapy costs about low of PhP 2000-5000 per session (excludes medical and professional fees). Usually there are about six chemotherapy sessions and 30 radiotherapy sessions.
In these hard times, cost should indeed be considered but we do hope that on top of that, you will seek the best medical advice and treatment in battling this disease. There are ways to seek for financial assistance. Government hospitals usually provide free physician services and subsidized machine costs particularly for service indigent patients. There are some senators who have allotted part of their Priority Development Allocation Fund (PDAF) to cancer patients needing help. The Philippine Charity Sweepstakes also helps patients in need. There are also numerous humanitarian organizations peopled by volunteer doctors and non-doctors helping cancer victims like the Kythe Foundation, Inc. The latter is based at the East Avenue Medical Center and is principally run by volunteers from the Ateneo School system. This organization mainly helps children with cancer. We are not aware of the exact protocol but we hope you will explore financial assistance programs to help you.
Work and radiation therapy
Question: Can I still work while undergoing radiation therapy?
Answer: You have to take a leave from your work temporarily for this treatment. A woman receiving external radiation therapy goes to the hospital or clinic each day for treatment. Usually treatments are given 5 days a week for 5 to 6 weeks. At the end of that time, the tumor site very often gets an extra "boost" of radiation.
And then there is the internal or implant radiation. For this treatment, a capsule containing radioactive material is placed directly in the cervix. The implant puts cancer-killing rays close to the tumor while sparing most of the healthy tissue around it. It is usually left in place for 1 to 3 days, and the treatment may be repeated several times over the course of 1 to 2 weeks. The patient stays in the hospital while the implants are in place. Give or take, it is best if you give yourself a week or two to fully recover.
Radiation therapy for prostate cancer
Question: Can prostate cancer be treated with radiation therapy?
Answer: Yes, but it will depend on the severity of the cancer. In early stage prostate cancer, radiation therapy may be the primary treatment (instead of surgery). It also may be used after surgery to destroy any cancer cells that may remain in the area. In advanced stages, radiation therapy may help relieve pain.
Doctors use two types of radiation therapy to treat prostate cancer; others having the possibility of undergoing both: external and internal. Some men with prostate cancer receive 3-dimensional conformal radiation therapy. This type of radiation therapy more closely targets the cancer and spares normal tissue.
In internal radiation (implant radiation or brachytherapy), radioactive material placed in seeds, needles, or thin plastic tubes are inserted directly in the tissue. The patient stays in the hospital and the implants generally remain in place for several days. Usually they are removed before the patient goes home.
Radiation therapy and chemotherapy for breast cancer
Question: What is the difference between a radiation therapy and chemotherapy? Of the two, which is the best treatment for breast cancer?
Answer: Radiation therapy is a cancer treatment that uses high-energy rays to kill cancer cells while chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Both are given depending on the type and stage of the cancer being treated.
There is really no way to say which is a better treatment because it will all depend on the kind of cancer a patient has and his or her response to these treatments. But let me give you an overview of how these treatments work.
There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, wires, or catheters that are placed directly into or near the cancer.
On the other hand, when chemotherapy is taken by mouth or injected into a vein or muscle, the medications enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, the medications mainly affect cancer cells in those areas (regional chemotherapy). When chemotherapy is applied on the skin or mucous membrane, the effect is mainly in this area (local topical chemotherapy).
Question: Of these two treatments, which is more costly?
Answer: Although expense may vary based on the hospital you are staying and the professional fee of your doctor, one chemotherapy session more or less cost around PhP 40,000.00 while a radiotherapy session costs between PhP 30,000.00 to PhP 45,000.00.
In these hard times, cost should indeed be considered but I do hope that on top of that, you will seek the best medical advice and treatment in battling this disease. There are ways to seek for financial assistance. There are some Senators who have allotted part of their Priority Development Allocation Fund (PDAF) to cancer patients needing help. There are also numerous humanitarian organizations peopled by volunteer doctors and non-doctors helping cancer victims like the Kythe Foundation, Inc. The latter is based at the East Avenue Medical Center and is principally run by volunteers from the Ateneo School system. I am not aware of the exact protocol but you have to explore financial assistance programs to help you.
