or IMMUNOTHERAPY for an additive effect.
Adverse side effects generally stay localized
(remain in the area exposed to the radiation).- Chemotherapy uses drugs to kill cancer cells.
Like radiation therapy, chemotherapy may pre-
cede or follow surgery to shrink tumors or kill
residual cancer cells, serve as the sole treat-
ment, or function as an adjuvant treatment in
combination with other treatment methods for
optimal effectiveness against certain types of
cancer. Because chemotherapy affects the
entire body, it can have significant side effects. - Immunotherapy, also called biological response
modification, uses methods to enhance the
ability of the body’s natural IMMUNE SYSTEM
functions to target cancer cells for containment
and destruction. Genetically engineered sub-
stances such as MONOCLONAL ANTIBODIES(MABS),
INTERFERONS, and INTERLEUKINS are among the
immunotherapy agents oncologists may admin-
ister to boost the IMMUNE RESPONSE.
•HORMONE THERAPYtargets HORMONE-driven can-
cers such as PROSTATE CANCER, OVARIAN CANCER,
ENDOMETRIAL CANCER, andBREAST CANCER. These
cancers require hormones, typically ESTROGENS
or TESTOSTERONE, to grow. Treatment either sup-
presses or boosts the presence of these hor-
mones in the body. HORMONE THERAPYfor breast
cancer, for example, deprives the woman’s
body of estrogen or the ability to use it, and
hormone therapy for prostate cancer deprives
the man’s body of testosterone or the ability to
use it. Hormone therapy for prostate cancer
may also include administration of estrogen in
a further effort to shut down the tumor’s hor-
mone sources.
•BONE MARROW TRANSPLANTATION is a treatment
option for LEUKEMIA, MULTIPLE MYELOMA, and lym-
phoma. BONEmarrow transplantation replaces
cancerous bone marrow with healthy marrow
from a genetically matched donor called an allo-
geneic transplants (a syngeneic transplant when
the donor is an identical twin). An autologous
transplant uses the patient’s own bone marrow,
which is an option only when the cancer is in
remission or when it does not involve the bone
marrow. Bone marrow transplantation may
sometimes be a treatment option for other types
of cancer though has not proven to be as effec-
tive as originally hoped.- Stem cell transplantation may be a treatment
option in cancers that do not involve the bone
marrow. The person’s stem cells (precursors for
red blood cells, white blood cells, and platelets)
are gathered from the person’s blood, then
reinfused into the person after CHEMOTHERAPY.
Though there are established approaches, called
treatment protocols, for most types of cancer, can-
cer treatment is highly individualized and treat-
ment decisions evolve as a collaboration between
the person who has cancer and the health-care
team providing care for the person. The treatment
decision process begins with consideration of the
cancer’s type, stage, and grade—the characteristics
of the cancer cells, how widespread within the
body the cancer is, and how aggressive the cancer
cells are in their growth pattern. Other important
factors include the person’s age and overall health
status, any other health conditions, and the per-
son’s preferences or goals for treatment.INFORMATION MANAGEMENT
Because there is so much information to absorb
and sort through when it comes to CANCER TREAT-
MENT OPTIONS AND DECISIONS, it is a good idea to
have a trusted family member or friend go along
for key doctor visits to take notes. This lets the
patient focus on the discussion with the doctor
during the visit with the opportunity to later go
over the notes and consider the options.Sometimes there are clear “best” choices for
treatment. Other times there are several treatment
options that are likely to produce similar results. A
person whose cancer is widespread (metastatic) by
the time of diagnosis may choose only palliative
treatment—treatments to relieve PAINand other
symptoms—or may choose to enter a clinical trial,
a research study evaluating a new treatment that
shows promise for the person’s particular type or
stage of cancer. Each treatment method has bene-
fits and risks, which are important to consider
when evaluating the various options.
A second opinion consultation from another
oncologist (cancer specialist) is often helpful when
there are numerous treatment options or when372 Cancer