Cancer
Methods of Cancer Treatment Although efforts to cure cancer are still ongoing, thanks to early diagnosis and advancements in treatment, cancer is now among the diseases that can be treated. In cases where treatment is not possible or in advanced-stage cancer, long-term management of the disease can be provided. In recent years, targeted molecules and immunotherapy have also been used in cancer treatment. A treatment plan is created based on the type of cancer, its stage, and the genetic characteristics of cancer cells. The main methods used in cancer treatment are Surgical Oncology, Medical Oncology, and Radiation Oncology.
What Is Medical Oncology? Medical oncology is not just a treatment for cancer patients, but also an area that encompasses cancer prevention, screening, early diagnosis, and more. In other words, every stage of cancer is related to medical oncology. Additionally, collaboration occurs with various fields such as surgery or radiology in the diagnosis and treatment of cancer, and patient care is planned multidisciplinarily based on scientific information.
How Is Treatment Administered? Treatment is administered in the form of drug applications through injection or oral intake. However, this treatment regimen varies depending on the type of cancer. Treatment planning depends on factors such as the type of cancer, cell type, the organ of origin, and the extent of its spread. Treatment can be used alone or in combination for adjuvant therapy to reduce the risk of recurrence, for palliative therapy to alleviate symptoms and extend the life of patients in the terminal stage, and for palliative therapy to improve the quality of life in advanced disease. Treatment can be administered locally or systemically.
Which Methods Does Medical Oncology Apply? Chemotherapy (Drug Therapy) The goal of chemotherapy is to eliminate uncontrollably growing cancer cells due to certain changes in their structures. Often, multiple drugs with different mechanisms of action are combined to plan the killing of cancer cells.
Hormone Therapy in Oncology Hormonal drugs are used in the treatment of hormone-sensitive tumors such as prostate and breast cancer. The application is generally done orally or through injections.
Immunotherapy (Immunity Treatment) Natural substances produced by the body's defense system are used to recognize and kill cancer cells by alerting the immune system to cancer cells.
Targeted Biological Treatment Biological treatments that target specific but non-existent targets in normal cells carried by cancer cells are considered the most significant developments in cancer treatment in the last 10 years. Targeted treatments are applied in many cancer types, primarily in colon, lung, and kidney cancers.
Which Cancer Types Are Treated with Medical Oncology? Medical oncology can be used to treat many cancer types, including gastric cancer, lung cancer, gastric-intestinal cancers, pancreatic cancer, liver cancers, bile duct and pathway cancers, head and neck tumors, osteosarcoma and soft tissue sarcomas, brain tumors, kidney-bladder cancers, prostate cancer, malignant melanoma, thyroid cancer, ovarian cancer, cervical cancer, endometrial cancer, testicular cancer, lymphomas, and multiple myeloma.
Surgical Oncology Surgery is one of the most important treatment methods in cancer treatment. Surgical oncology, which plays a role in the surgical treatment of the cancer region, also has a significant share in the diagnosis and treatment of other areas. Oncology surgical practices are performed by general surgeons trained in this field.
Application Areas of Surgical Treatment Therapeutic (curative) surgery is also applied within oncology surgery. However, a prerequisite for the application of therapeutic surgery is that the disease is confined to the organ or lymph nodes from which it originates. These patients should not have distant metastasis, and there should be no pathological enlargement at the border obtained by surgical resection. After the borders of the patients are well delineated, the mass can be completely removed. However, there are cases where the mass is not completely removed. In such cases, debulking surgery can be performed to reduce the mass. In addition, the removal of a small number of metastases can improve the chances of recovery. Surgical procedures are also used in other areas of diagnosis and treatment. These areas are summarized in four topics:
Prophylactic Surgery Prophylactic surgery aims to eliminate the risk of surgical removal of cancerous growth. Polyps with a risk of cancer, skin lesions, and changes in the intestine can be treated with prophylactic surgery.
Biopsy Biopsy is performed as a surgical procedure that takes part in the evaluation of a portion removed by various medical devices. It can be biopsied and a definitive diagnosis can be made.
Staging Sampling from places needed to understand the stage of the disease is called staging.
Adjuvant After determining the stage of the disease, it is the arrangement of protective treatment.
Radiation Oncology Radiation Oncology is a field of science that examines the effects of radiation on cancer using ionizing radiation and conducts research and applications in this field. Radiation Oncology has two application areas: radiotherapy and radiosurgery.
