Cancer Treatments at Medical City Fort Worth

Cancer can be treated by surgery, chemotherapy, radiation therapy, immunotherapy or other methods. The decision of which therapy to use depends upon the location and grade of the tumor and the stage of the disease, as well as the general condition of the patient. In addition to established treatments, several new and experimental cancer treatments are being developed.

The goal of cancer treatment is to remove the cancerous cells without damaging the rest of the body. Each of the main methods of treatment have limitations and risks, however.

Cancer Surgery

The purpose of surgery is to physically remove tumors from the body. It is not always possible to fully remove a tumor; when a cancer has metastasized and spread to other sites in the body prior to surgery, a complete surgical removal is generally impossible.

There are several different types of surgery for cancer. These include mastectomy for breast cancer and prostatectomy for prostate cancer. Sometimes, nearly all of a mass of cancerous cells can be removed, but even a single leftover cell can then regrow into a new tumor in a process called recurrence. Since each cell is invisible to the naked eye, it can be difficult to completely extract an entire cancer mass. A pathologist examines the removed surgical specimen to determine if a reasonable amount of healthy tissue is present, which would decrease the chance of microscopic cancer cells remaining in the patient.

Besides primary tumor removal, surgery can be used for determining the extent of the disease and whether it has metastasized to regional lymph nodes. Surgery may also occasionally be used to relieve symptoms such as bowel obstruction or spinal cord compression.

Chemotherapy

This is a form of treatment that uses anticancer drugs to destroy cancer cells. It hinders the division of cancer cells, preventing them from forming new ones. Most chemotherapy regimens combine two or more drugs, known as combination chemotherapy, since many drugs perform better together than separately.

Chemotherapy, however, is not specific to cancer cells, and can harm healthy tissues. These cells, though, are generally able to repair themselves after chemotherapy. During treatment, chemotherapy can be very taxing on the body as a whole. Fortunately, chemoprotective agents have been and are still being developed that minimize the side effects of chemotherapy.

Irreversible Electroporation (IRE)

Also known as the NanoKnife, this procedure may provide a minimally invasive option for patients with inoperable or difficult-to-reach tumors, including tumors located near critical structures and major blood vessels. This tissue ablation system uses electrical currents to destroy cancerous tumors.

Potential benefits of IRE include:

  • No open incisions
  • Less damage to healthy tissue
  • Minimal post-operative pain
  • Fewer side effects
  • Short hospital stay
  • Quick post-operative recovery
  • Ability to repeat the procedure if new tumors develop

Radiation Therapy

Another method of treatment involves using ionizing radiation to shrink tumors and kill cancer cells. It can be given externally through external beam radiotherapy, or internally through brachytherapy. Radiation therapy affects only the area being treated, destroying cells in the target tissue by damaging their genetic material so that they cannot continue and grow and multiply. Additionally, radiation therapy cuts off blood supply to cancer cells, causing them to die.

Like chemotherapy, radiation therapy damages normal cells as wells as cancer cells, although most normal cells are able to recover from the effects of radiation and function properly thereafter. Radiation therapy’s goal is to damage as many cancer cells as possible, while limiting harm to adjoining healthy tissue.

This treatment can be used with practically every type of solid tumor, including cancer of the brain, breast, cervix, larynx, lung, pancreas, prostate, skin, stomach and uterus, as well as soft tissue sarcomas. Some forms of lymphoma may also be treated with radiation therapy. There are associated side effects that arise from radiation, which may be either temporary or permanent. Radiation and chemotherapy may be given together or one after another.

Transarterial Chemoembolization (TACE)

Transarterial chemoembolization (TACE) is performed by inserting a tiny catheter into the artery in the groin or arm and then positioning the catheter in the liver artery feeding the liver tumor. Special embolization beads coated with chemotherapy drugs are delivered directly to the tumor, and the chemotherapy agent is slowly released from the beads, to destroy the tumor over a period of time.

With this technique, the chemotherapy targets the tumor while sparing the patient from the typical side effects of traditional chemotherapy applied to the entire body.

TACE therapy can be used to treat primary liver cancer or metastatic liver tumors, with the goal of extending survival, relieving pain and alleviating symptoms. TACE can also be used to down-stage patients or as a bridge to transplant in patients who are candidates for liver transplantation. The TACE procedure can be performed multiple times to achieve the desired response in the tumor.

Radioembolization/Yttrium-90 (Y-90) Selective Internal Radiation Therapy

This unique interventional radiology treatment, performed on an outpatient basis, combines the radioactive isotope Y-90 into microspheres (small beads about the width of five red blood cells) that deliver radiation directly to a tumor, providing a treatment that doesn't harm healthy cells.

A tiny catheter is inserted into the artery in the groin or arm, then positioned in the liver artery supplying the liver tumor. Tiny particles infused with radiation are released into the tumor. A tumoricidal dose of radiation is delivered directly to the liver tumor with minimal radiation to the adjacent healthy liver. The radiation in the particle gradually disappears.

The goal of therapy is to decrease tumor size and prevent growth. If the tumor shrinks enough, patients may be re-considered for surgery or liver transplantation.

Other Treatment Methods

Immunotherapy is a treatment that attempts to use immune mechanisms against tumors. Immunotherapy may be useful for diseases such as melanoma, kidney cancer, lymphoma and myeloma.

Hormonal suppression involves blocking certain hormones to inhibit the growth of some cancers. Estrogen and testosterone are hormones commonly suppressed in this treatment. Hormone therapy is commonly used for breast and prostate cancer.

Targeted therapies for lung cancer offer alternative to chemotherapy.