Question: My mother had her mastectomy and now the doctor says that aside from this surgery, she has to undergo radiation therapy. I’ve seen how pained she was with her first treatment and as much as possible, don’t want her to go thru something like that again. Can a cancer patient have a combination of treatments? Is this really necessary?
Answer: Yes, this is a way of making sure that as much as possible cancer will not recur again. I’m sorry that your mother has to go through these painful treatments but this is the only way to make sure that she will not suffer more at a later time if cancer is left to advance to an incurable stage.
Even if the doctor removes all of the cancer that can be seen at the time of surgery, the patient may be given radiation therapy, chemotherapy, or hormone therapy after surgery to try to kill any cancer cells that may be left. We call adjuvant therapy or the treatment given after surgery to increase the chances of a cure.
Radiation therapy for cervical cancer
Question: Aside from the removal of ovaries, are there other treatment options for cervical cancer?
Answer: Yes, radiation therapy (also called radiotherapy) is another cure for this particular cancer. This procedure uses high-energy rays to damage cancer cells and stop them from growing. Like surgery, radiation therapy is local therapy; the radiation can affect cancer cells only in the treated area. The radiation may come from a large machine (external radiation) or from radioactive materials placed directly into the cervix (implant radiation). Some patients receive both types of radiation therapy dependent on the stage and extent of the disease.
Hormone therapy
Question: My wife has recently been diagnosed with breast cancer. Since hers is at the early stages of cancer, the doctor recommended hormone therapy. Do you think this is the best treatment option?
Answer: Different patients respond differently to treatment so it is hard to say which the best treatment is. Your doctors will be able to establish this from your wife’s medical history and from her diagnostic tests. Hormones are substances produced by glands in the body and circulated in the bloodstream. Hormone therapy with the drug trastuzumab or capecitabine is often given to patients with early stages of breast cancer and those with metastatic breast cancer (cancer that has spread to other parts of the body). This is a treatment that removes hormones or blocks their action and stops cancer cells from growing.
Question: We are a young couple and we both fervently wish to have kids. Will hormone therapy in any way affect our chances? I’ve read somewhere that it has some side effects.
Answer: In some cases, recent studies show that in treating breast cancer, one of the side effects of hormone therapy is the presence of some hormones which can cause certain cancers to grow. Hormone therapy with trastuzumab or estrogens can act on cells all over the body and may increase the chance of developing cancer of the uterus.
Especially for a young couple like you wishing to have kids, should you opt for hormone therapy with trastuzumab, I suggest you let your wife have a pelvic examination every year to look for any signs of cancer. Any vaginal bleeding, other than menstrual bleeding, should be reported to a doctor as soon as possible.
Reconstructive surgery after breast removal
Question: My 23-year old sister has had her right breast removed due to breast cancer. This has severely affected her self-esteem. Can she have a reconstructive surgery to replace her damaged breast? Will it interfere with her treatment? If not, how soon can she have it?
Answer: I am assuming that your sister underwent a total mastectomy, a surgical procedure to remove the whole breast that contains cancer. Lymph node dissection may be an option at the same time of this type of surgery. In some cases, modified radical mastectomy or the removal of the whole breast that contains cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles is also done.
This takes a lot of psychological adjustment especially as this causes a disfigurement to what society considers among the main symbols of a woman’s femininity. Thanks to science and the advancement of technology, breast reconstruction (surgery to rebuild a breast’s shape after a mastectomy) may be considered. Breast reconstruction may be done at the time of the mastectomy or at a future time depending on the patient’s age and recovery. Often the reconstructed breast may be made with the patient’s own (non-breast) tissue or by using implants filled with saline or silicone gel.