What Is Radiotherapy (Radiation Therapy)? Radiotherapy is defined as the treatment of malignant tumors or certain benign tumors by radiation. This is why it is also referred to as "Radiation Treatment" or "Radiation Therapy" among the public. In radiotherapy, different types of radiation are used to stop the growth of cancer cells in the treated area or to kill those cells. Radiotherapy is frequently used in cancer treatment. In fact, after a cancer diagnosis is made in 60-80% of cancer patients, radiation therapy is needed at least once.
How Is the Treatment Method Determined? There are many factors that influence the form of treatment. These include the patient's age, overall health status, the type of diagnosed cancer, its stage, and the patient's place of residence. Treatment decisions are made based on evaluations made by a specialist physician in many different fields and each patient is evaluated individually. Therefore, even if they have the same type of cancer, the treatment of each patient is planned according to their own conditions.
Who Is in the Treatment Team? Radiation Oncologist: The physician who decides where and how much radiation therapy will be applied. Radiation Physics: Responsible for the safety of the radiation therapy process, planning, quality, and technical support of radiation therapy equipment. Works together with a radiation oncologist in treatment planning and application. Radiation Therapy Technicians: Professionals trained in radiation therapy devices. They are not in the room with the patient during treatment, but they are in constant communication with the patient through an intercom. They are responsible for ensuring that the patient's correct position is maintained, the device is operated, and images for evaluation are taken during treatment. Oncology Nurse: A member of the team who is closest to the patient during the course of treatment. They serve as a bridge between the doctor and the patient, especially in matters such as side effects of radiation, what the patient should or should not do. Secretary: Responsible for directing the patient correctly, organizing appointments, creating and storing files, providing information about treatment costs, and ensuring the patient's health insurance. Radiation Oncology Patient: During the course of treatment, the radiation oncologist and the radiation therapy team work together with the patient. The patient's compliance with the recommendations and whether they are followed or not is also important for the success of the treatment.
How Does Radiotherapy Work? In radiotherapy, beams of radiation are directed at the affected area of the body from different angles. The beams are precisely targeted to hit the tumor and minimize exposure to surrounding healthy tissue. This precision is crucial in minimizing side effects.
Radiotherapy damages the DNA inside cells, including cancer cells. This damage prevents the cells from growing and dividing, eventually causing them to die. Healthy cells can also be affected, but they can usually repair themselves better than cancer cells. The treatment is carefully planned to deliver a high dose of radiation to the tumor while sparing nearby healthy tissue.
Types of Radiotherapy There are several types of radiotherapy, including:
External Beam Radiotherapy (EBRT): This is the most common type of radiotherapy, where a machine outside the body delivers radiation to the tumor. It is a non-invasive procedure.
Internal Radiotherapy (Brachytherapy): Radioactive sources are placed inside or very close to the tumor. This is often used in gynecological cancers, prostate cancer, and some head and neck cancers.
Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT): These are highly precise forms of radiotherapy used for small tumors or lesions, often in the brain or lungs.
Intensity-Modulated Radiation Therapy (IMRT): This technique adjusts the intensity of the radiation beams to conform to the shape of the tumor, allowing higher doses to be delivered to the tumor while minimizing exposure to surrounding tissues.
Image-Guided Radiation Therapy (IGRT): This uses imaging techniques, such as CT scans, to precisely target the tumor before each treatment session.
Proton Therapy: Protons are used instead of X-rays to deliver radiation. This can be particularly useful in treating certain types of tumors, especially in children and in cases where precision is critical.
The choice of radiotherapy type depends on the type and location of cancer, the patient's overall health, and the treatment goals. Side Effects of Radiotherapy Radiotherapy can have side effects, which vary depending on the type of radiotherapy, the location of the tumor, and the individual patient. Common side effects include fatigue, skin changes (redness, irritation), hair loss (in the treated area), and changes in bowel or urinary habits (if the pelvic area is treated). Side effects are usually temporary and can be managed with medications or other treatments. In summary, cancer treatment in Turkey, like in many countries, involves a multidisciplinary approach that may include medical oncology, surgical oncology, and radiation oncology, depending on the type and stage of cancer. Treatment plans are tailored to individual patients, and various methods, including surgery, chemotherapy, immunotherapy, targeted therapy, and radiation therapy, may be employed. The goal is to provide the most effective treatment while minimizing side effects and improving the patient's quality of life.
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