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The main treatments for cancer include radiation therapy, chemotherapy, and surgery.
World Cancer Day is observed on February 4th every year. This day aims to raise awareness about cancer. Cancer is a large group of diseases that can affect any organ or tissue in the body. This refers to the abnormal growth of cells that divide uncontrollably. The main treatments for cancer include radiation therapy, chemotherapy, surgery, hormone therapy, targeted therapy, and immunotherapy. Cancer treatment is increasingly moving toward multidisciplinary treatment.
Chemotherapy and radiation therapy represent two different types of cancer treatment. However, patients and the general public are often confused by these similar terms because they both have similar suffixes and are used in cancer management.
Chemotherapy: Systemic drug therapy
Chemotherapy involves giving drugs intravenously or orally. The goal is to circulate the drug throughout the body, thereby targeting cancer cells. This is also called systemic treatment because it can reach cancer cells both locally and at distant sites.
Radiation therapy: targeted therapy
Radiation therapy is a locally focused treatment. It works by damaging the DNA of cancer cells. Radiation therapy uses high-energy light or particles that are carefully directed at tumors or other areas at risk. This is a targeted, localized procedure that primarily targets the area of the body where the radiation is administered.
Depending on the location of the tumor, radiation therapy may be given alone, in combination with surgery or chemotherapy, or as palliative therapy in advanced cases. Almost 60% to 70% of all cancer cases require radiation therapy at some point during the entire treatment process.
Treatment period and technique
Chemotherapy is usually given in cycles (eg, repeated doses every two weeks would result in a two-week cycle). Certain regimens of chemotherapy can last for 2 to 6 cycles. A typical chemotherapy infusion cycle is a single drug or a combination of drugs.
In contrast, radiation therapy is usually given every day (excluding weekends). The typical schedule for radiation is 3 to 6 weeks. However, with SRS (stereotactic radiosurgery) and SBRT (stereotactic body radiotherapy), the entire treatment can be completed in 1 to 7 days. The latter technique can only be used in selected patient groups, including those with very early or localized disease.
Benefits and side effects
Both treatments have their own benefits and side effect profiles. Radiation therapy is often used to curatively treat localized cancers and can also be used to shrink tumors before surgery. It is also often used after surgery to treat invisible microscopic disease at or near the tumor bed. Side effects can cause skin irritation, fatigue, and changes in skin color. Notably, its effects (or side effects) are minimal beyond the area of administration. Furthermore, side effects vary depending on the treated area and the organs adjacent to that area. Modern radiation treatments are highly conformal (close to the target area) and use techniques such as CT scan-based image guidance immediately before delivery of the radiation beam.
Chemotherapy can be used to treat a variety of cancers. It is also commonly used to reduce the size of a tumor, making it operable or suitable for curative treatment. It is often combined with other treatments such as surgery or radiation therapy. However, depending on the intensity of the treatment and the type of medication, it may cause side effects such as hair loss, nausea, and fatigue to varying degrees.
Determining the optimal treatment strategy
The type of cancer, its stage, and the patient’s unique characteristics will determine whether radiation therapy, chemotherapy, surgery, or a combination of these is best for your situation. It is important to consult a qualified medical professional to determine the best course of treatment for each case. Most hospitals have tumor boards, and the sequence and pattern of treatment for specific disease sites and patients are jointly determined by the team.
Radiation therapy and chemotherapy are effective tools in cancer management. However, its administration and use is best under the guidance of a qualified oncology team. Remarkably, advances in technology have significantly reduced the side effects of both radiotherapy and chemotherapy, making cancer management more comfortable for physicians as well as patients.
(Dr. Anushel Munshi, Head of Radiation Oncology, Manipal Hospital, Dwarka)
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