Self-breast exam
Question: I am a teacher at an exclusive girl’s college and I want to do my part in the in spreading cancer awareness. Is self-breast exam really effective? Can you please tell me how to do it so I can teach my students?
Answer: Awareness is the first step to beating cancer or any disease for that matter. So congratulations for being so vigilant! More than anyone else, we should all listen to our bodies and be very familiar with the changes that it undergoes. And yes, prevention through self-breast exam is among our ammunitions against cancer. There is a step-by-step guide at the Resources section of this website. Let this help you.
Radiation therapy and chemotherapy for breast cancer
Question: What is the difference between a radiation therapy and chemotherapy? Of the two, which is the best treatment for breast cancer?
Answer: Radiation therapy is a cancer treatment that uses high-energy rays to kill cancer cells while chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Both are given depending on the type and stage of the cancer being treated.
There is really no way to say which is a better treatment because it will all depend on the kind of cancer a patient has and his or her response to these treatments. But let me give you an overview of how these treatments work.
There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, wires, or catheters that are placed directly into or near the cancer.
On the other hand, when chemotherapy is taken by mouth or injected into a vein or muscle, the medications enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, the medications mainly affect cancer cells in those areas (regional chemotherapy).
Question: Of these two treatments, which is more costly?
Answer: Although expense may vary based on the type of and stage of cancer, and the type of drug regimen chosen, and considering patient shoulders all expense, one chemotherapy session more or less cost around low of Php 20,000.00 while a radiotherapy costs about low of PhP 2000-5000 per session (excludes medical and professional fees). Usually there are about six chemotherapy sessions and 30 radiotherapy sessions.
In these hard times, cost should indeed be considered but I do hope that on top of that, you will seek the best medical advice and treatment in battling this disease. There are ways to seek for financial assistance. Government hospitals usually provide free physician services and subsidized machine costs particularly for service indigent patients. There are some senators who have allotted part of their Priority Development Allocation Fund (PDAF) to cancer patients needing help. The Philippine Charity Sweepstakes also helps patients in need. There are also numerous humanitarian organizations peopled by volunteer doctors and non-doctors helping cancer victims like the Kythe Foundation, Inc. The latter is based at the East Avenue Medical Center and is principally run by volunteers from the Ateneo School system. This organization mainly helps children with cancer. We are not aware of the exact protocol but we hope you will explore financial assistance programs to help you.
Question: My mother had her mastectomy and now the doctor says that aside from this surgery, she has to undergo radiation therapy. I’ve seen how pained she was with her first treatment and as much as possible, don’t want her to go thru something like that again. Can a cancer patient have a combination of treatments? Is this really necessary?
Answer: Yes, this is a way of making sure that as much as possible cancer will not recur again. I’m sorry that your mother has to go through these painful treatments but this is the only way to make sure that she will not suffer more at a later time if cancer is left to advance to an incurable stage.
Even if the doctor removes all of the cancer that can be seen at the time of surgery, the patient may be given radiation therapy, chemotherapy, or hormone therapy after surgery to try to kill any cancer cells that may be left. We call adjuvant therapy or the treatment given after surgery to increase the chances of a cure.
General questions on prostate cancer
Question: Will removal of my testicles assure me that I will not have prostate cancer anymore?
Answer: No. Although after orchiectomy or treatment with an LH-RH agonist, the body no longer gets testosterone from the testicles, the adrenal glands still produce small amounts of male hormones. Sometimes, the man also receives an anti-androgen, which blocks the effect of male hormones made by the adrenal glands. This combination of treatments is known as total androgen blockade. Studies have not shown whether total androgen blockade is more effective than orchiectomy or an LH-RH agonist alone.
Prostate cancer that has spread to other parts of the body usually can be controlled with hormonal therapy for a period of time, often several years. Eventually, however, most prostate cancers are able to grow with very little or no male hormones. When this happens, hormonal therapy is no longer effective, and the doctor may suggest other forms of treatment that are under study.
Question: One of my colleagues at work has prostate cancer but his doctor did not advise him to undergo surgery or ay kind of radiation therapy and told him to wait until his condition is well established. Do you think he should get a second opinion?
