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Oncology

Chemotherapy

Chemotherapy is a form of cancer therapy in which cancer is stopped by means of effective medications that destroy rapidly multiplying cells in the organism. It is mainly connected with cancer, but can be treated with some other diseases as well. The medications take action by targeting cells that grow and multiply rapidly, and this characteristic is what cancer cells are known to have. However, due to the rapid division of some healthy cells, such as hair follicle cells, bone marrow cells, and cells in the digestive system, chemotherapy might lead to various side effects. It can be used in different ways, such as topically, orally, and intravenously, and most of the time, it is used in conjunction with other treatments such as surgery or radiation therapy.

Symptoms of Chemotherapy

  • Treating Cancer: Chemotherapy is considered a prime treatment method in most cancer cases as a way of eliminating cancer, thereby curing the condition completely. This is especially the case with some blood cancers, including leukaemia and lymphoma.
  • Tumour Shrinkage: Chemotherapy may be applied to make tumours smaller prior to surgery or radiation treatment, referred to as neoadjuvant therapy. This simplifies the process of getting rid of the tumour or makes the surgery less significant.
  • Preventing recurrence: Chemotherapy can be used to kill any potentially remaining cancer cells after having a tumour removed to ensure that cancer does not regrow. This is called adjuvant therapy and is administered to prevent the risk of cancer recurrence.
  • Palliative Care Advanced-stage cancers may use chemotherapy to ease the palliative effects and thus halt the cancer growth, thus leading to a better life for the patient. In such instances, management of symptoms rather than curing is aimed at.

Effects of Chemotherapy

  • Destruction of cancer cells: Destruction of cancer cells characterises the primary treatment effect, causing a shrinkage in the tumours or completely eliminating the disease. This is the end result of the kind of treatment.
  • Side Effects: The list of side effects is broad, as not only sick cells are being attacked by chemotherapy drugs, but healthy, fast-dividing cells as well. Such are the loss of hair, nausea, vomiting, fatigue, sores in the mouth, and higher chances of getting infections because of a weak white blood cell count.
  • Neutropenia: A common and serious side effect is a big drop in white-blood-cell count, called neutropenia. This massively weakens the system of immunity and hence, the patient is extremely vulnerable to infections that lead to death.
  • Long-term complications: Certain chemotherapy drugs may have either long-term or even permanent side effects, which may include heart damage, nerve damage (peripheral neuropathy), or an increased probability of developing other kinds of cancer in the future.

Immunotherapy

Immunotherapy is a radical form of cancer treatment that utilises the body's efficiency in order to attack cancer. In contrast to chemotherapy, in which cancer cells are actually assaulted, immunotherapy induces (or liberates) the immune system to detect and eliminate these cells. The immune system constantly monitors the body to detect any foreign bodies, and the cancer cells have found the means to hide in this way. Immunotherapy medications like checkpoint inhibitors basically take the brakes off the immune system, enabling it to attack the cancer with great power and specificity.

Indications of Immunotherapy

  • Metastatic Cancer: Immunotherapy is especially promising in treating cancers that have metastasised, where conventional treatment is usually ineffective, such as advanced melanoma, lung cancer, kidney cancer, etc.
  • Specific Cancer Biomarkers: Not every cancer is induced by immunotherapy. Its application is sometimes signalled by the presence of particular biomarkers on the cancer cells, including the expression of PD-L1, which aids in establishing whether the patient is a candidate to respond to the treatment or not.
  • Rejection of Other Treatment: Some types of cancer become unresponsive to existing therapeutic modalities such as chemotherapy or radiation, and that is when immunotherapy comes in to offer an alternative to the disease.
  • Hematologic Malignancies: Immunotherapy has had promising outcomes on certain blood cancers, lymphoma, and leukaemia, being a few troupes where there is an efficiency of immunotherapy, especially with CAR T-cell therapy, where the patients' own immune cells are genetically modified to combat the cancer.

Effects of Immunotherapy

  • Permanent Remissions: Possibly the greatest effect of immunotherapy is that it can produce very long-lasting, or even permanent remissions, even in advanced cancers. The effects can last many years after the treatment has ended because it trains the immune system to recall and destroy the cancer.
  • Targeted Attack: Immunotherapy is much more specific than chemotherapy, resulting in fewer serious side effects, such as the loss of hair growth and a feeling of nausea, which were triggered by the destruction of innocent rapidly dividing cells.
  • Immune-Related Adverse Events (irAEs): Immunotherapy is remarkably safe compared to chemotherapy; immunotherapy has the capacity to introduce a different type of side effects called irAEs. They occur when the overexcited immune system destroys the normal organs, thereby causing inflammation in the lungs, the colon, or any other organ.
  • Enhanced Quality of Life: Immunotherapy has the potential to increase the quality of life of a patient during and after treatment by offering a more focused treatment with usually fewer debilitating effects, so that a patient can continue to live their day-to-day lives to the fullest possible extent.

Surgical Oncology

Surgical oncology is the medical sub-speciality dealing with the treatment, diagnosis and staging method of cancer through surgical means. The surgical oncologist is an essential component of a solid tumour, and they collaborate with the other specialists, such as medical and radiation oncologists, to develop a comprehensive treatment plan. This is the essential aspect of cancer treatment because the thorough resection of a tumour is still one of the most effective methods of curing most types of cancer.

Indications

  • Diagnosis and Staging: Often, the best way to diagnose cancer and determine the type and stage of cancer is by use of a biopsy that involves surgical removal of a small amount of tissue.
  • Primary Tumour Removal: Surgery is the primary treatment used to eradicate the complete tumour and a gap of healthy tissue around the tumour in most solid tumours. This is typical with breast, colon and lung cancers.
  • Debulking: In cases where the removal of a tumour is impossible, a surgeon might perform what is referred to as a debulking procedure to shred it to the maximal extent possible. This may enhance further therapeutic processes such as chemotherapy or radiation.
  • Palliative Surgery: In terminal cancer, surgery can be employed as a measure of pain palliation, the unblocking of a pathway or removal of a focus of bleeding and thus would enhance the quality of life of a patient without the cancer being cured.

Consequences

  • Cure: In most cases, when the tumour is localised, full surgical excision of the tumour leaves most patients cured and gives them the best opportunity of a long-term cancer-free life.
  • Side Effects and Complications: Undergoing surgery may cause different kinds of side effects, such as pain, infection, bleeding, and nerve damage. In specific locations and degrees of implementation of the surgery, various effects will arise.
  • Better Prognosis: Sometimes surgery itself does not cure a patient; however, it can profoundly change his/her prognosis by lessening the tumour burden, making other therapies more viable, and enhancing the life span of a patient.
  • Rehabilitation: Recovery and post-operative rehabilitation are important parts of surgical oncology. This may include physical therapy, occupational therapy, and other supportive therapies to assist the patient in gaining some of the functions and adapting to any change related to the surgery.