Answer: If it will make him feel better, by all means, he should get a second and even a third opinion. In fact, we doctors advice our patients to do this. But I think I understand what his doctor wants to do. In medical parlance, this is what we call “watchful waiting”.
Men, after their doctors discuss with them the risks and benefits, sometimes choose watchful waiting when the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits.
Men who choose watchful waiting are offered treatment when symptoms occur or get worse. Watchful waiting may be advised for older men or for men who have prostate cancer and other serious medical problems. Also, watchful waiting may be suggested for some men who have prostate cancer that is found at an early stage and appears to be growing slowly.
Question: I recently found out I have prostate cancer. What are the treatments available?
Answer: Treatment for prostate cancer may involve surgery, radiation therapy, hormonal therapy, or watchful waiting. A man may have a combination of treatments. If the doctor recommends watchful waiting, your health will be monitored closely and treatment will be given only if symptoms occur or worsen.
At any stage of disease, a man with prostate cancer may have treatment to control pain and other symptoms, to relieve the side effects of therapy, and to ease emotional and practical problems. This kind of treatment is called supportive care, symptom management, or palliative care.
Surgery for prostate cancer
Question: My doctor said I have to undergo surgery for my prostate cancer. Please discuss the risks involve in surgery. Will this affect my ability to have sex?
Answer: Surgery is a common treatment for early stage prostate cancer. It is a type of local therapy and only affects cells in the area concerned.
The doctor may remove the whole prostate or only part of it. In some cases, the doctor can use a technique known as nerve-sparing surgery. This type of surgery may save the nerves that control erection and will only temporarily interfere with your sex life. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery.
Question: What are the types of surgery for prostate cancer?
Answer: There are basically 4 types of surgery for this cancer. Your doctor can discuss and compare their benefits and risks. Offhand, radical retropubic prostatectomy is a kind of surgery where the doctor removes the entire prostate and nearby lymph nodes through an incision in the abdomen, also called lymph dissection.
In radical perineal prostatectomy, the doctor removes the entire prostate through an incision between the scrotum and the anus. Nearby lymph nodes are sometimes removed through a separate incision in the abdomen.
The third kind is transurethral resection of the prostate (TURP). Here, the doctor removes part of the prostate with an instrument that is inserted through the urethra. The cancer is cut from the prostate by electricity passing through a small wire loop. TURP does not remove the whole prostate and may not remove all of the cancer, but it does remove tissue that blocks urine flow.
Lastly, the doctor removes lymph nodes in the pelvis to see if cancer has spread to them. Sometimes, the doctor removes the lymph nodes before doing a prostatectomy. This surgery is called pelvic lymphadenectomy. If the prostate cancer has not spread to the lymph nodes, the doctor then removes the prostate. If the pathologist finds cancer cells in the lymph nodes, it is likely that the disease has spread to other parts of the body. In this case, the doctor usually does not remove the prostate, but may suggest other treatment.
Radiation therapy for prostate cancer
Question: Can prostate cancer be treated with radiation therapy?
Answer: Yes, but it will depend on the severity of the cancer. In early stage prostate cancer, radiation therapy may be the primary treatment (instead of surgery). It also may be used after surgery to destroy any cancer cells that may remain in the area. In advanced stages, radiation therapy may help relieve pain.
Doctors use two types of radiation therapy to treat prostate cancer; others having the possibility of undergoing both: external and internal. Some men with prostate cancer receive 3-dimensional conformal radiation therapy. This type of radiation therapy more closely targets the cancer and spares normal tissue.
In internal radiation (implant radiation or brachytherapy), radioactive material placed in seeds, needles, or thin plastic tubes are inserted directly in the tissue. The patient stays in the hospital and the implants generally remain in place for several days. Usually they are removed before the patient goes home.
Hormone therapy for prostate cancer
Question: Can a man undergo hormone therapy or is this treatment exclusive to women?
Answer: Certainly, men with prostate cancer may undergo hormone therapy. This treatment keeps cancer cells from getting the male hormones they need to grow. It is called systemic therapy because it enters the bloodstream and can affect cancer cells throughout the body. Systemic therapy is used mainly to treat cancer that has spread. Sometimes this type of therapy is used to try to prevent cancer from coming back after surgery or radiation treatment.
Question: What exactly happens when a man undergoes hormone therapy? Is this a painful process?
Answer: There are several forms of hormonal therapy. Except for orchiectomy which is an operation to remove the testicles, which are the main source of the male hormone testosterone, the rest are without any surgical operation.
There will be changes in the man’s body undergoing hormone therapy. Some may be obvious and some are not. Doctors can prescribe luteinizing hormone-releasing hormone (LH-RH) agonists. These drugs can prevent the testicles from producing testosterone. Examples are leuprolide and goserelin.
Anti-androgens may also be given. These drugs can block the action of androgens. Drugs that can prevent the adrenal glands from making testosterone include ketoconazole and aminoglutethimide.
Effects on childbearing
Question: I have recently been diagnosed with cervical cancer. I don’t know how to tell my husband who is an overseas worker. We’ve been married for five years and have yet to be blessed with a child of our own. Does this mean I can’t have children anymore?
Answer: The first thing that you have to do is thoroughly discuss with your doctor the stage of your cancer and the best treatment options available to you. If the disease has invaded deeper layers of the cervix but has not spread beyond the cervix (metastasized,) your doctor will usually perform an operation to remove the tumor but leave the uterus and the ovaries. This means you can still have children. You will simply have to undergo a local therapy to remove abnormal tissue in or near the cervix. If the cancer is only on the surface of the cervix, the doctor may destroy the cancerous cells in ways similar to the methods used to treat pre-cancerous abrasions.
In other cases, however, a woman may need to have a hysterectomy. In this procedure, the doctor removes the entire uterus, including the cervix; sometimes the ovaries and fallopian tubes also are removed. In addition, the doctor may remove lymph nodes near the uterus to learn whether the cancer has spread to these organs. In this case, a woman will not be able to get pregnant anymore.
I hope yours is at the early stages. Do not stall. Undergo a treatment as soon as the doctor advises it. Of course you must tell your husband. Now more than ever, you need each other’s support to get though this difficult time in your lives. Have faith and be strong.
Radiation therapy for cervical cancer
Question: Aside from the removal of ovaries, are there other treatment options for cervical cancer?
Answer: Yes, radiation therapy (also called radiotherapy) is another cure for this particular cancer. This procedure uses high-energy rays to damage cancer cells and stop them from growing. Like surgery, radiation therapy is local therapy; the radiation can affect cancer cells only in the treated area. The radiation may come from a large machine (external radiation) or from radioactive materials placed directly into the cervix (implant radiation). Some patients receive both types of radiation therapy dependent on the stage and extent of the disease.
Biological therapy
Question: What is biological therapy and to what kind of cancer it is administered?
Answer: Biological therapy is treatment using substances to improve the way the body's immune system fights disease. It may be used to treat cancer that has spread from the cervix to other parts of the body.
Interferon is the most common form of biological therapy for cervical cancer and it may be used in combination with chemotherapy. Most patients who receive interferon are treated as outpatients. This therapy interferes with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and -gamma. The body normally produces these substances. But in cases where there is a need to produce more than what our body can produce to fight off cancer cells, they are also made in the laboratory to treat cancer and other diseases.
General questions on Hodgkin’s Lymphoma
Question: Who are at high risk of this disease?
Answer: Although there is still no conclusive profile of those at high risk, studies of cancer population seemed were able to established some common risk factors. Hodgkin's disease occurs most often in people between 15 and 34 and in people over the age of 55. It is more common in men than in women.
Question: Is this contagious? Or hereditary?
Answer: Hodgkin's disease is not caused by an injury, and it is not contagious. Genetics may come into play and may be one of the factors for this disease. Recent studies show that brothers and sisters of those with Hodgkin's disease have a higher-than-average chance of developing this disease.
Symptoms before treatment
Question: What is Hodgkin’s Lymphoma and what are the symptoms of this disease?
Answer: Symptoms may include a painless swelling in the lymph nodes in the neck, underarm, or groin, unexplained recurrent fevers, night sweats, unexplained weight loss, and itchy skin. By themselves, these symptoms may occur as symptoms of other less serious conditions such as flu. However, if these symptoms persist, you should consult a doctor so you can have an informed diagnosis. Especially if there is a swelling of the lymph nodes, do not wait to feel any pain, as there is usually no pain at the early stages of Hodkin’s lymphoma.
Treatment options
Question: What are the methods of treatment for Hodgkin’s Lymphoma?
Answer: Radiation therapy and chemotherapy are the most common treatments for Hodgkin's disease, although bone marrow transplantation, peripheral stem cell transplantation, and biological therapies are being studied as possible means of treating the illness.
Common methods of treatment
Question: What are the most common methods of treatment for Non-Hodgkin’s Lymphoma?
Answer: Like most cancer, chemotherapy and radiation therapy are the most common treatments for non-Hodgkin's lymphoma. However, bone marrow transplantation, biological therapies, or surgery are also sometimes used.
Question: How is radiation therapy administered for Non-Hodgkin's lymphoma? Can this be done in combination with chemotherapy?
Answer: It comes from a machine that aims the high-energy rays at a specific area of the body. There is no radioactivity in the body when the treatment is over.
Sometimes patients are given chemotherapy and/or radiation therapy to kill undetected cancer cells that may be present in the central nervous system (CNS). In this treatment, called central nervous system prophylaxis, the doctor injects anticancer medications directly into the cerebrospinal fluid.
Combination therapy
Question: Can a combination of radiotherapy and chemotherapy also be possible treatment for this cancer?
Answer: Yes, sometimes patients are given chemotherapy and/or radiation therapy to kill undetected cancer cells that may be present in the central nervous system (CNS). In this treatment, called central nervous system prophylaxis, the doctor injects anticancer medications directly into the cerebrospinal fluid.
Immunotherapy for Non-Hodgkin’s Lymphoma (NHL)
Question: Is immunotheraphy a possible treatment for NHL?
The current trio of standard anticancer modalities—chemotherapy, radiation therapy, and surgery—is the foundation of modern cancer treatment. However, despite intensive research dedicated to maximizing the value of these therapies, most advanced (or metastatic) malignancies are presently incurable.
In their quest for new treatment modalities, doctors are starting to see immunotherapy as a promising alternative to chemotherapy for many types of cancer, including Non-Hodkin’s Lymphoma. These therapies have included monoclonal antibodies (MoAbs), radioimmunoconjugates, cytokines, and interferons. Further, many studies have demonstrated that the combination of immunotherapy with conventional chemotherapy results in better clinical responses than those seen with chemotherapy regimens alone.
A recent clinical trial using the first engineered MoAb proved effective and safe in patients with relapsed or chemoresistant indolent or follicular NHL. Efficacy was proven in a trial of heavily pretreated patients achieving a 50% response rate in the evaluable population.
With this therapy, patients may experience generally mild-to-moderate, reversible, infusion-related symptoms, occurring predominantly during the first infusion. Other than these mild side effects, because of its unique mechanisms of action, this engineered MoAb can be combined with chemotherapy and other modalities. The entire course of therapy is readily administered on an outpatient basis and is completed in 22 days.
Bone marrow transplantation (BMT)
Question: How about bone marrow transplantation (BMT)? Is this treatment also possible for Non-Hodkin’s Lymphoma?
Answer: This may also be a treatment option, especially for patients whose non-Hodgkin's lymphoma has recurred (come back). BMT provides the patient with healthy stem cells (immature cells that produce blood cells) to replace cells damaged or destroyed by treatment with very high doses of chemotherapy and/or radiation therapy. The healthy bone marrow may come from a donor, or it may be marrow that was removed from the patient, treated to destroy cancer cells, stored, and then given back to the person following the high-dose treatment. Until the transplanted bone marrow begins to produce enough white blood cells, patients must carefully protected from infection. They usually stay in the hospital for several weeks.
Surgery
Question: I have a tissue around the tumor and nearby lymph nodes from this disease. Is it safe to remove the tumor through surgery?
Answer: Your doctors alone could best establish that. But lymph nodes may also be removed during surgery just like in other cancer tumors. My advice is you talk this thoroughly with your doctor.
SurgeryQuestion: After a trip to his doctor last week, my father found out that his lung cancer is already in its advanced stage and he has to undergo surgery to remove the cancer from his lungs. What is the success rate of such an operation?
Answer: Just as treatment depends on a number of factors, including the type of lung cancer (non-small or small cell lung cancer), the size, location, and extent of the tumor, and the general health of the patient, so is the success rate of any surgical operation.
The type of surgery a doctor performs depends on the location of the tumor in the lung. An operation to remove only a small part of the lung is called a segmental or wedge resection. When the surgeon removes an entire lobe of the lung, the procedure is called a lobectomy. In more severe cases, pneumonectom which is surgical operation to remove of an entire lung is performed.
However, some tumors cannot be removed by surgery because of the size or location, and some patients cannot have surgery for other medical reasons.
Question: Aside from surgery, what other methods of treatment are available for lung cancer?
Answer: Many different treatments and combinations of treatments may be used to control lung cancer, and/or to improve quality of life by reducing symptoms.
Chemotherapy may be used to control cancer growth or to relieve symptoms. Radiation therapy may be used before surgery to shrink a tumor, or after surgery to destroy any cancer cells that remain in the treated area. Doctors also use radiation therapy, often combined with chemotherapy, as primary treatment instead of surgery.
Photodynamic therapy
Question: What is photodynamic therapy and how is this used to treat lung cancer?
Answer: Another treatment particular to lung cancer is photodynamic therapy (PDT). This is a type of laser therapy that involves the use of a special chemical that is injected into the bloodstream and absorbed by cells all over the body. The chemical rapidly leaves normal cells but remains in cancer cells for a longer time. A laser light aimed at the cancer activates the chemical, which then kills the cancer cells that have absorbed it.
Photodynamic therapy may be used to reduce symptoms of lung cancer. For example, to control bleeding or to relieve breathing problems due to blocked airways when the cancer cannot be removed through surgery. Photodynamic therapy may also be used to treat very small tumors in patients for whom the usual treatments for lung cancer are not appropriate.
Treatment for Non-small Cell Lung Cancer
Question: What is the treatment for Non-small Cell Lung Cancer?
Answer: Patients with non-small cell lung cancer may be treated in several ways. The choice of treatment depends mainly on the size, location, and extent of the tumor. Surgery is the most common way to treat this type of lung cancer. Cryosurgery, a treatment that freezes and destroys cancer tissue, may be used to control symptoms in the later stages of non-small cell lung cancer. Radiation therapy and chemotherapy may also be used to slow the progress of the disease and to manage symptoms. One of the more prescribed medications for non-small cell lung cancer is erlotinib.
Treatment for Small Cell Lung Cancer
Question: What are the treatment options for Small Cell Lung Cancer?
Answer: Small cell lung cancer spreads quickly. In many cases, cancer cells have already spread to other parts of the body when the disease is diagnosed. In order to reach cancer cells throughout the body, doctors almost always use chemotherapy. Treatment may also include radiation therapy aimed at the tumor in the lung or tumors in other parts of the body. Some patients have radiation therapy to the brain even though no cancer is found there. This treatment, called prophylactic cranial irradiation (PCI), is given to prevent tumors from forming in the brain. Surgery is part of the treatment plan for a small number of patients with small cell lung cancer.
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